Search results for: weighted risk scores
4460 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan
Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee
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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis
Procedia PDF Downloads 1344459 Long-Term Results of Coronary Bifurcation Stenting with Drug Eluting Stents
Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki
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Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions
Procedia PDF Downloads 2064458 College Readiness Outcomes of No Child Left Behind: A Critical Analysis
Authors: Tianyu Chen
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The No Child Left Behind Act (NCLB) of 2001 was a major federal education policy that aimed to improve academic outcomes for all students in the United States. This study examines whether NCLB improved college readiness, measured by access to higher education, for different demographic groups. Using data from the Integrated Public Use Microdata Series (IPUMS) from 2003-2008, regression analyses explore the relationship between gender, race, family income, and region with occupational education score. The results indicate that NCLB implementation had a positive effect on college access for women and Asian students compared to other groups. Higher family income was also associated with an increased likelihood of pursuing higher education, especially for families in the South. While NCLB intended to close achievement gaps, disparities in college readiness remained five years after implementation. Further research could examine longer-term trends and additional factors influencing the policy's effectiveness across student subgroups. This study provides evidence that simply holding schools accountable for test scores may not sufficiently improve equitable educational outcomes. More targeted support of disadvantaged groups may be needed to fulfill the goal of "no child left behind."Keywords: no child left behind act, college readiness, achievement gaps, educational equity
Procedia PDF Downloads 594457 Identifying a Drug Addict Person Using Artificial Neural Networks
Authors: Mustafa Al Sukar, Azzam Sleit, Abdullatif Abu-Dalhoum, Bassam Al-Kasasbeh
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Use and abuse of drugs by teens is very common and can have dangerous consequences. The drugs contribute to physical and sexual aggression such as assault or rape. Some teenagers regularly use drugs to compensate for depression, anxiety or a lack of positive social skills. Teen resort to smoking should not be minimized because it can be "gateway drugs" for other drugs (marijuana, cocaine, hallucinogens, inhalants, and heroin). The combination of teenagers' curiosity, risk taking behavior, and social pressure make it very difficult to say no. This leads most teenagers to the questions: "Will it hurt to try once?" Nowadays, technological advances are changing our lives very rapidly and adding a lot of technologies that help us to track the risk of drug abuse such as smart phones, Wireless Sensor Networks (WSNs), Internet of Things (IoT), etc. This technique may help us to early discovery of drug abuse in order to prevent an aggravation of the influence of drugs on the abuser. In this paper, we have developed a Decision Support System (DSS) for detecting the drug abuse using Artificial Neural Network (ANN); we used a Multilayer Perceptron (MLP) feed-forward neural network in developing the system. The input layer includes 50 variables while the output layer contains one neuron which indicates whether the person is a drug addict. An iterative process is used to determine the number of hidden layers and the number of neurons in each one. We used multiple experiment models that have been completed with Log-Sigmoid transfer function. Particularly, 10-fold cross validation schemes are used to access the generalization of the proposed system. The experiment results have obtained 98.42% classification accuracy for correct diagnosis in our system. The data had been taken from 184 cases in Jordan according to a set of questions compiled from Specialists, and data have been obtained through the families of drug abusers.Keywords: drug addiction, artificial neural networks, multilayer perceptron (MLP), decision support system
Procedia PDF Downloads 3044456 Modeling Driving Distraction Considering Psychological-Physical Constraints
Authors: Yixin Zhu, Lishengsa Yue, Jian Sun, Lanyue Tang
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Modeling driving distraction in microscopic traffic simulation is crucial for enhancing simulation accuracy. Current driving distraction models are mainly derived from physical motion constraints under distracted states, in which distraction-related error terms are added to existing microscopic driver models. However, the model accuracy is not very satisfying, due to a lack of modeling the cognitive mechanism underlying the distraction. This study models driving distraction based on the Queueing Network Human Processor model (QN-MHP). This study utilizes the queuing structure of the model to perform task invocation and switching for distracted operation and control of the vehicle under driver distraction. Based on the assumption of the QN-MHP model about the cognitive sub-network, server F is a structural bottleneck. The latter information must wait for the previous information to leave server F before it can be processed in server F. Therefore, the waiting time for task switching needs to be calculated. Since the QN-MHP model has different information processing paths for auditory information and visual information, this study divides driving distraction into two types: auditory distraction and visual distraction. For visual distraction, both the visual distraction task and the driving task need to go through the visual perception sub-network, and the stimuli of the two are asynchronous, which is called stimulus on asynchrony (SOA), so when calculating the waiting time for switching tasks, it is necessary to consider it. In the case of auditory distraction, the auditory distraction task and the driving task do not need to compete for the server resources of the perceptual sub-network, and their stimuli can be synchronized without considering the time difference in receiving the stimuli. According to the Theory of Planned Behavior for drivers (TPB), this study uses risk entropy as the decision criterion for driver task switching. A logistic regression model is used with risk entropy as the independent variable to determine whether the driver performs a distraction task, to explain the relationship between perceived risk and distraction. Furthermore, to model a driver’s perception characteristics, a neurophysiological model of visual distraction tasks is incorporated into the QN-MHP, and executes the classical Intelligent Driver Model. The proposed driving distraction model integrates the psychological cognitive process of a driver with the physical motion characteristics, resulting in both high accuracy and interpretability. This paper uses 773 segments of distracted car-following in Shanghai Naturalistic Driving Study data (SH-NDS) to classify the patterns of distracted behavior on different road facilities and obtains three types of distraction patterns: numbness, delay, and aggressiveness. The model was calibrated and verified by simulation. The results indicate that the model can effectively simulate the distracted car-following behavior of different patterns on various roadway facilities, and its performance is better than the traditional IDM model with distraction-related error terms. The proposed model overcomes the limitations of physical-constraints-based models in replicating dangerous driving behaviors, and internal characteristics of an individual. Moreover, the model is demonstrated to effectively generate more dangerous distracted driving scenarios, which can be used to construct high-value automated driving test scenarios.Keywords: computational cognitive model, driving distraction, microscopic traffic simulation, psychological-physical constraints
Procedia PDF Downloads 974455 The Impact of Text Modifications on Ethiopian Students’ Reading Comprehension and Motivation
Authors: Asefa Kenefergib, Dawit Amogne, Yinager Teklesellassie
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A study investigated the effects of text modifications on reading comprehension and motivation among Ethiopian secondary school students. A total of 120 students participated, initially taking a reading comprehension pretest and completing a reading motivation questionnaire. Afterward, they were divided into three groups: control, simplified, and elaborated. Each group then took part in a reading comprehension posttest and another reading motivation questionnaire following an eight-week instructional intervention. Despite initial differences, both the simplified and elaborated text groups showed comparable levels of reading motivation and comprehension. The data were analyzed using SPSS version 25, with a one-way ANOVA used to assess the effectiveness of the modified texts in enhancing reading comprehension. The results indicated that the experimental groups performed significantly better on the posttest compared to the control group, suggesting that text modifications can positively influence students' comprehension skills. Furthermore, the impact of text modifications on student reading motivation was assessed using a one-way ANOVA. The findings revealed that both the elaborated and simplified text groups scored higher than the control group in various dimensions of reading motivation, including reading efficacy, curiosity, challenge, compliance, and reading work avoidance. However, the control and simplified groups had nearly similar mean scores in the dimension of reading competition. These results clearly demonstrate that modifying texts can enhance EFL learners' reading motivation and comprehension.Keywords: simplification, elaboration, reading motivation, reading comprehension
Procedia PDF Downloads 464454 Grandiose Narcissists’ Adaptive Trade-Offs: Mating, Parental, and Somatic Investment
Authors: Jasmine H. Gagnon
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The present study examined how grandiose narcissists make adaptive trade-offs between mating investment, parenting investment, and somatic investment relative to individuals without narcissistic personalities. A sample of 509 males and females between the ages of 24 and 35 years old (49.31% female) completed a personality inventory assessing Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness to Experience. In a Latent Profile Analysis (LPA), personality inventory scores were used to classify participants into latent groups. The model of best fit identified one grandiose narcissist group and three groups with non-narcissistic personalities. Covariate analyses revealed that individuals with narcissistic traits made significantly more significant somatic investments in comparison to two of the three non-narcissistic latent groups. No other significant differences between the narcissistic and non-pathological groups were found. Thus, grandiose narcissists trade off parenting and mating investments to make more significant somatic investments. That is, they expend a larger portion of their energetic resources on maintaining their physical health and careers and similar quantities of energetic resources on maintaining relationships with their offspring and potential romantic partners as individuals without narcissistic personalities.Keywords: narcissism, grandiose narcissism, HEXACO, trade-offs, mating, parenting, somatic, dark triad
Procedia PDF Downloads 844453 Distributed Energy Resources in Low-Income Communities: a Public Policy Proposal
Authors: Rodrigo Calili, Anna Carolina Sermarini, João Henrique Azevedo, Vanessa Cardoso de Albuquerque, Felipe Gonçalves, Gilberto Jannuzzi
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The diffusion of Distributed Energy Resources (DER) has caused structural changes in the relationship between consumers and electrical systems. The Photovoltaic Distributed Generation (PVDG), in particular, is an essential strategy for achieving the 2030 Agenda goals, especially SDG 7 and SDG 13. However, it is observed that most projects involving this technology in Brazil are restricted to the wealthiest classes of society, not yet reaching the low-income population, aligned with theories of energy justice. Considering the research for energy equality, one of the policies adopted by governments is the social electricity tariff (SET), which provides discounts on energy tariffs/bills. However, just granting this benefit may not be effective, and it is possible to merge it with DER technologies, such as the PVDG. Thus, this work aims to evaluate the economic viability of the policy to replace the social electricity tariff (the current policy aimed at the low-income population in Brazil) by PVDG projects. To this end, a proprietary methodology was developed that included: mapping the stakeholders, identifying critical variables, simulating policy options, and carrying out an analysis in the Brazilian context. The simulation answered two key questions: in which municipalities low-income consumers would have lower bills with PVDG compared to SET; which consumers in a given city would have increased subsidies, which are now provided for solar energy in Brazil and for the social tariff. An economic model was created for verifying the feasibility of the proposed policy in each municipality in the country, considering geographic issues (tariff of a particular distribution utility, radiation from a specific location, etc.). To validate these results, four sensitivity analyzes were performed: variation of the simultaneity factor between generation and consumption, variation of the tariff readjustment rate, zeroing CAPEX, and exemption from state tax. The behind-the-meter modality of generation proved to be more promising than the construction of a shared plant. However, although the behind-the-meter modality presents better results than the shared plant, there is a greater complexity in adopting this modality due to issues related to the infrastructure of the most vulnerable communities (e.g., precarious electrical networks, need to reinforce roofs). Considering the shared power plant modality, many opportunities are still envisaged since the risk of investing in such a policy can be mitigated. Furthermore, this modality can be an alternative due to the mitigation of the risk of default, as it allows greater control of users and facilitates the process of operation and maintenance. Finally, it was also found, that in some regions of Brazil, the continuity of the SET presents more economic benefits than its replacement by PVDG. However, the proposed policy offers many opportunities. For future works, the model may include other parameters, such as cost with low-income populations’ engagement, and business risk. In addition, other renewable sources of distributed generation can be studied for this purpose.Keywords: low income, subsidy policy, distributed energy resources, energy justice
Procedia PDF Downloads 1194452 Learning the Most Common Causes of Major Industrial Accidents and Apply Best Practices to Prevent Such Accidents
Authors: Rajender Dahiya
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Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention
Procedia PDF Downloads 624451 Evaluating the Implementation of Machine Learning Techniques in the South African Built Environment
Authors: Peter Adekunle, Clinton Aigbavboa, Matthew Ikuabe, Opeoluwa Akinradewo
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The future of machine learning (ML) in building may seem like a distant idea that will take decades to materialize, but it is actually far closer than previously believed. In reality, the built environment has been progressively increasing interest in machine learning. Although it could appear to be a very technical, impersonal approach, it can really make things more personable. Instead of eliminating humans out of the equation, machine learning allows people do their real work more efficiently. It is therefore vital to evaluate the factors influencing the implementation and challenges of implementing machine learning techniques in the South African built environment. The study's design was one of a survey. In South Africa, construction workers and professionals were given a total of one hundred fifty (150) questionnaires, of which one hundred and twenty-four (124) were returned and deemed eligible for study. Utilizing percentage, mean item scores, standard deviation, and Kruskal-Wallis, the collected data was analyzed. The results demonstrate that the top factors influencing the adoption of machine learning are knowledge level and a lack of understanding of its potential benefits. While lack of collaboration among stakeholders and lack of tools and services are the key hurdles to the deployment of machine learning within the South African built environment. The study came to the conclusion that ML adoption should be promoted in order to increase safety, productivity, and service quality within the built environment.Keywords: machine learning, implementation, built environment, construction stakeholders
Procedia PDF Downloads 1384450 Teacher's Health: Evaluation of the Health Status of Portuguese and Spanish Teachers
Authors: Liberata Borralho, Saúl N. de Jesus, Adelinda Candeias, Victória Fernández-Puig
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In the last decades, we have witnessed a deterioration in the health of teachers worldwide, reflecting the constant social, political and economic changes. The quality of teaching and the success of students depends on the health status of the teachers, which justifies the importance of periodically evaluating their health. With this purpose, the Teacher’s Health Questionnaire was applied to 15.394 teachers teaching in Portugal and Spain (6.208 Spanish and 9.186 Portuguese) of primary and secondary education (3.482 men, 11.911 women). This questionnaire is specific and includes both the main risks of the teaching profession and the manifestations of teacher well-being, according to the definition recommended by the World Health Organization. A descriptive analysis of the results was carried out, including a study of the dimensions and the differences according to some sociodemographic and professional variables, from an analysis of variance ANOVA, applying the Bonferroni correction. Cluster analysis (K-means) allowed us to obtain cutoff scores to assess health status. The results allow concluding that Portuguese teachers perceive a poor well-being in the performance of their professional activity and that more than half present manifestations in the various dimensions of health deterioration, highlighting the exhaustion and cognitive disorders. In turn, Spanish teachers demonstrate a high level of well-being, being the musculoskeletal dimensions and cognitive disorders the main manifestations of deterioration of health.Keywords: job prevention, occupational health, teacher’s health, teachers work risks, teacher’s well-being
Procedia PDF Downloads 2394449 The Socio-Culturals Factors Hindering Female Sport Participation, in the Centre for Biokinetics, Recreation and Sport Science, University of Venda
Authors: P. Mambanga, Goon, L. O. Amusa
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The purpose of the study was to investigate the socio-cultural factors hindering sport participation among female students in the Centre for Biokinetics, Recreation and Sport Science, University of Venda. A descriptive survey of 100 female student selected by simple random sampling was used and utilises the close ended questionnaire designed in a likert format was use for data collection. Face and content validity was employed in which the supervisor went through the instrument and correct and accept it thus checking the validity of the instrument. The test-retest approach was used to test the reliability of the instrument. Ethical considerations were ensured and confidentiality respected. Data was collected and presented in tables and results interpreted. Chi square which is a measure of non-parametric investigation was employed in order to analyse the observed and expected scores, with the probability value was set at 0.05 levels of significance on a two-tailed test of the hypotheses formulated for the study. Findings of the study established significant socio-cultural factors that hinder female sport participation among female students in the Centre for Biokinetics, Recreation and Sport Science. The study concluded that the low level participation of female students at the University of Venda might be as a result of socio-cultural factors.Keywords: female students, sport participation, University of Venda, biokinetic
Procedia PDF Downloads 5204448 Nutritional Genomics Profile Based Personalized Sport Nutrition
Authors: Eszter Repasi, Akos Koller
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Our genetic information determines our look, physiology, sports performance and all our features. Maximizing the performances of athletes have adopted a science-based approach to the nutritional support. Nowadays genetics studies have blended with nutritional sciences, and a dynamically evolving, new research field have appeared. Nutritional genomics is needed to be used by nutritional experts. This is a recent field of nutritional science, which can provide a solution to reach the best sport performance using correlations between the athlete’s genome, nutritions, molecules, included human microbiome (links between food, microbiome and epigenetics), nutrigenomics and nutrigenetics. Nutritional genomics has a tremendous potential to change the future of dietary guidelines and personal recommendations. Experts need to use new technology to get information about the athletes, like nutritional genomics profile (included the determination of the oral and gut microbiome and DNA coded reaction for food components), which can modify the preparation term and sports performance. The influence of nutrients on the genes expression is called Nutrigenomics. The heterogeneous response of gene variants to nutrients, dietary components is called Nutrigenetics. The human microbiome plays a critical role in the state of health and well-being, and there are more links between food or nutrition and the human microbiome composition, which can develop diseases and epigenetic changes as well. A nutritional genomics-based profile of athletes can be the best technic for a dietitian to make a unique sports nutrition diet plan. Using functional food and the right food components can be effected on health state, thus sports performance. Scientists need to determine the best response, due to the effect of nutrients on health, through altering genome promote metabolites and result changes in physiology. Nutritional biochemistry explains why polymorphisms in genes for the absorption, circulation, or metabolism of essential nutrients (such as n-3 polyunsaturated fatty acids or epigallocatechin-3-gallate), would affect the efficacy of that nutrient. Controlled nutritional deficiencies and failures, prevented the change of health state or a newly discovered food intolerance are observed by a proper medical team, can support better sports performance. It is important that the dietetics profession informed on gene-diet interactions, that may be leading to optimal health, reduced risk of injury or disease. A special medical application for documentation and monitoring of data of health state and risk factors can uphold and warn the medical team for an early action and help to be able to do a proper health service in time. This model can set up a personalized nutrition advice from the status control, through the recovery, to the monitoring. But more studies are needed to understand the mechanisms and to be able to change the composition of the microbiome, environmental and genetic risk factors in cases of athletes.Keywords: gene-diet interaction, multidisciplinary team, microbiome, diet plan
Procedia PDF Downloads 1754447 Microplastic Concentrations in Cultured Oyster in Two Bays of Baja California, Mexico
Authors: Eduardo Antonio Lozano Hernandez, Nancy Ramirez Alvarez, Lorena Margarita Rios Mendoza, Jose Vinicio Macias Zamora, Felix Augusto Hernandez Guzman, Jose Luis Sanchez Osorio
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Microplastics (MPs) are one of the most numerous reported wastes found in the marine ecosystem, representing one of the greatest risks for organisms that inhabit that environment due to their bioavailability. Such is the case of bivalve mollusks, since they are capable of filtering large volumes of water, which increases the risk of contamination by microplastics through the continuous exposure to these materials. This study aims to determine, quantify and characterize microplastics found in the cultured oyster Crassostrea gigas. We also analyzed if there are spatio-temporal differences in the microplastic concentration of organisms grown in two bays having quite different human population. In addition, we wanted to have an idea of the possible impact on humans via consumption of these organisms. Commercial size organisms (>6cm length; n = 15) were collected by triplicate from eight oyster farming sites in Baja California, Mexico during winter and summer. Two sites are located in Todos Santos Bay (TSB), while the other six are located in San Quintin Bay (SQB). Site selection was based on commercial concessions for oyster farming in each bay. The organisms were chemically digested with 30% KOH (w/v) and 30% H₂O₂ (v/v) to remove the organic matter and subsequently filtered using a GF/D filter. All particles considered as possible MPs were quantified according to their physical characteristics using a stereoscopic microscope. The type of synthetic polymer was determined using a FTIR-ATR microscope and using a user as well as a commercial reference library (Nicolet iN10 Thermo Scientific, Inc.) of IR spectra of plastic polymers (with a certainty ≥70% for polymers pure; ≥50% for composite polymers). Plastic microfibers were found in all the samples analyzed. However, a low incidence of MP fragments was observed in our study (approximately 9%). The synthetic polymers identified were mainly polyester and polyacrylonitrile. In addition, polyethylene, polypropylene, polystyrene, nylon, and T. elastomer. On average, the content of microplastics in organisms were higher in TSB (0.05 ± 0.01 plastic particles (pp)/g of wet weight) than found in SQB (0.02 ± 0.004 pp/g of wet weight) in the winter period. The highest concentration of MPs found in TSB coincides with the rainy season in the region, which increases the runoff from streams and wastewater discharges to the bay, as well as the larger population pressure (> 500,000 inhabitants). Otherwise, SQB is a mainly rural location, where surface runoff from streams is minimal and in addition, does not have a wastewater discharge into the bay. During the summer, no significant differences (Manne-Whitney U test; P=0.484) were observed in the concentration of MPs found in the cultured oysters of TSB and SQB, (average: 0.01 ± 0.003 pp/g and 0.01 ± 0.002 pp/g, respectively). Finally, we concluded that the consumption of oyster does not represent a risk for humans due to the low concentrations of MPs found. The concentration of MPs is influenced by the variables such as temporality, circulations dynamics of the bay and existing demographic pressure.Keywords: FTIR-ATR, Human risk, Microplastic, Oyster
Procedia PDF Downloads 1774446 Learning Vocabulary with SkELL: Developing a Methodology with University Students in Japan Using Action Research
Authors: Henry R. Troy
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Corpora are becoming more prevalent in the language classroom, especially in the development of dictionaries and course materials. Nevertheless, corpora are still perceived by many educators as difficult to use directly in the classroom, a process which is also known as “data-driven learning” (DDL). Action research has been identified as a method by which DDL’s efficiency can be increased, but it is also an approach few studies on DDL have employed. Studies into the effectiveness of DDL in language education in Japan are also rare, and investigations focused more on student and teacher reactions rather than pre and post-test scores are rarer still. This study investigates the student and teacher reactions to the use of SkELL, a free online corpus designed to be user-friendly, for vocabulary learning at a university in Japan. Action research is utilized to refine the teaching methodology, with changes to the method based on student and teacher feedback received via surveys submitted after each of the four implementations of DDL. After some training, the students used tablets to study the target vocabulary autonomously in pairs and groups, with the teacher acting as facilitator. The results show that the students enjoyed using SkELL and felt it was effective for vocabulary learning, while the teaching methodology grew in efficiency throughout the course. These findings suggest that action research can be a successful method for increasing the efficacy of DDL in the language classroom, especially with teachers and students who are new to the practice.Keywords: action research, corpus linguistics, data-driven learning, vocabulary learning
Procedia PDF Downloads 2584445 The Ethics of Physical Restraints in Geriatric Care
Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu
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This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.Keywords: ethics healthcare, geriatric care, healthcare, physical restraint
Procedia PDF Downloads 1364444 Lifelong Education for Teachers: A Tool for Achieving Effective Teaching and Learning in Secondary Schools in Benue State, Nigeria
Authors: Adzongo Philomena Ibuh, Aloga O. Austin
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The purpose of the study was to examine lifelong education for teachers as a tool for achieving effective teaching and learning. Lifelong education enhances social inclusion, personal development, citizenship, employability, teaching and learning, community and the nation, and the challenges of lifelong education were also discussed. Descriptive survey design was adopted for the study. A simple random sampling technique was used to select 80 teachers as sample from a population of 105 senior secondary school teachers in Makurdi local government area of Benue state. A 20-item self designed questionnaire subjected to expert validation and reliability was used to collect data. The reliability Alpha coefficient of 0.87 was established using Crombach Alpha technique, mean scores and standard deviation were used to answer the 2 research questions while chi-square was used to analyze data for the 2 hypotheses. The findings of the study revealed that, lifelong education for teachers can be used to achieve as a tool for achieving effective teaching and learning, and the study recommended among others that government, organizations and individuals should in collaboration put lifelong education programmes for teachers on the priority list. The paper concluded that the strategic position of lifelong education for teachers towards enhanced teaching and learning makes it imperative for all hands to be on deck to support the programme financially and otherwise.Keywords: effective teaching and learning, lifelong education, teachers, tool
Procedia PDF Downloads 4784443 Comparative Sustainability Performance Analysis of Australian Companies Using Composite Measures
Authors: Ramona Zharfpeykan, Paul Rouse
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Organizational sustainability is important to both organizations themselves and their stakeholders. Despite its increasing popularity and increasing numbers of organizations reporting sustainability, research on evaluating and comparing the sustainability performance of companies is limited. The aim of this study was to develop models to measure sustainability performance for both cross-sectional and longitudinal comparisons across companies in the same or different industries. A secondary aim was to see if sustainability reports can be used to evaluate sustainability performance. The study used both a content analysis of Australian sustainability reports in mining and metals and financial services for 2011-2014 and a survey of Australian and New Zealand organizations. Two methods ranging from a composite index using uniform weights to data envelopment analysis (DEA) were employed to analyze the data and develop the models. The results show strong statistically significant relationships between the developed models, which suggests that each model provides a consistent, systematic and reasonably robust analysis. The results of the models show that for both industries, companies that had sustainability scores above or below the industry average stayed almost the same during the study period. These indices and models can be used by companies to evaluate their sustainability performance and compare it with previous years, or with other companies in the same or different industries. These methods can also be used by various stakeholders and sustainability ranking companies such as the Global Reporting Initiative (GRI).Keywords: data envelopment analysis, sustainability, sustainability performance measurement system, sustainability performance index, global reporting initiative
Procedia PDF Downloads 1844442 Role of Interlukin-18 in Primary Knee Osteoarthritis: Clinical, Laboratory and Radiological Study
Authors: Ibrahim Khalil Ibrahim, Enas Mohamed Shahine, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Ghada Salah Attia Hussein
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Osteoarthritis (OA) is a multifactorial disease characterized by a progressive degradation of articular cartilage and is the leading cause of disability in elderly persons. IL-18 contributes to the destruction of cartilage and bone in the disease process of arthritis. The aim of the study was to investigate the role of IL-18 in primary knee OA patients. Serum level of IL-18 was assessed by enzyme-linked immunosorbent assay in 30 primary knee OA patients and compared to 20 age and gender-matched healthy volunteers as a control group. Radiographic severity of OA was assessed by Kellgren and Lawrence (KL) global scale. Pain, stiffness and functional assessment were done using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). OA patients had significantly higher serum IL-18 level than in control group (420.93 ± 345.4 versus 151.03 ± 144.16 pg/ml, P=0.001). Serum level of IL-18 was positively correlated with KL global scale (P=0.001). There were no statistically significant correlations between serum level of IL-18 and pain, stiffness, function subscales and total WOMAC index scores among the studied patients. In conclusions, IL-18 has a role in the pathogenesis of OA and it is positively correlated with the radiographic damage of OA.Keywords: Interlukin-18, knee osteoarthritis, primary osteoarthritis, WOMAC scale
Procedia PDF Downloads 3864441 Carbohydrate Intake and Physical Activity Levels Modify the Association between FTO Gene Variants and Obesity and Type 2 Diabetes: First Nutrigenetics Study in an Asian Indian Population
Authors: K. S. Vimal, D. Bodhini, K. Ramya, N. Lakshmipriya, R. M. Anjana, V. Sudha, J. A. Lovegrove, V. Mohan, V. Radha
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Gene-lifestyle interaction studies have been carried out in various populations. However, to date there are no studies in an Asian Indian population. Hence, we examined whether lifestyle factors such as diet and physical activity modify the association between fat mass and obesity–associated (FTO) gene variants and obesity and type 2 diabetes (T2D) in an Asian Indian population. We studied 734 unrelated T2D and 884 normal glucose-tolerant (NGT) participants randomly selected from the Chennai Urban Rural Epidemiology Study (CURES) in Southern India. Obesity was defined according to the World Health Organization Asia Pacific Guidelines (non-obese, BMI < 25 kg/m2; obese, BMI ≥ 25 kg/m2). Six single nucleotide polymorphisms (SNPs) in the FTO gene (rs9940128, rs7193144, rs8050136, rs918031, rs1588413 and rs11076023) identified from recent genome-wide association studies for T2D were genotyped by polymerase chain reaction-restriction fragment length polymorphism and direct sequencing. Dietary assessment was carried out using a validated food frequency questionnaire and physical activity was based upon the self-report. Interaction analyses were performed by including the interaction terms in the model. A joint likelihood ratio test of the main SNP effects and the SNP-diet/physical activity interaction effects was used in the linear regression analyses to maximize statistical power. Statistical analyses were performed using STATA version 13. There was a significant interaction between FTO SNP rs8050136 and carbohydrate energy percentage (Pinteraction=0.04) on obesity, where the ‘A’ allele carriers of the SNP rs8050136 had 2.46 times higher risk of obesity than those with ‘CC’ genotype (P=3.0x10-5) among individuals in the highest tertile of carbohydrate energy percentage. Furthermore, among those who had lower levels of physical activity, the ‘A’ allele carriers of the SNP rs8050136 had 1.89 times higher risk of obesity than those with ‘CC’ genotype (P=4.0x10-5). We also found a borderline interaction between SNP rs11076023 and carbohydrate energy percentage (Pinteraction=0.08) on T2D, where the ‘A’ allele carriers in the highest tertile of carbohydrate energy percentage, had 1.57 times higher risk of T2D than those with ‘TT’ genotype (P=0.002). There was also a significant interaction between SNP rs11076023 and physical activity (Pinteraction=0.03) on T2D. No further significant interactions between SNPs and macronutrient intake or physical activity on obesity and T2D were observed. In conclusion, this is the first study to provide evidence for a gene-diet and gene-physical activity interaction on obesity and T2D in an Asian Indian population. These findings suggest that the association between FTO gene variants and obesity and T2D is influenced by carbohydrate intake and physical activity levels. Greater understanding of how FTO gene influences obesity and T2D through dietary and exercise interventions will advance the development of behavioral intervention and personalised lifestyle strategies predicted to reduce the development of metabolic diseases in ‘A’ allele carriers of both SNPs in this Asian Indian population.Keywords: dietary intake, FTO, obesity, physical activity, type 2 diabetes, Asian Indian.
Procedia PDF Downloads 5344440 Protein Quality of Game Meat Hunted in Latvia
Authors: Vita Strazdina, Aleksandrs Jemeljanovs, Vita Sterna
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Not all proteins have the same nutritional value, since protein quality strongly depends on its amino acid composition and digestibility. The meat of game animals could be a high protein source because of its well-balanced essential amino acids composition. Investigations about biochemical composition of game meat such as wild boar (Sus scrofa scrofa), roe deer (Capreolus capreolus) and beaver (Castor fiber) are not very much. Therefore, the aim of the investigation was evaluate protein composition of game meat hunted in Latvia. The biochemical analysis, evaluation of connective tissue and essential amino acids in meat samples were done, the amino acids score were calculate. Results of analysis showed that protein content 20.88-22.05% of all types of meat samples is not different statistically. The content of connective tissue from 1.3% in roe deer till 1.5% in beaver meat allowed classified game animal as high quality meat. The sum of essential amino acids in game meat samples were determined 7.05–8.26g100g-1. Roe deer meat has highest protein content and lowest content of connective tissues among game meat hunted in Latvia. Concluded that amino acid score for limiting amino acids phenylalanine and tyrosine is high and shows high biological value of game meat.Keywords: dietic product, game meat, amino acids, scores
Procedia PDF Downloads 3274439 Examining the Attitudes of Pre-School Teachers towards Values Education in Terms of Gender, School Type, Professional Seniority and Location
Authors: Hatice Karakoyun, Mustafa Akdag
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This study has been made to examine the attitudes of pre-school teachers towards values education. The study has been made as a general scanning model. The study’s working group contains 108 pre-school teachers who worked in Diyarbakır, Turkey. In this study Values Education Attitude Scale (VEAS), which developed by Yaşaroğlu (2014), was used. In order to analyze the data for sociodemographic structure, percentage and frequency values were examined. The Kolmogorov-Smirnov method was used in determination of the normal distribution of data. During analyzing the data, KolmogorovSimirnov test and the normal curved histograms were examined to determine which statistical analyzes would be applied on the scale and it was found that the distribution was not normal. Thus, the Mann Whitney U analysis technique which is one of the nonparametric statistical analysis techniques were used to test the difference of the scores obtained from the scale in terms of independent variables. According to the analyses, it seems that pre-school teachers’ attitudes toward values education are positive. According to the scale with the highest average, it points out that pre-school teachers think that values education is very important for students’ and children’s future. The variables included in the scale (gender, seniority, age group, education, school type, school place) seem to have no effect on the pre-school teachers’ attitude grades which joined to the study.Keywords: attitude scale, pedagogy, pre-school teacher, values education
Procedia PDF Downloads 2504438 Ethically Integrating Robots to Assist Elders and Patients with Dementia
Authors: Suresh Lokiah
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The emerging trend of integrating robots into elderly care, particularly for assisting patients with dementia, holds the potential to greatly transform the sector. Assisted living facilities, which house a significant number of elderly individuals and dementia patients, constantly strive to engage their residents in stimulating activities. However, due to staffing shortages, they often rely on volunteers to introduce new activities. Despite the availability of social interaction, these residents, frequently overlooked in society, are in desperate need of additional support. Robots designed for elder care are categorized based on their design and functionality. These categories include companion robots, telepresence robots, health monitoring robots, and rehab robots. However, the integration of such robots raises significant ethical concerns, notably regarding privacy, autonomy, and the risk of dehumanization. Privacy issues arise as these robots may need to continually monitor patient activities. There is also a risk of patients becoming overly dependent on these robots, potentially undermining their autonomy. Furthermore, the replacement of human touch with robotic interaction may lead to the dehumanization of care. This paper delves into the ethical considerations of incorporating robotic assistance in eldercare. It proposes a series of guidelines and strategies to ensure the ethical deployment of these robots. These guidelines suggest involving patients in the design and development process of the robots and emphasize the critical need for human oversight to respect the dignity and rights of the elderly and dementia patients. The paper also recommends implementing robust privacy measures, including secure data transmission and data anonymization. In conclusion, this paper offers a thorough examination of the ethical implications of using robotic assistance in elder care. It provides a strategic roadmap to ensure this technology is utilized ethically, thereby maximizing its potential benefits and minimizing any potential harm.Keywords: human-robot interaction, robots for eldercare, ethics, health, dementia
Procedia PDF Downloads 1044437 Innovative Tool for Improving Teaching and Learning
Authors: Izharul Haq
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Every one of us seek to aspire to gain quality education. The biggest stake holders are students who labor through years acquiring knowledge and skill to help them prepare for their career. Parents spend a fortune on their children’s education. Companies spend billions of dollars to enhance standards by developing new education products and services. Quality education is the golden key to a long lasting prosperity for the individual and the nation. But unfortunately, education standards are continuously deteriorating and it has become a global phenomenon. Unfortunately, teaching is often described as a ‘popularity contest’ and those teachers who are usually popular with students are often those who compromise teaching to appease students. Such teachers also ‘teach-to-the-test’ ensuring high test scores. Such teachers, hence, receive good student rating. Teachers who are conscientious, rigorous and thorough are often the victims of good appraisal. Government and private organizations are spending billions of dollars trying to capture the characteristics of a good teacher. But the results are still vague and inconclusive. At present there is no objective way to measure teaching effectiveness. In this paper we present an innovative method to objectively measure teaching effectiveness using a new teaching tool (TSquare). The TSquare tool used in the study is practical, easy to use, cost effective and requires no special equipment to implement. Hence it has a global appeal for poor and the rich countries alike.Keywords: measuring teaching effectiveness, quality in education, student learning, teaching styles
Procedia PDF Downloads 3014436 Short Answer Grading Using Multi-Context Features
Authors: S. Sharan Sundar, Nithish B. Moudhgalya, Nidhi Bhandari, Vineeth Vijayaraghavan
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Automatic Short Answer Grading is one of the prime applications of artificial intelligence in education. Several approaches involving the utilization of selective handcrafted features, graphical matching techniques, concept identification and mapping, complex deep frameworks, sentence embeddings, etc. have been explored over the years. However, keeping in mind the real-world application of the task, these solutions present a slight overhead in terms of computations and resources in achieving high performances. In this work, a simple and effective solution making use of elemental features based on statistical, linguistic properties, and word-based similarity measures in conjunction with tree-based classifiers and regressors is proposed. The results for classification tasks show improvements ranging from 1%-30%, while the regression task shows a stark improvement of 35%. The authors attribute these improvements to the addition of multiple similarity scores to provide ensemble of scoring criteria to the models. The authors also believe the work could reinstate that classical natural language processing techniques and simple machine learning models can be used to achieve high results for short answer grading.Keywords: artificial intelligence, intelligent systems, natural language processing, text mining
Procedia PDF Downloads 1374435 Depressive Symptoms in Children with Epilepsy Attending a Tertiary Care Hospital in Oman
Authors: Hamood Al Kiyumi, Salim Al Huseini, Khalid Al Risi, Hassan Mirza, Amira Al Hosni, Sanjay Jaju, Asaad Al Habsi
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Objectives: The aim of this study was to assess the proportion of depressive symptoms along with demographic data in children diagnosed with epilepsy in a tertiary care institution in Oman. Methods: This cross-sectional study was conducted between June 2016 and August 2018. We have included 75 children with age group from five to 12 years old, attending epilepsy clinic at Sultan Qaboos University Hospital who were diagnosed with epilepsy and already on treatment. Patients were excluded if they have mental retardation. Validated Depression Scale for Children (CES-DC) questionnaire was utilized to assess the level of depressive symptoms among children. In addition, we have looked at associated factors including seizure status in the last three months, compliance with antiepileptic medications, type of epilepsy, and number of antiepileptic medications. Results: In this study, we found that depressive symptoms were present in 39 (52%) of patients. We also found that 96% of the patients were compliant to medications. In addition, seizure was present in the last three months in 48% of the sample studies. There was no statistically significant association between any of the studied variables and depression. Conclusions: Although depression is highly prevalent in children with epilepsy, this study did not find any significant association between the CES-DC scores and the studied factors.Keywords: depression, children, epilepsy, Oman
Procedia PDF Downloads 1704434 Islamic Financial Instrument, Standard Parallel Salam as an Alternative to Conventional Derivatives
Authors: Alireza Naserpoor
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Derivatives are the most important innovation which has happened in the past decades. When it comes to financial markets, it has changed the whole way of operations of stock, commodities and currency market. Beside a lot of advantages, Conventional derivatives contracts have some disadvantages too. Some problems have been caused by derivatives contain raising Volatility, increasing Bankruptcies and causing financial crises. Standard Parallel Salam contract as an Islamic financial product meanwhile is a financing instrument can be used for risk management by investors. Standard Parallel Salam is a Shari’ah-Compliant contract. Furthermore, it is an alternative to conventional derivatives. Despite the fact that the unstructured types of that, has been used in several Islamic countries, This contract as a structured and standard financial instrument introduced in Iran Mercantile Exchange in 2014. In this paper after introducing parallel Salam, we intend to examine a collection of international experience and local measure regarding launching standard parallel Salam contract and proceed to describe standard scenarios for trading this instrument and practical experience in Iran Mercantile Exchange about this instrument. Afterwards, we make a comparison between SPS and Futures contracts as a conventional derivative. Standard parallel salam contract as an Islamic financial product, can be used for risk management by investors. SPS is a Shariah-Compliant contract. Furthermore it is an alternative to conventional derivatives. This contract as a structured and standard financial instrument introduced in Iran Mercantile Exchange in 2014. despite the fact that the unstructured types of that, has been used in several Islamic countries. In this article after introducing parallel salam, we intend to examine a collection of international experience and local measure regarding launching standard parallel salam contract and proceed to describe standard scenarios for trading this instrument containing two main approaches in SPS using, And practical experience in IME about this instrument Afterwards, a comparison between SPS and Futures contracts as a conventional derivatives.Keywords: futures contracts, hedging, shari’ah compliant instruments, standard parallel salam
Procedia PDF Downloads 3944433 Effective Infection Control Measures to Prevent Transmission of Multi-Drug Resistant Organisms from Burn Transfer Cases in a Regional Burn Centre
Authors: Si Jack Chong, Chew Theng Yap, Wan Loong James Mok
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Introduction: Regional burn centres face the spectra of introduced multi-drug resistant organisms (MDRO) from transfer patients resident in MDRO endemic countries. MDRO can cause severe nosocomial infection, which in massive burn patients, will lead to greater morbidity and mortality and strain the institution financially. We aim to highlight 4 key measures that have effectively prevented transmission of imported MDRO. Methods: A case of Candida auris (C. auris) from a massive burn patient transferred from an MDRO endemic country is used to illustrate the measures. C. auris is a globally emerging multi-drug resistant fungal pathogen causing nosocomial transmission. Results: Infection control measures used to mitigate the risk of outbreak from transfer cases are: (1) Multidisciplinary team approach involving Infection Control and Infectious Disease specialists early to ensure appropriate antibiotics use and implementation of barrier measures, (2) aseptic procedures for dressing change with strict isolation and donning of personal protective equipment in the ward, (3) early screening of massive burn patient from MDRO endemic region, (4) hydrogen peroxide vaporization terminal cleaning for operating theatres and rooms. Conclusion: The prevalence of air travel and international transfer to regional burn centres will need effective infection control measures to reduce the risk of transmission from imported massive burn patients. In our centre, we have effectively implemented 4 measures which have reduced the risks of local contamination. We share a recent case report to illustrate successful management of a potential MDRO outbreak resulting from transfer of massive burn patient resident in an MDRO endemic area.Keywords: burns, burn unit, cross infection, infection control
Procedia PDF Downloads 1564432 The Evaluation of Subclinical Hypothyroidism in Children with Morbid Obesity
Authors: Mustafa M. Donma, Orkide Donma
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Cardiovascular pathology is one of the expected consequences of excessive fat gain. The role of zinc in thyroid hormone metabolism is an important matter. The concentrations of both thyroid stimulating hormone (TSH) and zinc are subject to variation in obese individuals. Zinc exhibits protective effects on cardiovascular health and is inversely correlated with cardiovascular markers in childhood obesity. The association between subclinical hypothyroidism (SCHT) and metabolic disorders is under investigation due to its clinical importance. Underactive thyroid gland causes high TSH levels. Subclinical hypothyroidism is defined as the elevated serum TSH levels in the presence of normal free thyroxin (T4) concentrations. The aim of this study was to evaluate the associations between TSH levels and zinc concentrations in morbid obese (MO) children exhibiting SCHT. The possibility of using the probable association between these parameters was also evaluated for the discrimination of metabolic syndrome positive (MetS+) and metabolic syndrome negative (MetS-) groups. Forty-two children were present in each group. Informed consent forms were obtained. Institutional Ethics Committee approved the study protocol. Tables prepared by World Health Organization were used for the definition of MO children. Children, whose age- and sex-dependent body mass index percentile values were above 99, were defined as MO. Children with at least two MetS components were included in MOMetS+ group. Elevated systolic/diastolic blood pressure values, increased fasting blood glucose, triglycerides (TRG)/decreased high density lipoprotein-cholesterol (HDL-C) concentrations in addition to central obesity were listed as MetS components. Anthropometric measures were recorded. Routine biochemical analyses were performed. Thirteen and fifteen children had SCHT in MOMetS- and MOMetS+ groups, respectively. Statistical analyses were performed. p<0.05 was accepted as statistically significant. In MOMetS- and MOMetS+ groups, TSH levels were 4.1±2.9 mU/L and 4.6±3.1 mU/L, respectively. Corresponding values for SCHT cases in these groups were 7.3±3.1 mU/L and 8.0±2.7 mU/L. Free T4 levels were within normal limits. Zinc concentrations were negatively correlated with TSH levels in both groups. The significant negative correlation calculated in MOMetS+ group (r= -0.909; p<0.001) was much stronger than that found in MOMetS- group (r= -0.706; p<0.05). This strong correlation (r= -0.909; p<0.001) calculated for cases with SCHT in MOMetS+ group was much lower (r= -0.793; p<0.001) when all MOMetS+ cases were considered. Zinc is closely related to T4 and TSH therefore, it participates in thyroid hormone metabolism. Since thyroid hormones are required for zinc absorption, hypothyroidism can lead to zinc deficiency. The presence of strong correlations between TSH and zinc in SCHT cases found in both MOMetS- and MOMetS+ groups pointed out that MO children were under the threat of cardiovascular pathologies. The detection of the much stronger correlation in MOMetS+ group in comparison with the correlation found in MOMetS- group was the indicator of greater cardiovascular risk due to the presence of MetS. In MOMetS+ group, correlation in SCHT cases found higher than correlation calculated for all cases confirmed much higher cardiovascular risk due to the contribution of SCHT.Keywords: cardiovascular risk, children, morbid obesity, subclinical hypothyroidism, zinc
Procedia PDF Downloads 834431 Assessing the Danger Factors Correlated With Dental Fear: An Observational Study
Authors: Mimoza Canga, Irene Malagnino, Giulia Malagnino, Alketa Qafmolla, Ruzhdie Qafmolla, Vito Antonio Malagnino
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The goal of the present study was to analyze the risk factors regarding dental fear. This observational study was conducted during the period of February 2020 - April 2022 in Albania. The sample was composed of 200 participants, of which 40% were males and 60% were females. The participants' age range varied from 35 to 75 years old. We divided them into four age groups: 35-45, 46-55, 56-65, and 66-75 years old. Statistical analysis was performed using IBM SPSS Statistics 23.0. Data were scrutinized by the Post Hoc LSD test in analysis of variance (ANOVA). The P ≤ 0.05 values were considered significant. Data analysis included Confidence Interval (95% CI). The prevailing age range in the sample was mostly from 55 to 65 years old, 35.6% of the patients. In all, 50% of the patients had extreme fear about the fact that the dentist may be infected with Covid-19, 12.2% of them had low dental fear, and 37.8% had extreme dental fear. However, data collected from the current study indicated that a large proportion of patients 49.5% of them had high dental fear regarding the dentist not respecting the quarantine due to COVID-19, in comparison with 37.2% of them who had low dental fear and 13.3% who had extreme dental fear. The present study confirmed that 22.2% of the participants had an extreme fear of poor hygiene practices of the dentist that have been associated with the transmission of COVID-19 infection, 57.8% had high dental fear, and 20% of them had low dental fear. The present study showed that 50% of the patients stated that another factor that causes extreme fear was that the patients feel pain after interventions in the oral cavity. Strong associations were observed between dental fear and pain 95% CI; 0.24-0.52, P-value ˂ .0001. The results of the present study confirmed strong associations between dental fear and the fact that the dentist may be infected with Covid-19 (95% CI; 0.46-0.70, P-value ˂ .0001). Similarly, the analysis of the present study demonstrated that there was a statistically significant correlation between dental fear and poor hygiene practices of the dentist with 95% CI; 0.82-1.02, P-value ˂ .0001. On the basis of our statistical data analysis, the dentist did not respect the quarantine due to COVID-19 having a significant impact on dental fear with a P-value of ˂ .0001. This study shows important risk factors that significantly increase dental fear.Keywords: Covid-19, dental fear, pain, past dreadful experiences
Procedia PDF Downloads 144