Search results for: fire severity level
13531 A Real-World Evidence Analysis of Associations between Costs, Quality of Life and Disease-Severity Indicators of Alzheimer’s Disease in Thailand
Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk
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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life
Procedia PDF Downloads 14313530 Time Pressure and Its Effect at Tactical Level of Disaster Management
Authors: Agoston Restas
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Introduction: In case of managing disasters decision makers can face many times such a special situation where any pre-sign of the drastically change is missing therefore the improvised decision making can be required. The complexity, ambiguity, uncertainty or the volatility of the situation can require many times the improvisation as decision making. It can be taken at any level of the management (strategic, operational and tactical) but at tactical level the main reason of the improvisation is surely time pressure. It is certainly the biggest problem during the management. Methods: The author used different tools and methods to achieve his goals; one of them was the study of the relevant literature, the other one was his own experience as a firefighting manager. Other results come from two surveys that are referred to; one of them was an essay analysis, the second one was a word association test, specially created for the research. Results and discussion: This article proves that, in certain situations, the multi-criteria, evaluating decision-making processes simply cannot be used or only in a limited manner. However, it can be seen that managers, directors or commanders are many times in situations that simply cannot be ignored when making decisions which should be made in a short time. The functional background of decisions made in a short time, their mechanism, which is different from the conventional, was studied lately and this special decision procedure was given the name recognition-primed decision. In the article, author illustrates the limits of the possibilities of analytical decision-making, presents the general operating mechanism of recognition-primed decision-making, elaborates on its special model relevant to managers at tactical level, as well as explore and systemize the factors that facilitate (catalyze) the processes with an example with fire managers.Keywords: decision making, disaster managers, recognition primed decision, model for making decisions in emergencies
Procedia PDF Downloads 25913529 Determination of Mercury in Gold Ores by CVAAS Method
Authors: Ratna Siti Khodijah, Mirzam Abdurrachman
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Gold is recovered from gold ores. Within the ores, there are not only gold but also several types of precious metals. Copper, silver, and platinum group elements (ruthenium, rhodium, palladium, rhenium, osmium, and iridium) are metals commonly found in the ores. These metals combine to form an ore because they have the same properties. It is due to their position in periodic-system-of-elements are near to gold. However, the presence of mercury in every gold ore has not been mentioned, even though it is located right next to gold in the periodic-system-of-elements and they are located in the same block, d-block. Thus, it is possible that mercury is contained in the ores. Moreover, the elements of the same group with mercury—zinc and cadmium—sometimes can be found in the ores. It is suspected that mercury can not be detected because the processing of gold ores usually using fire assay method. Before the ores melting, mercury would evaporate because it has the lowest boiling point of all precious metal in the ores. Therefore, it suggested doing research on the presence of mercury in gold ores by CVAAS method. The results of this study would obtain the amount of mercury in gold ores that should be purified. So it can be produced economically if possible.Keywords: boiling point, d-block, fire assay, precious metal
Procedia PDF Downloads 34113528 Comparing the Effects of Ondansetron and Acupressure in PC6 Point on Postoperative Nausea and Vomiting in Patients Undergone Elective Cesarean Section: A Randomized Clinical Trial
Authors: Nasrin Galehdar, Sedigheh Nadri, Elham Nazari, Isan Darvishi, Abouzar Mohammadi
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Background and aim:Nausea and vomiting are complications of cesarean section. The pharmacological and non-pharmacological approaches were applied to decrease postoperative nausea and vomiting. The aim of the present study was to compare the effects of Ondansetron and acupressure on postoperative nausea and vomiting in patients undergone an elective cesarean section. Materials and method: The study was designed as a randomized clinical trial. A total of 120 patients were allocated to two equal groups. Four mgs of Ondansetron was administered for the Ondansetron group after clamping the umbilical cord. The acupressure bracelets were fastened in the PC6 point for acupressure group for 15 minutes. The patients were monitored in terms of incidence, severity, and episodes of nausea and vomiting. The data obtained were analyzed by SPSS software version 18 with a significance level of 0.05. Results: There was no significant statistical difference in nausea severity among the groups intra-operatively, in the recovery and surgery wards. The incidence and episodes of vomiting were significantly higher in patients undergone acupressure intra-operatively, in the recovery and surgery wards (P< 0.05). No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Conclusion: No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Thus, it is suggested to perform the studies with larger size and comparing the effects of acupressure with other antiemetic medications.Keywords: ondansetron, acupressure, nausea, vomiting
Procedia PDF Downloads 10913527 Efficacy of Cool's and Rhythmic Stabilization Exercises on Scapular up Ward Rotation and Ut/Sa Ratio in Patients with Shoulder Impingement Syndrome
Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda
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Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch
Procedia PDF Downloads 24013526 Analysis of Factors Influencing the Response Time of an Aspirating Gaseous Agent Concentration Detection Method
Authors: Yu Guan, Song Lu, Wei Yuan, Heping Zhang
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Gas fire extinguishing system is widely used due to its cleanliness and efficiency, and since its spray will be affected by many factors such as convection and obstacles in jetting region, so in order to evaluate its effectiveness, detecting concentration distribution in the jetting area is indispensable, which is commonly achieved by aspirating concentration detection technique. During the concentration measurement, the response time of detector is a very important parameter, especially for those fire-extinguishing systems with rapid gas dispersion. Long response time will not only underestimate its concentration but also prolong the change of concentration with time. Therefore it is necessary to analyze the factors influencing the response time. In the paper, an aspirating concentration detection method was introduced, which is achieved by using a small critical nozzle and a laminar flowmeter, and because of the response time is mainly related to the gas transport process from sampling site to the sensor, the effects of exhaust pipe size, gas flow rate, and gas concentration on its response time were analyzed. During the research, Bromotrifluoromethane (CBrF₃) was used. The effect of the sampling tube was investigated with different length of 1, 2, 3, 4 and 5 m (5mm in pipe diameter) and different pipe diameter of 3, 4, 5, 6 and 8 mm (3m in length). The effect of gas flow rate was analyzed by changing the throat diameter of the critical nozzle with 0.5, 0.682, 0.75, 0.8, 0.84 and 0.88 mm. The effect of gas concentration on response time was studied with the concentration range of 0-25%. The result showed that the response time increased with the increase of both the length and diameter of the sampling pipe, and the effect of length on response time was linear, but for the effect of diameter, it was exponential. It was also found that as the throat diameter of critical nozzle increased, the response time reduced a lot, in other words, gas flow rate has a great influence on response time. For the effect of gas concentration, the response time increased with the increase of the CBrF₃ concentration, and the slope of the curve was reduced.Keywords: aspirating concentration detection, fire extinguishing, gaseous agent, response time
Procedia PDF Downloads 27013525 A Systematic Map of the Research Trends in Wildfire Management in Mediterranean-Climate Regions
Authors: Renata Martins Pacheco, João Claro
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Wildfires are becoming an increasing concern worldwide, causing substantial social, economic, and environmental disruptions. This situation is especially relevant in Mediterranean-climate regions, present in all the five continents of the world, in which fire is not only a natural component of the environment but also perhaps one of the most important evolutionary forces. The rise in wildfire occurrences and their associated impacts suggests the need for identifying knowledge gaps and enhancing the basis of scientific evidence on how managers and policymakers may act effectively to address them. Considering that the main goal of a systematic map is to collate and catalog a body of evidence to describe the state of knowledge for a specific topic, it is a suitable approach to be used for this purpose. In this context, the aim of this study is to systematically map the research trends in wildfire management practices in Mediterranean-climate regions. A total of 201 wildfire management studies were analyzed and systematically mapped in terms of their: Year of publication; Place of study; Scientific outlet; Research area (Web of Science) or Research field (Scopus); Wildfire phase; Central research topic; Main objective of the study; Research methods; and Main conclusions or contributions. The results indicate that there is an increasing number of studies being developed on the topic (most from the last 10 years), but more than half of them are conducted in few Mediterranean countries (60% of the analyzed studies were conducted in Spain, Portugal, Greece, Italy or France), and more than 50% are focused on pre-fire issues, such as prevention and fuel management. In contrast, only 12% of the studies focused on “Economic modeling” or “Human factors and issues,” which suggests that the triple bottom line of the sustainability argument (social, environmental, and economic) is not being fully addressed by fire management research. More than one-fourth of the studies had their objective related to testing new approaches in fire or forest management, suggesting that new knowledge is being produced on the field. Nevertheless, the results indicate that most studies (about 84%) employed quantitative research methods, and only 3% of the studies used research methods that tackled social issues or addressed expert and practitioner’s knowledge. Perhaps this lack of multidisciplinary studies is one of the factors hindering more progress from being made in terms of reducing wildfire occurrences and their impacts.Keywords: wildfire, Mediterranean-climate regions, management, policy
Procedia PDF Downloads 12413524 Performance Analysis on the Smoke Management System of the Weiwuying Center for the Arts Using Hot Smoke Tests
Authors: K. H. Yang, T. C. Yeh, P. S. Lu, F. C. Yang, T. Y. Wu, W. J. Sung
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In this study, a series of full-scale hot smoke tests has been conducted to validate the performances of the smoke management system in the WWY center for arts before grand opening. Totaled 19 scenarios has been established and experimented with fire sizes ranging from 2 MW to 10 MW. The measured ASET data provided by the smoke management system experimentation were compared with the computer-simulated RSET values for egress during the design phase. The experimental result indicated that this system could successfully provide a safety margin of 200% and ensure a safe evacuation in case of fire in the WWY project, including worst-cases and fail-safe scenarios. The methodology developed and results obtained in this project can provide a useful reference for future applications, such as for the large-scale indoor sports dome and arena, stadium, shopping malls, airport terminals, and stations or tunnels for railway and subway systems.Keywords: building hot smoke tests, performance-based smoke management system designs, full-scale experimental validation, tenable condition criteria
Procedia PDF Downloads 44513523 Effect of Sewing Speed on the Physical Properties of Firefighter Sewing Threads
Authors: Adnan Mazari, Engin Akcagun, Antonin Havelka, Funda Buyuk Mazari, Pavel Kejzlar
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This article experimentally investigates various physical properties of special fire retardant sewing threads under different sewing speeds. The aramid threads are common for sewing the fire-fighter clothing due to high strength and high melting temperature. 3 types of aramid threads with different linear densities are used for sewing at different speed of 2000 to 4000 r/min. The needle temperature is measured at different speeds of sewing and tensile properties of threads are measured before and after the sewing process respectively. The results shows that the friction and abrasion during the sewing process causes a significant loss to the tensile properties of the threads and needle temperature rises to nearly 300oC at 4000 r/min of machine speed. The Scanning electron microscope images are taken before and after the sewing process and shows no melting spots but significant damage to the yarn. It is also found that machine speed of 2000r/min is ideal for sewing firefighter clothing for higher tensile properties and production.Keywords: Kevlar, needle temperautre, nomex, sewing
Procedia PDF Downloads 53213522 Effect of Bulk Density and Fiber Blend Content of Nonwoven Textiles on Flammability Properties
Authors: Klara Masnicova, Jiri Chaloupek
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Flammability plays an important role in applications such as thermal and acoustic insulation and other technical nonwoven textiles. The study was conducted in an attempt to investigate the flammability behavior of nonwoven textiles in relation to their structural and material characteristics, with emphasis given to the blending ratios of flammable and non-flammable fibers or fibers with reduced flammability. Nonwoven structures made of blends of viscose/oxidized polyacrylonitrile (VS/oxidized PAN fibers and polyethylene terephthalate/oxidized polyacrylonitrile (PET/oxidized PAN) fibers in several bulk densities are evaluated. The VS/oxidized PAN blend is model material. The flammability was studied using a cone calorimeter. Reaction to fire was observed using the small flame test method. Interestingly, the results show some of the blending ratios do not react to the heat in linear response to bulk density. This outcome can have a huge impact on future product development in fire safety and for the general understanding of flammability behavior of nonwovens made of staple fibers.Keywords: bulk density, cone calorimetry, flammability, nonwoven textiles
Procedia PDF Downloads 30813521 Combustion Characteristic of Propane/Acetylene Fuel Blends Pool Fire
Authors: Yubo Bi, Xiao Chen, Shouxiang Lu
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A kind of gas-fueled burner, named Burning Rate Emulator, was proposed for the purpose of the emulation of condensed fuel recently. The gaseous fuel can be pure combustible fuel gas or blends of gaseous fuel or inert gas. However, this concept was recently proposed without detailed study on the combustion characteristic of fuel blends. In this study, two kinds of common gaseous fuels were selected, propane and acetylene, to provide the combustion heat as well as a large amount of smoke, which widely exists in liquid and solid fuel burning process. A set of experiments were carried out using a gas-fueled burner with a diameter of 8 cm. The total volume flow rate of propane and acetylene was kept at 3 liters per minute. The volume fraction of propane varied from 0% to 100% at interval of 10%. It is found that the flame height increases with propane volume fraction, which may be caused by the increase of heat release rate, as the energy density of propane is larger than that of acetylene. The dimensionless flame height is correlated against dimensionless heat release rate, which shows a power function relationship. The radiation fraction of the flame does not show a monotonic relationship with propane volume fraction. With the increase of propane volume fraction from 0% to 100%, the value of radiation fraction increases first and reach a maximum value around 0.46 at a propane volume fraction of 10%, and then decreases continuously to a value of 0.25 at the propane volume fraction of 100%. The flame radiation is related to the soot in the flame. The trend of the radiation fraction reflects that there may be a synergistic effect of soot formation between propane and acetylene which can be guessed from the significantly high radiation fraction at a propane volume fraction of 10%. This work provides data for combustion of gaseous fuel blends pool fire and also give reference on the design of Burning Rate Emulator.Keywords: Burning Rate Emulator, fuel blends pool fire, flame height, radiation fraction
Procedia PDF Downloads 22813520 Outcome of Bowel Management Program in Patient with Spinal Cord Injury
Authors: Roongtiwa Chobchuen, Angkana Srikhan, Pattra Wattanapan
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Background: Neurogenic bowel is common condition after spinal cord injury. Most of spinal cord injured patients have motor weakness, mobility impairment which leads to constipation. Moreover, the neural pathway involving bowel function is interrupted. Therefore, the bowel management program should be implemented in nursing care in the earliest time after the onset of the disease to prevent the morbidity and mortality. Objective: To study the outcome of bowel management program of the patients with spinal cord injury who admitted for rehabilitation program. Study design: Descriptive study. Setting: Rehabilitation ward in Srinagarind Hospital. Populations: patients with subacute to chronic spinal cord injury who admitted at rehabilitation ward, Srinagarind hospital, aged over 18 years old. Instrument: The neurogenic bowel dysfunction score (NBDS) was used to determine the severity of neurogenic bowel. Procedure and statistical analysis: All participants were asked to complete the demographic data; age gender, duration of disease, diagnosis. The individual bowel function was assessed using NBDS at admission. The patients and caregivers were trained by nurses about the bowel management program which consisted of diet modification, abdominal massage, digital stimulation, stool evacuation including medication and physical activity. The outcome of the bowel management program was assessed by NBDS at discharge. The chi-square test was used to detect the difference in severity of neurogenic bowel at admission and discharge. Results: Sixteen spinal cord injured patients were enrolled in the study (age 45 ± 17 years old, 69% were male). Most of them (50%) were tetraplegia. On the admission, 12.5%, 12.5%, 43.75% and 31.25% were categorized as very minor (NBDS 0-6), minor (NBDS 7-9), moderate (NBDS 10-13) and severe (NBDS 14+) respectively. The severity of neurogenic bowel was decreased significantly at discharge (56.25%, 18.755%, 18.75% and 6.25% for very minor, minor, moderate and severe group respectively; p < 0.001) compared with NBDS at admission. Conclusions: Implementation of the effective bowel program decrease the severity of the neurogenic bowel in patient with spinal cord injury.Keywords: neurogenic bowel, NBDS, spinal cord injury, bowel program
Procedia PDF Downloads 24313519 Patterns of Change in Specific Behaviors of Autism Symptoms for Boys and for Girls Across Childhood
Authors: Einat Waizbard, Emilio Ferrer, Meghan Miller, Brianna Heath, Derek S. Andrews, Sally J. Rogers, Christine Wu Nordahl, Marjorie Solomon, David G. Amaral
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Background: Autism symptoms are comprised of social-communication deficits and restricted/repetitive behaviors (RRB). The severity of these symptoms can change during childhood, with differences between boys and girls. From the literature, it was found that young autistic girls show a stronger tendency to decrease and a weaker tendency to increase their overall autism symptom severity levels compared to young autistic boys. It is not clear, however, which symptoms are driving these sex differences across childhood. In the current study, we evaluated the trajectories of independent autism symptoms across childhood and compared the patterns of change in such symptoms between boys and girls. Method: The study included 183 children diagnosed with autism (55 girls) evaluated three times across childhood, at ages 3, 6 and 11. We analyzed 22 independent items from the Autism Diagnostic Observation Scheudule-2 (ADOS-2), the gold-standard assessment tool for autism symptoms, each item representing a specific autism symptom. First, we used latent growth curve models to estimate the trajectories for the 22 ADOS-2 items for each child in the study. Second, we extracted the factor scores representing the individual slopes for each ADOS-2 item (i.e., slope representing that child’s change in that specific item). Third, we used factor analysis to identify common patterns of change among the ADOS-2 items, separately for boys and girls, i.e., which autism symptoms tend to change together and which change independently across childhood. Results: The best-emerging patterns for both boys and girls identified four common factors: three factors representative of changes in social-communication symptoms and one factor describing changes in RRB. Boys and girls showed the same pattern of change in RRB, with four items (e.g., speech abnormalities) changing together across childhood and three items (e.g., mannerisms) changing independently of other items. For social-communication deficits in boys, three factors were identified: the first factor included six items representing initiating and engaging in social-communication (e.g., quality of social overtures, conversation), the second factor included five items describing responsive social-communication (e.g., response to name) and the third factor included three items related to different aspects of social-communication (e.g., level of language). Girls’ social-communications deficits also loaded onto three factors: the first factor included five items (e.g., unusual eye contact), the second factor included six items (e.g., quality of social response), and the third factor included four items (e.g., showing). Some items showed similar patterns of change for both sexes (e.g., responsive joint attention), while other items showed differences (e.g., shared enjoyment). Conclusions: Girls and boys had different patterns of change in autism symptom severity across childhood. For RRB, both sexes showed similar patterns. For social-communication symptoms, however, there were both similarities and differences between boys and girls in the way symptoms changed over time. The strongest patterns of change were identified for initiating and engaging in social communication for boys and responsive social communication for girls.Keywords: autism spectrum disorder, autism symptom severity, symptom trajectories, sex differences
Procedia PDF Downloads 5113518 Management Tools for Assessment of Adverse Reactions Caused by Contrast Media at the Hospital
Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya
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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media
Procedia PDF Downloads 30313517 Guillain Barre Syndrome in Children
Authors: A. Erragh, K. Amanzoui, M. Elharit, H. Salem, M. Ababneh, K. Elfakhr, S. Kalouch, A. Chlilek
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Guillain-Barre syndrome (GBS) is the most common form of acute polyradiculoneuritis (PRNA). It is a medical emergency in pediatrics that requires rapid diagnosis and immediate assessment of the severity criteria for the implementation of appropriate treatment. Retrospective, descriptive study in 24 patients under the age of 18 who presented with GBS between September 2017 and July 2021 and were hospitalized in the multipurpose pediatric intensive care unit of the Abderrahim EL Harouchi children's hospital in Casablanca. The average age was 7.91 years, with extremes ranging from 18 months and 14 years and a male predominance of 75%. After a prodromal event, most often infectious (80%) and a free interval of 12 days on average, 2 types of motor disorders begin either hypo or arereflectic flaccid paralysis of the lower limbs (45.8%) or flaccid quadriplegia hypo or arereflectic (54.2%). During GBS, the most formidable complication is respiratory distress, which can occur at any time. In our study, respiratory impairment was observed in 70.8% of cases. In addition, other signs of severity, such as swallowing disorders (75%) and dysautonomic disorders (8.33%), were also observed, which justified care in the intensive care unit for all of our patients. The use of invasive ventilation was necessary in 76.5% of cases, and specific treatments based on immunoglobulins were administered in all our patients. Despite everything, the death rate remains high (25%) and is mainly due to complications related to hospitalization. Guillain Barré syndrome is, therefore, a pediatric emergency that requires rapid diagnosis and immediate assessment of severity criteria for the implementation of appropriate treatment.Keywords: guillain barre syndrome, emergency, children, medical
Procedia PDF Downloads 7113516 Variable Renewable Energy Droughts in the Power Sector – A Model-based Analysis and Implications in the European Context
Authors: Martin Kittel, Alexander Roth
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The continuous integration of variable renewable energy sources (VRE) in the power sector is required for decarbonizing the European economy. Power sectors become increasingly exposed to weather variability, as the availability of VRE, i.e., mainly wind and solar photovoltaic, is not persistent. Extreme events, e.g., long-lasting periods of scarce VRE availability (‘VRE droughts’), challenge the reliability of supply. Properly accounting for the severity of VRE droughts is crucial for designing a resilient renewable European power sector. Energy system modeling is used to identify such a design. Our analysis reveals the sensitivity of the optimal design of the European power sector towards VRE droughts. We analyze how VRE droughts impact optimal power sector investments, especially in generation and flexibility capacity. We draw upon work that systematically identifies VRE drought patterns in Europe in terms of frequency, duration, and seasonality, as well as the cross-regional and cross-technological correlation of most extreme drought periods. Based on their analysis, the authors provide a selection of relevant historical weather years representing different grades of VRE drought severity. These weather years will serve as input for the capacity expansion model for the European power sector used in this analysis (DIETER). We additionally conduct robustness checks varying policy-relevant assumptions on capacity expansion limits, interconnections, and level of sector coupling. Preliminary results illustrate how an imprudent selection of weather years may cause underestimating the severity of VRE droughts, flawing modeling insights concerning the need for flexibility. Sub-optimal European power sector designs vulnerable to extreme weather can result. Using relevant weather years that appropriately represent extreme weather events, our analysis identifies a resilient design of the European power sector. Although the scope of this work is limited to the European power sector, we are confident that our insights apply to other regions of the world with similar weather patterns. Many energy system studies still rely on one or a limited number of sometimes arbitrarily chosen weather years. We argue that the deliberate selection of relevant weather years is imperative for robust modeling results.Keywords: energy systems, numerical optimization, variable renewable energy sources, energy drought, flexibility
Procedia PDF Downloads 7213515 Using Wearable Device with Neuron Network to Classify Severity of Sleep Disorder
Authors: Ru-Yin Yang, Chi Wu, Cheng-Yu Tsai, Yin-Tzu Lin, Wen-Te Liu
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Background: Sleep breathing disorder (SDB) is a condition demonstrated by recurrent episodes of the airway obstruction leading to intermittent hypoxia and quality fragmentation during sleep time. However, the procedures for SDB severity examination remain complicated and costly. Objective: The objective of this study is to establish a simplified examination method for SDB by the respiratory impendence pattern sensor combining the signal processing and machine learning model. Methodologies: We records heart rate variability by the electrocardiogram and respiratory pattern by impendence. After the polysomnography (PSG) been done with the diagnosis of SDB by the apnea and hypopnea index (AHI), we calculate the episodes with the absence of flow and arousal index (AI) from device record. Subjects were divided into training and testing groups. Neuron network was used to establish a prediction model to classify the severity of the SDB by the AI, episodes, and body profiles. The performance was evaluated by classification in the testing group compared with PSG. Results: In this study, we enrolled 66 subjects (Male/Female: 37/29; Age:49.9±13.2) with the diagnosis of SDB in a sleep center in Taipei city, Taiwan, from 2015 to 2016. The accuracy from the confusion matrix on the test group by NN is 71.94 %. Conclusion: Based on the models, we established a prediction model for SDB by means of the wearable sensor. With more cases incoming and training, this system may be used to rapidly and automatically screen the risk of SDB in the future.Keywords: sleep breathing disorder, apnea and hypopnea index, body parameters, neuron network
Procedia PDF Downloads 15013514 Causes of Deteriorations of Flexible Pavement, Its Condition Rating and Maintenance
Authors: Pooja Kherudkar, Namdeo Hedaoo
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There are various causes for asphalt pavement distresses which can develop prematurely or with aging in services. These causes are not limited to aging of bitumen binder but include poor quality materials and construction, inadequate mix design, inadequate pavement structure design considering the traffic and lack of preventive maintenance. There is physical evidence available for each type of pavement distress. Distress in asphalt pavements can be categorized in different distress modes like fracture (cracking and spalling), distortion (permanent deformation and slippage), and disintegration (raveling and potholes). This study shows the importance of severity determination of distresses for the selection of appropriate preventive maintenance treatment. Distress analysis of the deteriorated roads was carried out. Four roads of urban flexible pavements from Pune city was selected as a case study. The roads were surveyed to detect the types, to measure the severity and extent of the distresses. Causes of distresses were investigated. The pavement condition rating values of the roads were calculated. These ranges of ratings were as follows; 1 for poor condition road, 1.1 to 2 for fair condition road and 2.1 to 3 for good condition road. Out of the four roads, two roads were found to be in fair condition and the other two were found in good condition. From the various preventive maintenance treatments like crack seal, fog seal, slurry seal, microsurfacing, surface dressing and thin hot mix/cold mix bituminous overlays, the effective maintenance treatments with respect to the surface condition and severity levels of the existing pavement were recommended.Keywords: distress analysis, pavement condition rating, preventive maintenance treatments, surface distress measurement
Procedia PDF Downloads 19813513 Susceptibility Assessment and Genetic Diversity of Iranian and CIMMYT Wheat Genotypes to Common Root Rot Disease Bipolaris sorokiniana
Authors: Mehdi Nasr Esfahani, Abdal-Rasool Gholamalian, Abdelfattah A. Dababat
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Wheat, Triticum aestivum L. is one of the most important and strategic crops in the human diet. Several diseases threaten this particular crop. Common root rot disease of wheat by a fungal agent, Bipolaris sorokiniana is one of the important diseases, causing considerable losses worldwide. Resistant sources are the only feasible and effective method of control for managing diseases. In this study, the response of 33 domestic and exotic wheat genotypes, including cultivars and promising lines were screened to B. sorokiniana at greenhouse and field conditions, based on five scoring scale indexes of 0 to 100 severity percentage. The screening was continued on resistant wheat genotypes and repeated several times to confirm the greenhouse and field results. Statistical and cluster analysis of data was performed using SAS and SPSS software, respectively. The results showed that, the response of wheat genotypes to the disease in the greenhouse and field conditions was highly significant. The highest rate of common root rot disease infection, B. sorokiniana in the greenhouse and field, was of CVS. Karkheh and Beck Cross-Roshan with 60.83% and 59.16% disease severity respectively, and the lowest one were in cv. Alvand with 18.33%, followed by cv. Baharan with 19.16% disease severity, with a highly significant difference respectively. The remaining wheat genotypes were located in between these two highest and lowest infected groups to B. sorokiniana significantly. There was a high correlation coefficient between the related statistical groups and cluster analysis.Keywords: wheat, rot, root, crown, fungus, genotype, resistance
Procedia PDF Downloads 13413512 Annual and Seasonal Variations in Air Quality Index of the National Capital Region, India
Authors: Surinder Deswal, Vineet Verma
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Air Quality Index (AQI) is used as a tool to indicate the level of severity and disseminate the information on air pollution to enable the public to understand the health and environmental impacts of air pollutant concentration levels. The annual and seasonal variation of criteria air pollutants concentration based on the National Ambient Air Quality Monitoring Programme has been conducted for a period of nine years (2006-2014) using the AQI system. AQI was calculated using IND-AQI methodology and Maximum Operator Concept is applied. An attempt has been made to quantify the variations in AQI on an annual and seasonal basis over a period of nine years. Further, year-wise frequency of occurrence of AQI in each category for all the five stations is analysed, which presents in depth analysis of trends over the period of study. The best air quality was observed in the Noida residential area, followed by Noida industrial area during the study period; whereas, Bulandshahar industrial area and Faridabad residential area were observed to have the worst air quality. A shift in the worst air quality from winter to summer season has also been observed during the study period. Further, the level of Respirable Suspended Particulate Matter was found to be above permissible limit at all the stations. The present study helps in enhancing public awareness and calls for the need of immediate measures to be taken to counter-effect the cause of the increasing level of air pollution.Keywords: air quality index, annual trends, criteria pollutants, seasonal variation
Procedia PDF Downloads 28013511 Testing Plastic-Sand Construction Blocks Made from Recycled Polyethylene Terephthalate (rPET)
Authors: Cassi Henderson, Lucia Corsini, Shiv Kapila, Egle Augustaityte, Tsemaye Uwejamomere Zinzan Gurney, Aleyna Yildirim
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Plastic pollution is a major threat to human and planetary health. In Low- and Middle-Income Countries, plastic waste poses a major problem for marginalized populations who lack access to formal waste management systems. This study explores the potential for converting waste plastic into construction blocks. It is the first study to analyze the use of polyethylene terephthalate (PET) as a binder in plastic-sand bricks. Unlike previous studies of plastic sand-bricks, this research tests the properties of bricks that were made using a low-cost kiln technology that was co-designed with a rural, coastal community in Kenya. The mechanical strength, resistance to fire and water absorption properties of the bricks are tested in this study. The findings show that the bricks meet structural standards for mechanical performance, fire resistance and water absorption. It was found that 30:70 PET to sand demonstrated the best overall performance.Keywords: recycling, PET, plastic, sustainable construction, sustainable development
Procedia PDF Downloads 12513510 A Matched Case-Control Study to Asses the Association of Chikunguynya Severity among Blood Groups and Other Determinants in Tesseney, Gash Barka Zone, Eritrea
Authors: Ghirmay Teklemicheal, Samsom Mehari, Sara Tesfay
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Objectives: A total of 1074 suspected chikungunya cases were reported in Tesseney Province, Gash Barka region, Eritrea, during an outbreak. This study was aimed to assess the possible association of chikungunya severity among ABO blood groups and other potential determinants. Methods: A sex-matched and age-matched case-control study was conducted during the outbreak. For each case, one control subject had been selected from the mild Chikungunya cases. Along the same line of argument, a second control subject had also been designated through which neighborhood of cases were analyzed, scrutinized, and appeared to the scheme of comparison. Time is always the most sacrosanct element in pursuance of any study. According to the temporal calculation, this study was pursued from October 15, 2018, to November 15, 2018. Coming to the methodological dependability, calculating odds ratios (ORs) and conditional (fixed-effect) logistic regression methods were being applied. As a consequence of this, the data was analyzed and construed on the basis of the aforementioned methodological systems. Results: In this outbreak, 137 severe suspected chikungunya cases and 137 mild chikungunya suspected patients, and 137 controls free of chikungunya from the neighborhood of cases were analyzed. Non-O individuals compared to those with O blood group indicated as significant with a p-value of 0.002. Separate blood group comparison among A and O blood groups reflected as significant with a p-value of 0.002. However, there was no significant difference in the severity of chikungunya among B, AB, and O blood groups with a p-value of 0.113 and 0.708, respectively, and a strong association of chikungunya severity was found with hypertension and diabetes (p-value of < 0.0001); whereas, there was no association between chikungunya severity and asthma with a p-value of 0.695 and also no association with pregnancy (p-value =0.881), ventilator (p-value =0.181), air conditioner (p-value = 0.247), and didn’t use latrine and pit latrine (p-value = 0.318), among individuals using septic and pit latrine (p-value = 0.567) and also among individuals using flush and pit latrine (p-value = 0.194). Conclusions: Non- O blood groups were found to be at risk more than their counterpart O blood group individuals with severe form of chikungunya disease. By the same token, individuals with chronic disease were more prone to severe forms of the disease in comparison with individuals without chronic disease. Prioritization is recommended for patients with chronic diseases and non-O blood group since they are found to be susceptible to severe chikungunya disease. Identification of human cell surface receptor(s) for CHIKV is quite necessary for further understanding of its pathophysiology in humans. Therefore, molecular and functional studies will necessarily be helpful in disclosing the association of blood group antigens and CHIKV infections.Keywords: Chikungunya, Chikungunya virus, disease outbreaks, case-control studies, Eritrea
Procedia PDF Downloads 16213509 Comparison of Spiking Neuron Models in Terms of Biological Neuron Behaviours
Authors: Fikret Yalcinkaya, Hamza Unsal
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To understand how neurons work, it is required to combine experimental studies on neural science with numerical simulations of neuron models in a computer environment. In this regard, the simplicity and applicability of spiking neuron modeling functions have been of great interest in computational neuron science and numerical neuroscience in recent years. Spiking neuron models can be classified by exhibiting various neuronal behaviors, such as spiking and bursting. These classifications are important for researchers working on theoretical neuroscience. In this paper, three different spiking neuron models; Izhikevich, Adaptive Exponential Integrate Fire (AEIF) and Hindmarsh Rose (HR), which are based on first order differential equations, are discussed and compared. First, the physical meanings, derivatives, and differential equations of each model are provided and simulated in the Matlab environment. Then, by selecting appropriate parameters, the models were visually examined in the Matlab environment and it was aimed to demonstrate which model can simulate well-known biological neuron behaviours such as Tonic Spiking, Tonic Bursting, Mixed Mode Firing, Spike Frequency Adaptation, Resonator and Integrator. As a result, the Izhikevich model has been shown to perform Regular Spiking, Continuous Explosion, Intrinsically Bursting, Thalmo Cortical, Low-Threshold Spiking and Resonator. The Adaptive Exponential Integrate Fire model has been able to produce firing patterns such as Regular Ignition, Adaptive Ignition, Initially Explosive Ignition, Regular Explosive Ignition, Delayed Ignition, Delayed Regular Explosive Ignition, Temporary Ignition and Irregular Ignition. The Hindmarsh Rose model showed three different dynamic neuron behaviours; Spike, Burst and Chaotic. From these results, the Izhikevich cell model may be preferred due to its ability to reflect the true behavior of the nerve cell, the ability to produce different types of spikes, and the suitability for use in larger scale brain models. The most important reason for choosing the Adaptive Exponential Integrate Fire model is that it can create rich ignition patterns with fewer parameters. The chaotic behaviours of the Hindmarsh Rose neuron model, like some chaotic systems, is thought to be used in many scientific and engineering applications such as physics, secure communication and signal processing.Keywords: Izhikevich, adaptive exponential integrate fire, Hindmarsh Rose, biological neuron behaviours, spiking neuron models
Procedia PDF Downloads 18013508 Linguistic Competencies of Students with Hearing Impairment
Authors: Khalil Ullah Khan
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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in the recent era vow to have addressed the situation and claim significant contributions in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess the linguistic competencies of students with hearing impairment in the English language. The goals were further broken down to identify the level of reading abilities in the subject population. The population involved students with HI studying at a higher secondary level in Lahore. A simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with the accelerated learning program by the Punjab Government to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach the findings. Spearman’s correlation was used to find out the relationship between the degree of hearing loss, grade level, gender and type of amplification device. An Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify for an independent level of reading according to their grades, as the majority fall at the frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence, as it is shown in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade. Wise. However, scores could only correspond to frustration level, and independent levels were never achieved. Reported achievements at the instructional level of the subject population may further to linguistic skills if practiced purposively.Keywords: linguistic competence, hearing impairment, reading levels, educationist
Procedia PDF Downloads 4113507 Crash and Injury Characteristics of Riders in Motorcycle-Passenger Vehicle Crashes
Authors: Z. A. Ahmad Noor Syukri, A. J. Nawal Aswan, S. V. Wong
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The motorcycle has become one of the most common type of vehicles used on the road, particularly in the Asia region, including Malaysia, due to its size-convenience and affordable price. This study focuses only on crashes involving motorcycles with passenger cars consisting 43 real world crashes obtained from in-depth crash investigation process from June 2016 till July 2017. The study collected and analyzed vehicle and site parameters obtained during crash investigation and injury information acquired from the patient-treating hospital. The investigation team, consisting of two personnel, is stationed at the Emergency Department of the treatment facility, and was dispatched to the crash scene once receiving notification of the related crashes. The injury information retrieved was coded according to the level of severity using the Abbreviated Injury Scale (AIS) and classified into different body regions. The data revealed that weekend crashes were significantly higher for the night time period and the crash occurrence was the highest during morning hours (commuting to work period) for weekdays. Bad weather conditions play a minimal effect towards the occurrence of motorcycle – passenger vehicle crashes and nearly 90% involved motorcycles with single riders. Riders up to 25 years old are heavily involved in crashes with passenger vehicles (60%), followed by 26-55 year age group with 35%. Male riders were dominant in each of the age segments. The majority of the crashes involved side impacts, followed by rear impacts and cars outnumbered the rest of the passenger vehicle types in terms of crash involvement with motorcycles. The investigation data also revealed that passenger vehicles were the most at-fault counterpart (62%) when involved in crashes with motorcycles and most of the crashes involved situations whereby both of the vehicles are travelling in the same direction and one of the vehicles is in a turning maneuver. More than 80% of the involved motorcycle riders had sustained yellow severity level during triage process. The study also found that nearly 30% of the riders sustained injuries to the lower extremities, while MAIS level 3 injuries were recorded for all body regions except for thorax region. The result showed that crashes in which the motorcycles were found to be at fault were more likely to occur during night and raining conditions. These types of crashes were also found to be more likely to involve other types of passenger vehicles rather than cars and possess higher likelihood in resulting higher ISS (>6) value to the involved rider. To reduce motorcycle fatalities, it first has to understand the characteristics concerned and focus may be given on crashes involving passenger vehicles as the most dominant crash partner on Malaysian roads.Keywords: motorcycle crash, passenger vehicle, in-depth crash investigation, injury mechanism
Procedia PDF Downloads 32213506 Effect of Muscle Energy Technique on Anterior Pelvic Tilt in Lumbar Spondylosis Patients
Authors: Enas El Sayed Abutaleb, Mohamed Taher Eldesoky, Shahenda Abd El Rasol
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Background: Muscle energy techniques (MET) have been widely used by manual therapists over the past years, but still limited research validated its use and there was limited evidence to substantiate the theories used to explain its effects. Objective: To investigate the effect of muscle energy technique (MET) on anterior pelvic tilt in patients with lumbar spondylosis. Design: Randomized controlled trial. Subjects: Thirty patients with anterior pelvic tilt from both sexes were involved, aged between 35 to 50 years old and they were divided into MET and control groups with 15 patients in each. Methods: All patients received 3 sessions/week for 4 weeks where the study group received MET, Ultrasound and Infrared, and the control group received U.S and I.R only. Pelvic angle was measured by palpation meter, pain severity by the visual analogue scale and functional disabilities by the Oswestry disability index. Results: Both groups showed significant improvement in all measured variables. The MET group was significantly better than the control group in pelvic angle, pain severity, and functional disability as p-value were (0.001, 0.0001, 0.0001) respectively. Conclusion and implication: The study group fulfilled greater improvement in all measured variables than the control group which implies that application of MET in combination with U.S and I.R were more effective in improving pelvic tilting angle, pain severity and functional disabilities than using electrotherapy only.Keywords: anterior pelvic tilt, lumbar spondylosis, muscle energy technique exercise, pelvic tilting angle
Procedia PDF Downloads 39513505 How Unpleasant Emotions, Morals and Normative Beliefs of Severity Relate to Cyberbullying Intentions
Authors: Paula C. Ferreira, Ana Margarida Veiga Simão, Nádia Pereira, Aristides Ferreira, Alexandra Marques Pinto, Alexandra Barros, Vitor Martinho
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Cyberbullying is a phenomenon of worldwide concern regarding children and adolescents’ mental health and risk behavior. Bystanders of this phenomenon can help diminish the incidence of this phenomenon if they engage in pro-social behavior. However, different social-cognitive and affective bystander reactions may surface because of the lack of contextual information and emotional cues in cyberbullying situations. Hence, this study investigated how cyberbullying bystanders’ unpleasant emotions could be related to their personal moral beliefs and their behavioral intentions to cyberbully or defend the victim. It also proposed to investigate how their normative beliefs of perceived severity about cyberbullying behavior could be related to their personal moral beliefs and their behavioral intentions. Three groups of adolescents participated in this study, namely a first of group 402 students (5th – 12th graders; Mage = 13.12; SD = 2.19; 55.7% girls) to compute explorative factorial analyses of the instruments used; a second group of 676 students (5th – 12th graders; Mage = 14.10; SD = 2.74; 55.5% were boys) to run confirmatory factor analyses; and a third group (N = 397; 5th – 12th graders; Mage = 13.88 years; SD = 1.45; 55.5% girls) to perform the main analyses to test the research hypotheses. Self-report measures were used, such as the Personal moral beliefs about cyberbullying behavior questionnaire, the Normative beliefs of perceived severity about cyberbullying behavior questionnaire, the Unpleasant emotions about cyberbullying incidents questionnaires, and the Bystanders’ behavioral intentions in cyberbullying situations questionnaires. Path analysis results revealed that unpleasant emotions were mediators of the relationship between adolescent cyberbullying bystanders’ personal moral beliefs and their intentions to help the victims in cyberbullying situations. Moreover, adolescent cyberbullying bystanders’ normative beliefs of gravity were mediators of the relationship between their personal moral beliefs and their intentions to cyberbully others. These findings provide insights for the development of prevention and intervention programs that promote social and emotional learning strategies as a means to prevent and intervene in cyberbullying.Keywords: cyberbullying, normative beliefs of perceived severity, personal moral beliefs, unpleasant emotions
Procedia PDF Downloads 21613504 Disaster Education and Children with Visual Impairment
Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri
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This study describes a series of learning workshops, which took place within CUIDAR project. The workshops aimed to empower children to share their experiences and views in relation to natural hazards and disasters. The participants in the workshops were ten primary school students who had severe visual impairments or multiple disabilities and visual impairments (MDVI). The main objectives of the workshops were: a) to promote access of the children through the use of appropriate educational material such as texts in braille, enlarged text, tactile maps and the implementation of differentiated instruction, b) to make children aware regarding their rights to have access to information and to participate in planning and decision-making especially in relation to disaster education programs, and c) to encourage children to have an active role during the workshops through child-led and experiential learning activities. The children expressed their views regarding the meaning of hazards and disasters. Following, they discussed their experiences and emotions regarding natural hazards and disasters, and they chose to place the emphasis on a hazard, which was more pertinent to them, their community and their region, namely fires. Therefore, they recalled fires that have caused major disasters, and they discussed about the impact that these fires had on their community or on their country. Furthermore, they were encouraged to become aware regarding their own role and responsibility to prevent a fire or get prepared and know how to behave if a fire occurs. They realized that prevention and preparation are a matter of personal responsibility. They also felt the responsibility to inform their own families. Finally, they met important people involved in fire protection such as rescuers and firefighters and had the opportunity to carry dialogues. In conclusion, through child led workshops, experiential and accessible activities, the students had the opportunity to share their own experiences, to express their views and their questions, to broaden their knowledge and to realize their personal responsibility in disaster risk reduction, specifically in relation to fires.Keywords: accessibility, children, disasters, visual impairment
Procedia PDF Downloads 21313503 The Association among Obesity, Lipid Profiles and Depression Severity in Patients with Depressive Disorder
Authors: In Hee Shim, Dong Sik Bae
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Introduction: Obesity and unfavorable lipid profile may be linked to depressive disorders. This study compared the levels of obesity, lipid profiles and depression severity of patients with depressive disorders. Methods: This study included 156 patients diagnosed with a depressive disorder who were hospitalized between March 2012 and February 2016. The patients were categorized into mild to moderate and severe depressive groups, based on Hamilton Depression Rating Scale scores (Mild to moderate depression 8-23 vs. severe depression ≥ 24). The charts of the patients were reviewed to evaluate body mass index and lipid profiles, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TG), confounding factors, such as other general medical disorders (hypertension, diabetes mellitus, and dyslipidemia), except smoking status (insufficient data). Demographic and clinical characteristics, such as age, sex, comorbidities, family history of mood disorders, psychotic features, and prescription patterns were also assessed. Results: Compared to the mild to the moderate depressive group, patients with severe depression had significantly lower rate of male and comorbidity. The patients with severe depression had a significantly lower TG than patients in the mild to moderate depressive group. After adjustment for the sex and comorbidity, there were no significant differences between the two groups in terms of the obesity and lipid profiles, including TG. Conclusion: These results did not show a significant difference in the association between obesity, lipid profiles and the depression severity. The role of obesity and lipid profiles in the pathophysiology of depression remains to be clarified.Keywords: depression, HAM-D, lipid profiles, obesity
Procedia PDF Downloads 28813502 The Test of Memory Malingering and Offence Severity
Authors: Kenji Gwee
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In Singapore, the death penalty remains in active use for murder and drug trafficking of controlled drugs such as heroin. As such, the psychological assessment of defendants can often be of high stakes. The Test of Memory Malingering (TOMM) is employed by government psychologists to determine the degree of effort invested by defendants, which in turn inform on the veracity of overall psychological findings that can invariably determine the life and death of defendants. The purpose of this study was to find out if defendants facing the death penalty were more likely to invest less effort during psychological assessment (to fake bad in hopes of escaping the death sentence) compared to defendants facing lesser penalties. An archival search of all forensic cases assessed in 2012-2013 by Singapore’s designated forensic psychiatric facility yielded 186 defendants’ TOMM scores. Offence severity, coded into 6 rank-ordered categories, was analyzed in a one-way ANOVA with TOMM score as the dependent variable. There was a statistically significant difference (F(5,87) = 2.473, p = 0.038). A Tukey post-hoc test with Bonferroni correction revealed that defendants facing lower charges (Theft, shoplifting, criminal breach of trust) invested less test-taking effort (TOMM = 37.4±12.3, p = 0.033) compared to those facing the death penalty (TOMM = 46.2±8.1). The surprising finding that those facing death penalties actually invested more test taking effort than those facing relatively minor charges could be due to higher levels of cooperation when faced with death. Alternatively, other legal avenues to escape the death sentence may have been preferred over the mitigatory chance of a psychiatric defence.Keywords: capital sentencing, offence severity, Singapore, Test of Memory Malingering
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