Search results for: health effects
14687 A Review: The Impact of Core Quality the Empirical Review of Critical Factors on the Causes of Delay in Road Constructions Projects in the GCC Countries
Authors: Sulaiman Al-Hinai, Setyawan Widyarto
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The aim of this study is to identify the critically dominating factors on the delays of road constructions in the GCC countries and their effects on project delivery in Arab countries. Towards the achieved of the objectives the study used the empirical literature from the all relevant online sources and database as many as possible. The findings of this study have summarized and short listed of the success factors in the two categories such as internal and external factors have caused to be influenced to delay of road constructions in the Arab regions. However, in the category of internal factors, there are 63 factors short listed from seven group of factors which has revealed to effects on the delay of road constructions especially, the consultant related factors, the contractor related factors, designed related factors, client related factors, labor related factors, material related issues, equipment related issues respectively. Moreover, for external related factors are also considered to summarized especially natural disaster (flood, hurricanes and cyclone etc.), conflict, war, global financial crisis, compensation delay to affected property owner, price fluctuated, unexpected ground conditions (soil and high-water level), changing of government regulations and laws, delays in obtaining permission from municipality, loss of time by traffic control and restrictions at job site, problem with inhabitant of community, delays in providing service from utilities (water and electricity’s) and accident during constructions accordingly. The present study also concluded the effects of above factors which has delay road constructions through increasing of cost and overrun it, taken overtime, creating of disputes, going for lawsuits, finally happening of abandon of projects. Thus, the present study has given the following recommendations to overcome of above problems by increasing of detailed site investigations, ensure careful monitoring and regular meetings, effective site management, collaborative working and effective coordination’s, proper and comprehensive planning and scheduling and ensure full and intensive commitment from all parties accordingly.Keywords: Arab GCC countries, critical success factors, road constructions delay, project management
Procedia PDF Downloads 13214686 Formal Group Laws and Toposes in Gauge Theory
Authors: Patrascu Andrei Tudor
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One of the main problems in high energy physics is the fact that we do not have a complete understanding of the interaction between local and global effects in gauge theory. This has an increasing impact on our ability to access the non-perturbative regime of most of our theories. Our theories, while being based on gauge groups considered to be simple or semi-simple and connected, are expected to be described by their simple local linear approximation, namely the Lie algebras. However, higher homotopy properties resulting in gauge anomalies appear frequently in theories of physical interest. Our assumption that the groups we deal with are simple and simply connected is probably not suitable, and ways to go beyond such assumptions, particularly in gauge theories, where the Lie algebra linear approximation is prevalent, are not known. We approach this problem from two directions: on one side we are explaining the potential role of formal group laws in describing certain higher homotopical properties and interferences with local or perturbative effects, and on the other side, we employ a categorical approach leading to synthetic theory and a way of looking at gauge theories. The topos approach is based on a geometry where the fundamental logic is intuitionistic logic, and hence the ‘tertium non datur’ principle is abandoned. This has a remarkable impact on understanding conformal symmetry and its anomalies in string theory in various dimensions.Keywords: Gauge theory, formal group laws, Topos theory, conformal symmetry
Procedia PDF Downloads 4514685 Developing Serious Games to Increase Children’s Knowledge of Diet and Nutrition
Authors: N. Liu, N. Tuah, D. Ying
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This research aims to identify and test whether serious games can help children learn and pick up healthy eating habits. The practical component takes the form of digitalizing an already existing educational board game called “All you can eat” (AYCE), designed with the nutritious subject matter in mind. This time with the added features of online playability, which will widen its availability and accessibility to reach more players compared to the physical iteration. The game will be deployed alongside the conducting of theoretical research, which also involves teachers leading children to play said digital version. The research methodology utilizes two experiments, such as handing out surveys to gather feedback from both the partners and students. The research was carried out in several countries, namely Brunei, Malaysia, and Taiwan. The results are to be used for validating the concept of “serious games,” particularly when tied to the health aspect of the players, which in this case were children. As for the research outcomes, they can be applied to a variety of serious games that are related to health topics more broadly and not simply limited to healthy eating habits alone, adopting a balanced combination of practical and theoretical considerations. The study will also help other researchers in the correlated fields of serious game development and pediatrics to better comprehend the needs of children. On the theoretical side, these findings can enable further technological advancements to be made possible, a case in point being more serious games, to provide the appropriate social support precisely on the matter of health-related issues. Not just individuals but rather communities could benefit from improved health and well-being as a result of the project, which, when done right, will potentially improve their quality of life and have fun while doing it. AYCE will be demonstrated to support a wide range of health issues as a result of this research case.Keywords: culture heritage, digital games, digitalization, traditional religious culture
Procedia PDF Downloads 8014684 An Analytical View of Albanian and French Legislation on Access to Health Care Benefits
Authors: Oljana Hoxhaj
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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.Keywords: effective service, harmonization level, innovation, reform
Procedia PDF Downloads 11614683 Sociological Analysis of Fulfillment Regarding Basic Needs of Females(Women) at Home with Special Reference of Balochistan (Pakistan)
Authors: Shabana Mohammad, Muhammad Irfan
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The aim of this study was to bring out the facts regarding the effects of gender discrimination in fulfilling the basic needs of females at home. The purpose of the study was to observe whether gender discrimination affects the fulfillment of their basic needs in comparison to male siblings. Balochistan is the largest province of Pakistan geographically and has a tribal system. Due to having tribal systems, the women are not treated equally as men at home because males are considered the strength and privilege of tribes; males are more valuable because they support their families economically as well, and females are not allowed to work outside the home. That’s why females are deprived of their basic needs of life. The females (women) are neglected to have better nourishment, health facilities, easy access to get an education, safe house, and self-confidence. The type of research is quantitative, and data was collected from all government girls’ degree colleges of Quetta city (the capital of Balochistan province) under the age of 18. Two hundred (200) Students of all FA arts faculty (first year) were selected through simple random sampling (fishbowl draw). Data were analyzed by SPSS, and a coefficient test was applied to test the hypothesis. The regression of coefficient has a significant association between gender discrimination and basic needs (P-value =.000). The results showed that women are underprivileged from all basic needs (fundamental rights) of life, which are entitled to everyone by their birth because of male preference that creates gender disparity between men and women.Keywords: basic needs, discrimination, value of women at home, hurdles of women
Procedia PDF Downloads 11714682 Weighing the Economic Cost of Illness Due to Dysentery and Cholera Triggered by Poor Sanitation in Rural Faisalabad, Pakistan
Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail
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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.Keywords: sanitation, toilet, economic cost of health, water, Punjab
Procedia PDF Downloads 12814681 Investigating Salience Theory’s Implications for Real-Life Decision Making: An Experimental Test for Whether the Allais Paradox Exists under Subjective Uncertainty
Authors: Christoph Ostermair
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We deal with the effect of correlation between prospects on human decision making under uncertainty as proposed by the comparatively new and promising model of “salience theory of choice under risk”. In this regard, we show that the theory entails the prediction that the inconsistency of choices, known as the Allais paradox, should not be an issue in the context of “real-life decision making”, which typically corresponds to situations of subjective uncertainty. The Allais paradox, probably the best-known anomaly regarding expected utility theory, would then essentially have no practical relevance. If, however, empiricism contradicts this prediction, salience theory might suffer a serious setback. Explanations of the model for variable human choice behavior are mostly the result of a particular mechanism that does not come to play under perfect correlation. Hence, if it turns out that correlation between prospects – as typically found in real-world applications – does not influence human decision making in the expected way, this might to a large extent cost the theory its explanatory power. The empirical literature regarding the Allais paradox under subjective uncertainty is so far rather moderate. Beyond that, the results are hard to maintain as an argument, as the presentation formats commonly employed, supposably have generated so-called event-splitting effects, thereby distorting subjects’ choice behavior. In our own incentivized experimental study, we control for such effects by means of two different choice settings. We find significant event-splitting effects in both settings, thereby supporting the suspicion that the so far existing empirical results related to Allais paradoxes under subjective uncertainty may not be able to answer the question at hand. Nevertheless, we find that the basic tendency behind the Allais paradox, which is a particular switch of the preference relation due to a modified common consequence, shared by two prospects, is still existent both under an event-splitting and a coalesced presentation format. Yet, the modal choice pattern is in line with the prediction of salience theory. As a consequence, the effect of correlation, as proposed by the model, might - if anything - only weaken the systematic choice pattern behind the Allais paradox.Keywords: Allais paradox, common consequence effect, models of decision making under risk and uncertainty, salience theory
Procedia PDF Downloads 20714680 Competitive Effects of Differential Voting Rights and Promoter Control in Indian Start-Ups
Authors: Prateek Bhattacharya
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The definition of 'control' in India is a rapidly evolving concept, owing to varying rights attached to varying securities. Shares with differential voting rights (DVRs) provide the holder with differential rights as to voting, as compared to ordinary equity shareholders of the company. Such DVRs can amount to both superior voting rights and inferior voting rights, where DVRs with superior voting rights amount to providing the holder with golden shares in the company. While DVRs are not a novel concept in India having been recognized since 2000, they were placed on a back burner by the Securities and Exchange Board of India (SEBI) in 2010 after issuance of DVRs with superior voting rights was restricted. In June 2019, the SEBI rekindled the ebbing fire of DVRs, keeping mind the fast-paced nature of the global economy, the government's faith that India’s ‘new age technology companies’ (i.e., Start-Ups) will lead the charge in achieving its goal of India becoming a $5 trillion dollar economy by 2024, and recognizing that the promoters of such Start-Ups seek to raise capital without losing control over their companies. DVRs with superior voting rights guarantee promoters with up to 74% shareholding in Start-Ups for a period of 5 years, meaning that the holder of such DVRs can exercise sole control and material influence over the company for that period. This manner of control has the potential of causing both pro-competitive and anti-competitive effects in the markets where these companies operate. On the one hand, DVRs will allow Start-Up promoters/founders to retain control of their companies and protect its business interests from foreign elements such as private/public investors – in a scenario where such investors have multiple investments in firms engaged in associated lines of business (whether on a horizontal or vertical level) and would seek to influence these firms to enter into potential anti-competitive arrangements with one another, DVRs will enable the promoters to thwart such scenarios. On the other hand, promoters/founders who themselves have multiple investments in Start-Ups, which are in associated lines of business run the risk of influencing these associated Start-Ups to engage in potentially anti-competitive arrangements in the name of profit maximisation. This paper shall be divided into three parts: Part I shall deal with the concept of ‘control’, as deliberated upon and decided by the SEBI and the Competition Commission of India (CCI) under both company/securities law and competition law; Part II shall review this definition of ‘control’ through the lens of DVRs, and Part III shall discuss the aforementioned potential pro-competitive and anti-competitive effects caused by the DVRs by examining the current Indian Start-Up scenario. The paper shall conclude by providing suggestions for the CCI to incorporate a clearer and more progressive concept of ‘control’.Keywords: competition law, competitive effects, control, differential voting rights, DVRs, investor shareholding, merger control, start-ups
Procedia PDF Downloads 12814679 The Underestimate of the Annual Maximum Rainfall Depths Due to Coarse Time Resolution Data
Authors: Renato Morbidelli, Carla Saltalippi, Alessia Flammini, Tommaso Picciafuoco, Corrado Corradini
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A considerable part of rainfall data to be used in the hydrological practice is available in aggregated form within constant time intervals. This can produce undesirable effects, like the underestimate of the annual maximum rainfall depth, Hd, associated with a given duration, d, that is the basic quantity in the development of rainfall depth-duration-frequency relationships and in determining if climate change is producing effects on extreme event intensities and frequencies. The errors in the evaluation of Hd from data characterized by a coarse temporal aggregation, ta, and a procedure to reduce the non-homogeneity of the Hd series are here investigated. Our results indicate that: 1) in the worst conditions, for d=ta, the estimation of a single Hd value can be affected by an underestimation error up to 50%, while the average underestimation error for a series with at least 15-20 Hd values, is less than or equal to 16.7%; 2) the underestimation error values follow an exponential probability density function; 3) each very long time series of Hd contains many underestimated values; 4) relationships between the non-dimensional ratio ta/d and the average underestimate of Hd, derived from continuous rainfall data observed in many stations of Central Italy, may overcome this issue; 5) these equations should allow to improve the Hd estimates and the associated depth-duration-frequency curves at least in areas with similar climatic conditions.Keywords: central Italy, extreme events, rainfall data, underestimation errors
Procedia PDF Downloads 19414678 Associated Mycoflora AF Mucuna Sloanei Seeds and Their Effects on Nutritional and Phytochemical Contents of the Seeds
Authors: U.N. Emiri, E. Moroyei
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Mycoflora associated with the seed rot disease of Mucuna sloanei and their effects on nutrient and phytochemical composition of the seeds were investigated. The fungal pathogens implicated in the seed rot disease were Rhizopus stolonifer, Aspergillus flavus, Aspergillus niger, and Fusarium oxysporum. The fungal isolates were aseptically inoculated into healthy M. Sloanei seeds and incubated for 7 days at room temperature of 25 ± 30c. The results of the proximate and mineral analysis in mg/100g of fungal infected and non-infected (control) seeds that were carried out revealed that there was an increase in Moisture and Carbohydrate content of the fungal infected seeds relative to the non-infected seeds (control). However, there was a decrease in Ash, Fibre, Lipid, and Protein content of the fungal infected seeds relative to the non-infected (control). It was observed that moisture had increased from 10.50 ± 0.16 in the non-infected seeds to 17.60 ± 0.20 in the infected samples and Carbohydrate content had also increased from 49.6 ± 0.25 in the non-infected to 52.50 ± 0.29 in the infected seeds. The following parameters decreased in the infected than in the non-infected seeds. They include Ash 2.60 ± 0.12, Crude fibre 1.9 ± 0.08, Lipid 6.50 ± 0.16, and Protein content 18.50 ± 0.06. Similarly, Calcium 2.50 ± 0.12, Phosphorus 1.80 + 0.12 and Potassium 1.80 + 0.09 increased in the infected than in the non-infected seed, while iron 0.20 ± 0.05, Sodium 0.02 ± 0.01 and Magnesium 0.06 ± 0.02 decreased in the infected seeds. All phytochemical contents analyzed increased in the infected seeds viz Tannim 0.50 ± 0.12, Oxalate 1.60 ± 0.05, Hydrogen cyanide 1.82 ± 0.06, and Saponin 2.50+0.28. However, the nutrient compositions and Phytochemical between the infected and non-infected seeds are not significantly different (p > 0.05).Keywords: Mycoflora, mucuna sloanei, seeds, phytochemical, nutrient composition
Procedia PDF Downloads 15814677 Formulation of Suppositories Using Allanblackia Floribunda Butter as a Base
Authors: Mary Konadu
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The rectal route for drug administration is becoming attractive to drug formulators because it can avoid hepatic first-pass effects, decrease gastrointestinal side effects and avoid undesirable effects of meals on drug absorption. Suppositories have been recognized as an alternative to the oral route in situations such as when the patient is comatose, unable to swallow, or when the drug produces nausea or vomiting. Effective drug delivery with appropriate pharmaceutical excipient is key in the production of clinically useful preparations. The high cost of available excipients coupled with other disadvantages have led to the exploration of potential excipients from natural sources. Allanblackia floribunda butter, a naturally occurring lipid, is used for medicinal, culinary, and cosmetic purposes. Different extraction methods (solvent (hexane) extraction, traditional/hot water extraction, and cold/screw press extraction) were employed to extract the oil. The different extracts of A. floribunda oil were analyzed for their physicochemical properties and mineral content. The oil was used as a base to formulate Paracetamol and Diclofenac suppositories. Quality control test were carried out on the formulated suppositories. The %age oil yield for hexane extract, hot water extract, and cold press extract were 50.40 ±0.00, 37.36±0.00, and 20.48±0.00, respectively. The acid value, saponification value, iodine value and free fatty acid were 1.159 ± 0.065, 208.51 ± 8.450, 49.877 ± 0.690 and 0.583 ± 0.032 respectively for hexane extract; 3.480 ± 0.055, 204.672±2.863, 49.04 ± 0.76 and 1.747 ± 0.028 respectively for hot water/traditional extract; 4.43 ± 0.055, 192.05±1.56, 49.96 ± 0.29 and 2.23 ± 0.03 respectively for cold press extract. Calcium, sodium, magnesium, potassium, and iron were minerals found to be present in the A. floribunda butter extracts. The uniformity of weight, hardness, disintegration time, and uniformity of content were found to be within the acceptable range. The melting point ranges for all the suppositories were found to be satisfactory. The cumulative drug release (%) of the suppositories at 45 minutes was 90.19±0.00 (Hot water extract), 93.75±0.00 (Cold Pres Extract), and 98.16±0.00 (Hexane Extract) for Paracetamol suppositories. Diclofenac sodium suppositories had a cumulative %age release of 81.60±0.00 (Hot water Extract), 95.33±0.00 (Cold Press Extract), and 99.20±0.00 (Hexane Extract). The physicochemical parameters obtained from this study shows that Allanblackia floribunda seed oil is edible and can be used as a suppository base. The suppository formulation was successful, and the quality control tests conformed to Pharmacopoeia standard.Keywords: allanblackia foribunda, paracetamol, diclofenac, suppositories
Procedia PDF Downloads 12714676 Maternal Adverse Childhood Experiences and Preschool Children’s Behavioural Problems: Mediation via Adult Attachment and Moderation by Maternal Mental Health, Social Support, and Child Sex
Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau
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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health
Procedia PDF Downloads 7814675 From De Soto’s Solution to Urban Disaster: The Effects of Land Titling Policies on the Development of Cities of the Global South in the Case of Lima Peru
Authors: Jitka Molnarova
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Based on De Soto’s idea that a formal land title can provide a secure home and access to credit to poor urban families, a large number of developing countries accepted the formalization of informal settlements as the ultimate solution for their housing crises and struggles with poverty. After two decades of implementation, very little is known about the effects this policy has on the quality of the neighborhoods it produces and on the development of cities in general. Using the capital of Peru -where the solution originated- as a case study, this paper illustrates the negative outcomes this policy has on urban development arguing that land titling encourages 1) expansion of the city often to areas of high physical risk, 2) production of precarious housing on unserviced land, and 3) practices of illegal land trafficking. The evidence is based on interviews with community leaders and officials working at the Cooperation for Formalization of Informal Property (COFOPRI), comparison of satellite images documenting the expansion of Lima in the past twenty years, and a technical evaluation of dozens of houses that have been or are in the process of being granted a land title.Keywords: COFOPRI, De Soto, housing policies, land titling, land trafficking, Lima, Peru, precarious housing, urban expansion
Procedia PDF Downloads 18814674 Endotracheal Intubation Self-Confidence: Report of a Realistic Simulation Training
Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo
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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation
Procedia PDF Downloads 14414673 On the Fixed Rainfall Intensity: Effects on Overland Flow Resistance, Shear Velocity and on Soil Erosion
Authors: L. Mouzai, M. Bouhadef
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Raindrops and overland flow both are erosive parameters but they do not act by the same way. The overland flow alone tends to shear the soil horizontally and concentrates into rills. In the presence of rain, the soil particles are removed from the soil surface in the form of a uniform sheet layer. In addition to this, raindrops falling on the flow roughen the water and soil surface depending on the flow depth, and retard the velocity, therefore influence shear velocity and Manning’s factor. To investigate this part, agricultural sandy soil, rainfall simulator and a laboratory soil tray of 0.2x1x3 m were the base of this work. Five overland flow depths of 0; 3.28; 4.28; 5.16; 5.60; 5.80 mm were generated under a rainfall intensity of 217.2 mm/h. Sediment concentration control is based on the proportionality of depth/microtopography. The soil loose is directly related to the presence of rain splash on thin sheet flow. The effect of shear velocity on sediment concentration is limited by the value of 5.28 cm/s. In addition to this, the rain splash reduces the soil roughness by breaking the soil crests. The rainfall intensity is the major factor influencing depth and soil erosion. In the presence of rainfall, the shear velocity of the flow is due to two simultaneous effects. The first, which is horizontal, comes from the flow and the second, vertical, is due to the raindrops.Keywords: flow resistance, laboratory experiments, rainfall simulator, sediment concentration, shear velocity, soil erosion
Procedia PDF Downloads 20314672 Urban Gamification: Analyzing the Effects of UFLab’s Tangible Gamified Tools in Four Hungarian Urban Public Participation Processes
Authors: Olivia Kurucz
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Gamification is one of the outstanding new methodological possibilities of urban public participation processes to make the most informed decision possible for the future steps of urban development. This paper examines four Hungarian experimental projects in which gamified tools were applied during the public participation progresses by the Urban Future Laboratory (UFLab) research workshop of Budapest University of Technology and Economics (BUTE). The recently implemented future planning projects (in the cities of Pécel, Kistarcsa, Budapest, and Salgótarján) were initiated by various motives, but the multi-stakeholder dialogues were facilitated through physical gamified tools in all cases. Based on the urban gamification hypothesis, the use of gamified tools supported certain steps of participatory processes in several aspects: it helped to increase the attractiveness of public events, to create a more informal atmosphere, to ensure equal conditions for actors, to recall a design mindset, to bridge contrasting social or cultural differences, to fix opinions and to assist dialogue between city actors, designers, and residents. This statement is confirmed by assessing the applied tools, analyzing the case studies, and comparing them to perceive their effects and interrelations.Keywords: experimental projects, future planning, gamification, gamified tools, Hungary, public participation, UFLab, urban gamification
Procedia PDF Downloads 14214671 Discovering the Effects of Guerrilla Advertisements on Perceiver's Ad Attitude, Ad Likability and Purchase Intention
Authors: S. Y. Ozkan, S. Taftaf
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This study aims to investigate the possible effects of guerrilla advertising on consumers' attitudes as well as purchase intentions in comparison with traditional advertising. Participants who were over 18 years of age were recruited and completed an online questionnaire. Each participant was randomly assigned to one of the four well-known brand conditions. The study had a within-subjects design where each participant evaluated two advertisements, one guerrilla advertisement, and one traditional advertisement od one respective brand. Participants rated both traditional advertisement and guerrilla advertisement on ad attitude, ad likability, and purchase intention scales. Ad attitude was measured by using both positive and negative adjectives. The hypotheses were tested by paired samples t-test analysis. The results indicated that perceivers were able to differentiate advertisements that include guerrilla techniques and advertisements that include traditional methods from one another. Regardless of the brand manipulation, guerrilla advertisements lead significantly higher positive ad attitude, negative ad attitude, ad likability, and purchase intention compared to traditional advertisements. Therefore, the results showed that while using guerrilla advertising, companies should be aware of any ethical concerns that may emerge in consumers' minds. Present study is one of the rare studies that measures the perceptions of guerrilla and traditional advertisements in an empirical manner in Turkish context, showing that guerrilla advertisements may stimulate negative ad attitudes together with positive ad attitudes, increasing ad likability and purchase intention.Keywords: ad attitude, guerrilla advertisement, purchase intention, traditional advertisement
Procedia PDF Downloads 14314670 Needs and Expectations of Digital Support among Parents of Children in Child Healthcare
Authors: Lotha Valan, Åsa Hörnsten, Ulf Isaksson
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Introduction: Sweden has a national child health care program (CHCP) where all parents are offered support to raise their children and support them for lifelong health. A systematic review concludes that there is a request for guidance in using the internet effectively for the health purposes of their children. However, a study about internet use among young mothers means that the internet is not always easy to navigate for parents, and they may need support. To fill this gap and develop a digital channel to complement the child health care (CHC) for the support of parents of children within CHC, there is a demand to investigate parents' needs in relation to this purpose. Methods: The study had a qualitative approach using focus group interviews with parents. The interview data were analyzed using qualitative content analysis. Results: The main theme highlights that parents expected that a digital support channel would be something that might strengthen them toward independence concerning the care of their children in a positive way. However, they also felt that they needed personal support and that relationships with other parents and the child health care nurse were significant and meaningful. Another parental desire that emerged was that a future digital channel would facilitate and simplify access to care, and they suggested having both planned and urgent times available for parents to book. The digital channel was expected to make this possible and be a good complement to the physical contacts the traditional child healthcare currently offers. Discussion/conclusions: The parents in this study believed that digital solutions could increase their parental power in relation to the care of their children. Examples were given as nurse-led parent groups where parents with similar problems and experiences around their children could support each other and were expected to strengthen them over time. The parents stressed that a planned digital support channel also needs satisfactory solutions for both contact and response. It was suggested that there should be bookable times for both planned and urgent needs and also the possibility of rescheduling visits.Keywords: child healthcare, parents, digital support, nursing
Procedia PDF Downloads 8214669 Canopy Temperature Acquired from Daytime and Nighttime Aerial Data as an Indicator of Trees’ Health Status
Authors: Agata Zakrzewska, Dominik Kopeć, Adrian Ochtyra
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The growing number of new cameras, sensors, and research methods allow for a broader application of thermal data in remote sensing vegetation studies. The aim of this research was to check whether it is possible to use thermal infrared data with a spectral range (3.6-4.9 μm) obtained during the day and the night to assess the health condition of selected species of deciduous trees in an urban environment. For this purpose, research was carried out in the city center of Warsaw (Poland) in 2020. During the airborne data acquisition, thermal data, laser scanning, and orthophoto map images were collected. Synchronously with airborne data, ground reference data were obtained for 617 studied species (Acer platanoides, Acer pseudoplatanus, Aesculus hippocastanum, Tilia cordata, and Tilia × euchlora) in different health condition states. The results were as follows: (i) healthy trees are cooler than trees in poor condition and dying both in the daytime and nighttime data; (ii) the difference in the canopy temperatures between healthy and dying trees was 1.06oC of mean value on the nighttime data and 3.28oC of mean value on the daytime data; (iii) condition classes significantly differentiate on both daytime and nighttime thermal data, but only on daytime data all condition classes differed statistically significantly from each other. In conclusion, the aerial thermal data can be considered as an alternative to hyperspectral data, a method of assessing the health condition of trees in an urban environment. Especially data obtained during the day, which can differentiate condition classes better than data obtained at night. The method based on thermal infrared and laser scanning data fusion could be a quick and efficient solution for identifying trees in poor health that should be visually checked in the field.Keywords: middle wave infrared, thermal imagery, tree discoloration, urban trees
Procedia PDF Downloads 11914668 Religion, Health and Ageing: A Geroanthropological Study on Spiritual Dimensions of Well-Being among the Elderly Residing in Old Age Homes in Jallandher Punjab, India
Authors: A. Rohit Kumar, B. R. K. Pathak
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Background: Geroanthropology or the anthropology of ageing is a term which can be understood in terms of the anthropology of old age, old age within anthropology, and the anthropology of age. India is known as the land of spirituality and philosophy and is the birthplace of four major religions of the world namely Hinduasim, Buddhisim, Jainisim, and Sikhism. The most dominant religion in India today is Hinduism. About 80% of Indians are Hindus. Hinduism is a religion with a large number of Gods and Goddesses. Religion in India plays an important role at all life stages i.e. at birth, adulthood and particularly during old age. India is the second largest country in the world with 72 million elder persons above 60 years of age in 2001 as compared to china 127 million. The very concept of old age homes in India is new. The elderly people staying away from their homes, from their children or left to them is not considered to be a very happy situation. This paper deals with anthropology of ageing, religion and spirituality among the elderly residing in old age homes and tries to explain that how religion plays a vital role in the health of the elderly during old age. Methods: The data for the present paper was collected through both Qualitative and Quantitative methods. Old age homes located in Jallandher (Punjab) were selected for the present study. Age sixty was considered as a cut off age. Narratives, case studies were collected from 100 respondents residing in old age homes. The dominant religion in Punjab was found to be Sikhism and Hinduism while Jainism and Buddhism were found to be in minority. It was found that as one grows older the religiosity increases. Religiosity and sprituality was found to be directly proportional to ageing. Therefore religiosity and health were found to be connected. Results and Conclusion: Religion was found out to be a coping mechanism during ill health. The elderly living in old age homes were purposely selected for the study as the elderly in old age homes gets medical attention provided only by the old age home authorities. Moreover, the inmates in old age homes were of low socio-economic status couldn’t afford medical attention on their own. It was found that elderly who firmly believed in religion were found to be more satisfied with their health as compare to elderly who does not believe in religion at all. Belief in particular religion, God and godess had an impact on the health of the elderly.Keywords: ageing, geroanthropology, religion, spirituality
Procedia PDF Downloads 34914667 Complementary Mathematical Model for Underwater Vehicles under Load Variation Test Conditions
Authors: Erim Koyun
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This paper aim to construct a mathematical model for Underwater vehicles under load variation test conditions. Propeller effects on underwater vehicle are investigated. Body with counter rotating propeller model is analyzed by CFD methods, thus forces and moment are obtained. Propeller effects of vehicle’s hydrodynamic performance under load variation conditions will be investigated. Additionally, pressure contour is examined for differences between different load conditions. Axial force equation is established using hydrodynamic coefficients, which contains resistance, thrust, and additional coefficients occurs due to load variations. Additional coefficients helps to express completely axial force on underwater vehicle. When the vehicle accelerates, additional force occurs besides thrust force increment. This is propeller effect on the body. Hence, mathematical model cover this effect. For CFD analysis, the incompressible, three-dimensional, and unsteady Reynolds Averaged Navier-Stokes equations will be used Numerical results is verified with experimental results for verification. The overall goal of this study is to present complementary mathematical model for body with counter rotating propeller.Keywords: counter rotating propeller, CFD, hydrodynamic mathematic model, hydrodynamics analysis, thrust deduction
Procedia PDF Downloads 13914666 The Effect of Evil Eye in the Individuals' Journey for Personhood within a Christian Orthodox Society
Authors: Nikolaos Souvlakis
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The present paper negotiates the effect of 'the evil eye' on individuals' mental health while at the same time poses the problem of how the evil eye fits into the anthropological arena as a key question that forges a fundamental link between religion, anthropology and mental health professions. It is the argument of the paper that the evil eye is an essential and fundamental human phenomenon and therefore any scholarly field involved in its study must consider the insight it provides into the development of personhood. The study was an anthropological study in the geographical area of Corfu, a Greek Orthodox society uninfluenced by the Ottoman Islamic Culture. The paper aims to deepen our understanding of the evil eye as it analyses the interaction between the evil eye and gaze and how they affect the development of personhood; based on the empirical data collected from the fieldwork. Therefore, the paper adopts a psychoanalytic anthropology approach to facilitate a better understanding of the evil eye through the accounts of individuals’ journeys in the process of their development of personhood. Finally, the paper aims to offer a detailed analysis of the particular element of eye (‘I’) and, more specifically, of ‘the others’, as they relate to the phenomenon of the evil eye.Keywords: gaze, evil eye, mental health, personhood
Procedia PDF Downloads 13014665 Blue Whale Body Condition from Photographs Taken over a 14-Year Period in the North East Pacific: Annual Variations and Connection to Measures of Ocean Productivity
Authors: Rachel Wachtendonk, John Calambokidis, Kiirsten Flynn
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Large marine mammals can serve as an indicator of the overall state of the environment due to their long lifespan and apex position in marine food webs. Reductions in prey, driven by changes in environmental conditions can have resounding impacts on the trophic system as a whole; this can manifest in reduced fat stores that are visible on large whales. Poor health can lead to reduced survivorship and fitness, both of which can be detrimental to a recovering population. A non-invasive technique was used for monitoring blue whale health and for seeing if it changes with ocean conditions. Digital photographs of blue whales taken in the NE Pacific by Cascadia Research and collaborators from 2005-2018 (n=3,545) were scored for overall body condition based on visible vertebrae and body shape on a scale of 0-3 where a score of 0 indicated best body condition and a score of 3 indicated poorest. The data was analyzed to determine if there were patterns in the health of whales across years and whether overall poor health was related to oceanographic conditions and predictors of prey abundance on the California coast. The year was a highly significant factor in body condition (Chi-Square, p<0.001). The proportion of whales showing poor body condition (scores 2 & 3) overall was 33% but by year varied widely from a low of 18% (2008) to a high of 55% (2015). The only two years where >50% of animals had poor body condition were 2015 and 2017 (no other year was above 45%). The 2015 maximum proportion of whales in poor body condition coincide with the marine heat wave that affected the NE Pacific 2014-16 and impacted other whale populations. This indicates that the scoring method was an effective way to evaluate blue whale health and how they respond to a changing ocean.Keywords: blue whale, body condition, environmental variability, photo-identification
Procedia PDF Downloads 20814664 The Perspective of Waria Transgenders in Singaraja on Their Reproduction Health
Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto
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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids
Procedia PDF Downloads 34214663 Bioreactor Simulator Design: Measuring Built Environment Health and Ecological Implications from Post-Consumer Textiles
Authors: Julia DeVoy, Olivia Berlin
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The United States exports over 1.6 billion pounds of post-consumer textiles every year, primarily to countries in the Global South. These textiles make their way to landfills and open-air dumps where they decompose, contaminating water systems and releasing harmful greenhouse gases. Through this inequitable system of waste disposal, countries with less political and economic power are coerced into accepting the environmental and health consequences of over-consumption in the Global North. Thus, the global trade of post-consumer textile waste represents a serious issue of environmental justice and a public health hazard. Our research located, characterizes, and quantifies the environmental and human health risks that occur when post-consumer textiles are left to decompose in landfills and open-air dumps in the Global South. In our work, we make use of United Nations International Trade Statistics data to map the global distribution of post-consumer textiles exported from the United States. Next, we present our landfill simulating reactor designed to measure toxicity of leachate resulting from the decomposition of textiles in developing countries and to quantify the related greenhouse gas emissions. This design makes use of low-cost and sustainable materials to promote frugal innovation and make landfill reactors more accessible. Finally, we describe how the data generated from these tools can be leveraged to inform individual consumer behaviors, local policies around textile waste disposal, and global advocacy efforts to mitigate the environmental harms caused by textile waste.Keywords: sustainability, textile design, public health, built environment
Procedia PDF Downloads 13614662 The Impacts of the COVID-19 Pandemic on Social Activities and Residential Areas
Authors: Asghar Motea Noparvar
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According to the World Health Organization (WHO), the coronavirus disease (COVID-19), which has been characterized as a pandemic since December 2019, is attacking societies in terms of different ways. It means that this is much more than a crisis that is related to human health. It is a human, economic and social crisis. Since December 2019, not only some significant transformations have happened in human life, but also there has been some mental health, daily life activities, and even urban space changes. The purpose of this study is to mention some tangible transformations in society by applying two main restrictions such as “lock down” and “social distancing,” and how people took refuge in their homes and fit every activity there. How this pandemic has been transforming human life and social activities is the main issue of this study. In order to gather the information, review the impacts of COVID-19 on social life by revising the literature and considering the “Risk Society” theory, which is gotten credited by a German sociologist, Ulrich Beck. Additionally, COVID-19 not only had a direct impact on health but also had significant impacts on the economy, education, tourism, the environment, and the construction industry. Therefore, the pandemic caused a disruption in the whole urban system. In this study, the main focused point is the transformation of activities and residential areas. In order to achieve this finding, the literature review is analyzed in the case of COVID-19 and its impacts on social life. To sum up, it can be concluded that a pandemic can change social life along with other transformations that it is able to do.Keywords: infectious disease, COVID-19, social activities, residential areas, transformation
Procedia PDF Downloads 9514661 Medical Surveillance Management
Authors: Jina K., Kittinan C. Athitaya J., Weerapat B., Amornrat T., Waraphan N.
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Working in the exploration and production of petroleum exposed workers to various health risks, including but not limited to physical and chemical risks. Although lots of barriers have been put in place, e.g., hazard monitoring in the workplace, appropriate training on health hazards, proper personal protective equipment (PPE), the health hazard may harm the workers if the barriers are not effectively implemented. To prove the effectiveness of these barriers, it is necessary to monitor exposure by putting in place the medical surveillance program via biological monitoring of chemical hazards and physical check-ups for physical hazards. Medical surveillance management is the systematic assessment and monitoring of employees exposed or potentially exposed to occupational hazards with the goal of reducing and ultimately preventing occupational illness and injury. The paper aims to demonstrate the effectiveness of medical surveillance management in mitigating health risks associated with physical and chemical hazards in the petroleum industry by focusing on implementing programs for biological monitoring and physical examinations, including defining procedures for biological monitoring, urine sample collection, physical examinations, and result management on offshore petroleum platforms. The implementation of medical surveillance management has proven effective in monitoring worker exposure to physical and chemical hazards, leading to reduced medical expenses and the risk associated with work-related diseases significantly.Keywords: medical surveillance, petroleum industry, occupational hazards, medical surveillance process
Procedia PDF Downloads 2514660 Wellbeing Effects from Family Literacy Education: An Ecological Study
Authors: Jane Furness, Neville Robertson, Judy Hunter, Darrin Hodgetts, Linda Nikora
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Background and significance: This paper describes the first use of community psychology theories to investigate family-focused literacy education programmes, enabling a wide range of wellbeing effects of such programmes to be identified for the first time. Evaluations of family literacy programmes usually focus on the economic advantage of gains in literacy skills. By identifying other effects on aspects of participants’ lives that are important to them, and how they occur, understanding of how such programmes contribute to wellbeing and social justice is augmented. Drawn from community psychology, an ecological systems-based, culturally adaptive framework for personal, relational and collective wellbeing illuminated outcomes of family literacy programmes that enhanced wellbeing and quality of life for adult participants, their families and their communities. All programmes, irrespective of their institutional location, could be similarly scrutinized. Methodology: The study traced the experiences of nineteen adult participants in four family-focused literacy programmes located in geographically and culturally different communities throughout New Zealand. A critical social constructionist paradigm framed this interpretive study. Participants were mainly Māori, Pacific islands, or European New Zealanders. Seventy-nine repeated conversational interviews were conducted over 18 months with the adult participants, programme staff and people who knew the participants well. Twelve participant observations of programme sessions were conducted, and programme documentation was reviewed. Latent theoretical thematic analysis of data drew on broad perspectives of literacy and ecological systems theory, network theory and holistic, integrative theories of wellbeing. Steps taken to co-construct meaning with participants included the repeated conversational interviews and participant checking of interview transcripts and section drafts. The researcher (this paper’s first author) followed methodological guidelines developed by indigenous peoples for non-indigenous researchers. Findings: The study found that the four family literacy programmes, differing in structure, content, aims and foci, nevertheless shared common principles and practices that reflected programme staff’s overarching concern for people’s wellbeing along with their desire to enhance literacy abilities. A human rights and strengths-based based view of people based on respect for diverse culturally based values and practices were evident in staff expression of their values and beliefs and in their practices. This enacted stance influenced the outcomes of programme participation for the adult participants, their families and their communities. Alongside the literacy and learning gains identified, participants experienced positive social and relational events and changes, affirmation and strengthening of their culturally based values, and affirmation and building of positive identity. Systemically, interconnectedness of programme effects with participants’ personal histories and circumstances; the flow on of effects to other aspects of people’s lives and to their families and communities; and the personalised character of the pathways people journeyed towards enhanced wellbeing were identified. Concluding statement: This paper demonstrates the critical contribution of community psychology to a fuller understanding of family-focused educational programme outcomes than has been previously attainable, the meaning of these broader outcomes to people in their lives, and their role in wellbeing and social justice.Keywords: community psychology, ecological theory, family literacy education, flow on effects, holistic wellbeing
Procedia PDF Downloads 26314659 The Food and Nutrition Security in Brazilian Quilombo: The Account of Experiences in Two Titled Territories
Authors: Dyego Ramos Henrique, Viviane Pimentel, Katia Souto, Ana Valéria Mendonça, Andrea Gallassi
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Socioeconomic inequalities in Brazil have accentuated the aggravations of poverty among the most vulnerable populations, among which are the quilombola communities. The objective was to reflect on a situation of food and nutritional security in two Brazilian quilombola communities. The data were collected by means of reports of experience through the production of talk wheels in two quilombola communities (Itamatatiua and Mesquita), located in the cities of Alcântara and Cidade Ocidental. Access to health services and health promotion actions were still incipient in the quilombola communities visited. The perceptions of the participants of the quilombolas revealed that there are still repressed demands that have rendered the fulfillment of the principles of equity, universality and integrality, both for access to health and for access and availability of food. They recognize in governmental instances a socioeconomic-cultural valorization and nutritional qualities intrinsic to the foods produced by them. Although they have been used as communities of quilombolas live and their level of access to services and programs, dealing with quilombola communities does not mean dealing with 'isolated groups or a strictly homogeneous population.' It demands a great need of attention in relation to the access and availability of food, besides overcoming barriers that made it an unfeasible valuation of social, economic and cultural precepts, intrinsic to the thought about food and nutritional security in Brazilian quilombos.Keywords: access to services, food and nutrition security, health promotion, quilombo population
Procedia PDF Downloads 23314658 Acupuncture Reduces Pain Disability, Stress, and Depression in United States Military Veterans with Chronic Pain
Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan
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The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing
Procedia PDF Downloads 261