Search results for: ethically problematic situations in clinical psychology

Authors: Heidi Ahonen

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Since antiquity, many cultures have seemingly known the power of low frequencies, incorporating them in healing practices through drumming, singing, humming, etc. Many music therapists recognize there is something in music that is transformative enough to make a difference in people’s lives. This paper summarizes the key findings of several low-frequency research with various client populations conducted by the author. Utilizing low-frequency sound (30 or 40 Hz) may have diverse therapeutic impacts: (1) Calming effect – decreased agitation (autism, brain injury, AD, dementia) (2) Muscle relaxation (CP & spasticity & pain/after surgery patients, MS, fibromyalgia) (3) Relaxation/stress release (anxiety, stress, PTSD, trauma, insomnia) (4) Muscular/motor functioning/ decrease of tremor (CP, MS, Parkinson) (5) Increase in alertness, cognitive awareness & short-term memory function (brain injury, severe global developmental delay, AD) (6) Increased focus (AD, PTSD, trauma). The paper will conclude by presenting ideas informing the clinical practice. Future studies need to investigate what frequencies are effective for particular client populations and why, what theories can explain the effect, and finally, something that has been long debated - is it auditive or kinaesthetic stimulation or the combination of both that is effective?

Keywords: low frequency, 40 Hz, sound, neuro disability

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Authors: Ghazal Doostmohammadi, Susan Rahimzadeh

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Aim: This research aimed to investigate the relationship between empathy and interpersonal trust and recognize the mediating role of loneliness between them in both genders. Methods: With a correlational descriptive design, 192 university students (130 female and 62 male) responded to the questionnaires on “empathy quotient,” “loneliness,” and “interpersonal trust” tests. These tests were designed and validated by experts in the field. Data were analysed using Pearson correlation and path analysis, which is a statistical technique that uses standard linear regression equations to determine the degree of conformity of a theoretical causal model with reality. Results: The data analysis showed that there was no significant correlation between interpersonal trust, both with loneliness (t=0.169) and empathy (t=0.186), while there was a significant negative correlation (t=0.359) between empathy and loneliness. This means that there is an inverse correlation between empathy and loneliness. The path analysis confirmed the hypothesis of the research about the mediating role of loneliness between empathy and interpersonal trust. But gender did not play a role in this relationship. Conclusion: As an outcome, clinical professionals and education trainers should pay more attention to interpersonal trust as a basic need and try to recreate and shape it to prevent people's social breakdown, and on the other hand, self-disclosure training (especially in Men), expression of feelings and courage should be given double importance to prevent the consequences of loneliness.

Keywords: empathy, loneliness, interpersonal trust, gender

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Authors: Ojo Oo, Akinde S. B., Kiilani A. O., Jayeola Jo, Jogbodo T. M., Ajani Ka, Olaniyan So, Adeagbo Oy, Bolarinwa Ra, Durosomo Ha, Sule W. F.

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Lockdown imposed to control SARS-CoV-2 transmission hampered malaria control services in Nigeria. Considering COVID-19 vaccination, we assessed Plasmodium falciparum (Pf) antigen and SARS-CoV-2 immunoglobulin-G (IgG) positivity among adults in Osogbo, Osun State, Nigeria. Consenting attendees of four Healthcare Centres were consecutively enrolled for blood sampling; relevant socio-demographic/behavioral/clinical/environmental data were collected with a questionnaire. Samples were tested, using commercial rapid test kits, for Pf antigen and SARS-CoV-2 IgG and results were analyzed using logistic regression. Participants' mean age was 40.99 years (n=200), and they were predominantly females (84.5%), traders/businessmen/women (86.0%), with self-reported receipt of COVID-19 vaccine from 123 (61.5%). Pf antigen positivity was 17.5% (95% CI: 12.23–22.77%) with age (p=0.004), marital status (p=0.004), report of stagnant water around the workplace (p=0.041) and bush around homes (p=0.008) being associated. SARS-CoV-2 IgG positivity was 56.5% (95% CI: 49.63–63.37%) with age (p=0.012) and receipt of COVID-19 vaccination (p=0.001) being associated. Although the vaccinated had a 22.8 times higher likelihood of IgG positivity, no factor was predictive of COVID-19 vaccine receipt. We report 17.5% Pf antigen positivity with four predictors, and 56.5% SARS-CoV-2 IgG positivity with two predictors.

Keywords: COVID-19, vaccine, IgG, Plasmodium falciparum, SARS-CoV-2

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Authors: A. Bhattacharya, Sanjay Gupta, S. H. Bodakhe

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HbA1c is form of the haemoglobin that is used to measure the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, and retinopathy. Guraku’s basic components are nicotine and jaggery, jaggery is made up of sugarcane so can have a diabetogenic potential which is exacerbated in presence of nicotine. This work had done with the aim to find correlation between Diabetic cataract, HbA1c and Guraku. Subjects were enrolled according to the inclusion and exclusion criteria. In this study total 75 subjects were included. In the study it was found that people consuming Guraku had a high level of HbA1c thus are more prone to the development of diabetic cataract. Male subjects are the more than female subjects. Most of the subjects belong to the lower socioeconomical class and not very educated. It could be concluded that this type of study could be useful in indentifying number of subjects suffering from diabetic cataract whose condition get worse by use of nicotine product like Guraku and preventive measure to be taken in prevention of this type of diabetic complication.

Keywords: diabetic cataract, HbA1c, Guraku, diabetogenic potential

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Authors: Sammy Xiaoyan Ying

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Professional skepticism remains one of the most important and controversial topics in auditing. This study examines the influence of client cooperativeness and fraud risk on judgments of professional skepticism among Chinese entry-level auditors in the context of evaluation of client-provided audit evidence. Given that the essence of auditors’ PS rests on distrust of clients, this study invokes trust-related theories from psychological and cultural perspectives. Specifically, invoking psychology theories of trust concerning positive relationship between risk and distrust, this study hypothesizes that professional skepticism is likely to be positively associated with client fraud risk. The results support the hypothesis and show that lower (higher) levels of client fraud risk lead to lower (higher) levels of professional skepticism. Furthermore, drawing on analysis of relationship between cooperation and trust, with particular reference to guanxi dynamics in the Chinese culture, this study hypothesizes that professional skepticism is likely to be negatively associated with client cooperativeness. The results support the hypothesis and show that higher (lower) levels of client cooperativeness lead to lower (higher) levels of professional skepticism. The findings may assist audit firms and auditing educators in improving training and education programs and enhancing entry-level auditors’ abilities to maintain professional skepticism. Also, practitioners and regulators may benefit from increasing awareness of psychological factors in influencing professional skepticism.

Keywords: audit judgment, Chinese culture, entry-level auditor, professional skepticism

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Authors: Grange Sylvain, Plancher Ronan, Reurink Guustav, Croisille Pierre, Edouard Pascal

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The primary objective of this study was to analyze the potential correlation between the pain experienced at the time of a hamstring muscle injury and the volume of the lesion measured on MRI. The secondary objectives were to analyze a correlation between this pain and the lesion grade as well as the affected hamstring muscle. We performed a retrospective analysis of the data collected in a prospective, multicenter, non-interventional cohort study (HAMMER). Patients with suspected hamstring muscle injury had an MRI after the injury and at the same time were evaluated for their pain intensity experienced at the time of the injury with a Numerical Pain Rating Scale (NPRS) from 0 to 10. A total of 61 patients were included in the present analysis. MRIs were performed in an average of less than 8 days. There was a significant correlation between pain and the injury volume (r=0.287; p=0.025). There was no significant correlation between the pain and the lesion grade (p>0.05), nor between the pain and affected hamstring muscle (p>0.05). Pain at the time of injury appeared to be correlated with the volume of muscle affected. These results confirm the value of a clinical approach in the initial evaluation of hamstring injuries to better select patients eligible for further imaging.

Keywords: hamstring muscle injury, MRI, volume lesion, pain

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Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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Authors: Bhavna Rajagopal, Mrinmoyi Kulkarni

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Today women experience more menstrual cycles than their ancestors did a hundred years ago, owing to early puberty, fewer pregnancies and dietary changes. Much of the research in menstruation is located in the medical domain with a focus on physical symptoms. The research in psychology is largely concerned with premenstrual syndrome (PMS), whereas the focus in sociology is on social and cultural practices relating to menstruation. Research that simultaneously studies the physical, psychological, social and cultural aspects is lacking. Therefore, in this study, an attempt has been made to identify socio-cultural, psychological and physical factors that interact to influence a woman’s experience of menstruation in the urban setting. The study included seven unmarried women in the age group of 24-30 and data was obtained through a focus group discussion. The transcript of the focus group discussion was thematically analysed. Two major themes relating to the self and social experience of menstruation emerged. Themes relating to the self included menarcheal experiences, self-perception, mood and management of menstrual hygiene and symptoms while themes relating to social experience included the construction of menstruation by family and peers, and cultural factors. Attitudes towards the menstrual cycle appeared to be primarily influenced by severity of symptoms and the resulting disruption to daily life. Outcomes of this study have indicated that future research needs to study menstruation and its impact on women’s wellbeing by adopting a socio-ecological approach and by collecting data using the whole cycle approach across a woman’s reproductive years.

Keywords: India, menstrual cycle, psychosocial approach, wellbeing

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Authors: Singh Baljinder, Sharma Navneet

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Microalbuminuria is the earliest detectable marker of diabetic nephropathy. We planned to evaluate the prevalence of microalbuminuria in type 1 diabetics and correlate with various risk factor. We randomly selected 100 type 1 diabetic patients after inclusion and exclusion criteria from DCRC, S. P. Medical College, Bikaner. Clinical examinations for anthropometeric parameters, hypertension, retinopathy, glycaemic status, lipid profile were done and microalbuminuria was estimated by micral test. Microalbuminuria was seen in 38% patients. The mean urinary albumin concentration was 96.61 mg/l in microalbuminuria positive cases, 134 mg/L in hypertensive patients while 74.5 mg/L in normal patients. Mean diabetic duration was 6.43 years in microalbuminurics. Albumin excretion increased significantly with age at onset of 10-18 years and declined thereafter. Microalbuminuria cases exhibited mean cholesterol 181.63 mg%, TG 130.94 mg%, LDL 109.87 mg%, HDL 57.5 mg% and VLDL 30.64 mg%. Mean urinary albumin concentration in patients with retinopathy was 160.52 mg/L while 78.66 mg/L without retinopathy. In multiple stepwise logistic regression analysis, a strong positive association was seen between microalbuminuria and hypertension (OR=5.087, CI=2.1319-12.101), fasting blood sugar (OR=3. 491, CI=1.138-10.70), duration of diabetes (OR=3.41, CI=1.360-8.55) and HbA1c (OR=2.381, CI-=1.1-5.64). The present study indicates that microalbuminuria is a common complication of type 1 diabetes mellitus and can be prevented by careful management of risk factors.

Keywords: type 1 diabetes, microalbuminuria, diabetic nephropathy, retinopathy, hypertension

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Jodie Hughes

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Endometriosis affects 1 in 10 individuals that were born female globally. Endometriosis incidence rates peak between 30-40 year of age, in young women and adolescents it is a rarely suspected and often ill-diagnosed. The average cost of endometriosis is €9,579 per woman. More than 75% of women have reported being absent from work due to endometriosis, with 40% of women becoming unemployed due to the disease. 46% of patients with endometriosis need to have appointments with upward of five doctors to gain a correct diagnosis. Quantitative data were collected by way of an online PSS-10 survey that included demographic questions from two sample groups of females, group 1 was females with endometriosis, group 2 were healthy women. The data were scored using Cohens scoring system, overall scores were input to SPSS. A non-parametric Mann-Whitney U test and ANOVA was used to ascertain any differences between the PSS-10 scores of the two groups. A significance level of P<0.05 was adopted. Four women were invited to take part in a semi structured interview that was recorded, transcribed and coded using interpretive phenomenological analysis (IPA) using NVivo 12. Results showed that the PSS-10 scores were significantly higher in women with endometriosis compared to healthy women with a p=<0.005. Endometriosis affects all aspects of a patient’s life, to adequately diagnose and treat the condition and improve HRQoL there needs to be better understanding of the clinical symptoms and how they impact the lives of patients.

Keywords: endometriosis, HRQoL, perceived stress, women

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Authors: Nuhi Arslani, Stojan Potrc, Timotej Mikuljan

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Background: In Department of Abdominal and General Surgery of University Medical Centre Maribor, we treated 578 patients for rectal cancer between 2004 and 2014. During and after treatment we especially concentrated on monitoring local and systemic complications. Methods: For analysis, we used data gathered from preoperative diagnostic tests, reports gathered during operation, reports from the pathohistologic review, and reports on complications after surgery and follow up. Results: In the case of 573 (out of 578) patients (99.1%) we performed resection. R0 was achieved in 551 patients (96,1%). R1 was achieved in 8 patients (1,4%). R2 was achieved in 14 patients (2,4%). Local complications were reported in 78 (13.5%) patients and systemic complications were reported in 68 (11.7%). We would like to point out the low number of local and systemic complications. Conclusions: With advances in surgical techniques, with a multimodal-multidisciplinary approach and with the use of total mesorectal excision we experienced a significant improvement in reducing the number of local and systemic complications in patients with rectal cancer. However, there still remains the question for truly optimal care for each patient with rectal cancer and his quality of life after surgical treatment.

Keywords: local complications, rectal cancer, resection, systemic complications

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Authors: Nerissa Gloria Balboa, Aire Yukdawan, Venice Gordula, Rhea Jannagen Curva

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This research examined the lived experiences and compared their similarities and differences of former Catholics turned Muslim converts in and out of prison. Qualitative comparative study with an Interpretative Phenomenological Analysis approach was used to explore the lives of Muslim converts. Interviews were conducted at Islamic Studies, Call and Guidance of the Philippines (ISCAG) and Tarbiyyah Islamic Female Institute for Muslim converts out of prison, New Bilibid Prison (NBP) and Correctional Institution for Women (CIW) for Muslim converts in prison. Results of the study show that first, for Muslim converts out of prison, exploration begins through (1) experiences of Catholicism as a norm in the family and eventual realization of its emptiness in practice, (2) experiences of Islam as a norm in the environment and discovery of meaningfulness of Islam (3) experiences of gradual holistic transformation of being a Muslim; and (4) experiences of extension of oneself towards family and society. Secondly, for Muslim converts in prison, exploration begins through (1) experiences of Apathy towards Catholicism and eventual deviation from moral standards, (2) experiences of prison condition as an environment of reflection on spirituality; and (3) experiences of positive effects of being a Muslim inside Prison. Comparisons show that there exists similarities and differences across the two settings in terms of (1) experiences of Catholicism and the degree of its internalization and actualization, (2) experiences of Islamic encounters and the process of conversion; and (3) experience of Islamic devotion and Islamic construct for the self. Theoretical bases of religious conversion found in unique contexts are discussed, initiating a paradigm shift of thinking that is needed to address the deeply rooted prejudices within Catholic and Islamic circles.

Keywords: Catholicism, Islamic conversion, social psychology, religion

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Authors: Wenxiao Liu, Kun Zhang, Yongqing Li

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Bovine herpesvirus 1, a member of the genus Variellovirus of the subfamily Alphaherpesvirinae, has caused severe economic cost to the bovine industry. In this study, BoHV-1 glycerol protein gD was expressed in insect cells, and the purified gD was immunized in the Balb/C mice to generate monoclonal antibodies. Based on hybridoma cell fusion techniques, 20 monoclonal antibodies against Bovine herpesvirus 1 have been obtained. Further, mAb 3F8 with neutralizing activity and gD were applied to develop a blocking enzyme-linked immunosorbent assay (Elisa) for detecting neutralizing antibodies against BoHV-1, which shows a significant correlation between the blocking Elisa and VNT. The sensitivity and specificity of the test were estimated to be 94.59% and 93.42%, respectively. Furthermore, antibody pairing tests revealed that mAb 1B6 conjugated to fluorescence microspheres was used as the capture antibody, and mAb 3F9 was used as the detectable antibody to establish the immunochromatographic assay (ICS). The ICS was conducted to detect BoHV-1 in bovine samples with high sensitivity, specificity, and good stability. Clinical sample testing revealed that the results of ICS and real-time PCR have a coincidence rate of 95.42%. Our research confirmed that the ICS is a rapid and reliable method for the diagnosis of BoHV-1. In conclusion, our results lay a solid foundation for the prevention and control of BoHV-1 infection.

Keywords: bovine disease, BoHV-1, ELISA, ICS assay

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Authors: Kashima Arora, Monika Tomar, Vinay Gupta

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Biosensors have found potential applications ranging from environmental testing and biowarfare agent detection to clinical testing, health care, and cell analysis. This is driven in part by the desire to decrease the cost of health care and to obtain precise information more quickly about the health status of patient by the development of various biosensors, which has become increasingly prevalent in clinical testing and point of care testing for a wide range of biological elements. Uric acid is an important byproduct in human body and a number of pathological disorders are related to its high concentration in human body. In past few years, rapid growth in the development of new materials and improvements in sensing techniques have led to the evolution of advanced biosensors. In this context, metal oxide thin film based matrices due to their bio compatible nature, strong adsorption ability, high isoelectric point (IEP) and abundance in nature have become the materials of choice for recent technological advances in biotechnology. In the past few years, wide band-gap metal oxide semiconductors including ZnO, SnO₂ and CeO₂ have gained much attention as a matrix for immobilization of various biomolecules. Tin oxide (SnO₂), wide band gap semiconductor (Eg =3.87 eV), despite having multifunctional properties for broad range of applications including transparent electronics, gas sensors, acoustic devices, UV photodetectors, etc., it has not been explored much for biosensing purpose. To realize a high performance miniaturized biomolecular electronic device, rf sputtering technique is considered to be the most promising for the reproducible growth of good quality thin films, controlled surface morphology and desired film crystallization with improved electron transfer property. Recently, iron oxide and its composites have been widely used as matrix for biosensing application which exploits the electron communication feature of Fe, for the detection of various analytes using urea, hemoglobin, glucose, phenol, L-lactate, H₂O₂, etc. However, to the authors’ knowledge, no work is being reported on modifying the electronic properties of SnO₂ by implanting with suitable metal (Fe) to induce the redox couple in it and utilizing it for reagentless detection of uric acid. In present study, Fe implanted SnO₂ based matrix has been utilized for reagentless uric acid biosensor. Implantation of Fe into SnO₂ matrix is confirmed by energy-dispersive X-Ray spectroscopy (EDX) analysis. Electrochemical techniques have been used to study the response characteristics of Fe modified SnO₂ matrix before and after uricase immobilization. The developed uric acid biosensor exhibits a high sensitivity to about 0.21 mA/mM and a linear variation in current response over concentration range from 0.05 to 1.0 mM of uric acid besides high shelf life (~20 weeks). The Michaelis-Menten kinetic parameter (Km) is found to be relatively very low (0.23 mM), which indicates high affinity of the fabricated bioelectrode towards uric acid (analyte). Also, the presence of other interferents present in human serum has negligible effect on the performance of biosensor. Hence, obtained results highlight the importance of implanted Fe:SnO₂ thin film as an attractive matrix for realization of reagentless biosensors towards uric acid.

Keywords: Fe implanted tin oxide, reagentless uric acid biosensor, rf sputtering, thin film

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Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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Authors: Ibeku Bernadine Ezenwanyi

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Hospital-Acquired Infections (HAI), also called ‘Nosocomial Infection’ is an infection you get while in the hospital for another reason. They are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes of some instruments used on patients especially catheter that was passed on them during their stay in the hospital. It was discovered that they had catheter–associated urinary tract infection (CAUTI). An observational study was carried out from January to March, 2022, on 180 patients (80 males and 100 females) admitted in the surgical wards, medical wards, dialysis unit and intensive care unit (ICU) of the hospital. The patient’s urine samples were collected for urine culture and the isolation was carried out using plate count agar medium and macconkey agar. Among the 80 males, 45 had Urinary Tract Infections (UTI) mostly proteus infection and among the 100 females, 70 also had (UTI) and the most common was caused by Escherichia coli. Other strain of microorganisms such as Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa. It is important to follow up patients that these devices were used on with antibiotics to make sure that these infections are not developed because the rate of these infections (UTI) are high especially in females.

Keywords: catheter, urinary tract infection, nosocomial infection, microorganisms

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Authors: Amal A. Qedrah, Sofia A. Malik, Madiha Akbar

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The aim of this article is to share a rare clinical case of pregnancy and surgical delivery in a patient who has undergone augmentation cystoplasty with mitrofanoff channel in the past. Methods: This case report is about a woman who conceived naturally at the age of 27, previously underwent augmentation cystoplasty at the age of 10 years with mitrofanoff procedure using self-clean intermittent catheterization. Furthermore, this pregnancy was complicated by the presence of preeclampsia diagnosed at term and PROM. Following the failure of induction for intrapartum preeclampsia, the patient delivered a healthy baby via low transverse cesarean section at 38 weeks done at Latifa Hospital, Dubai. Conclusion: The procedure is done at a pediatric or young age, after which most patients reach reproductive age. There is no contraindication to pregnancy vaginally or surgically; however, this case was complicated by preeclampsia, due to which this patient was taken for a cesarean section. It is advisable to consult a urologist frequently along with taking regular bacteriological urine samples and blood samples with renal ultrasonography for the evaluation of the kidney. Antibacterial treatment or prophylaxis should be used during pregnancy if necessary and intermittent self-catherization is mostly performed routinely. It is also important to have a urologist on standby during the surgery in order to avoid and/or fix any complications that might come forth.

Keywords: augmentation cystoplasty, cesarean section, delivery, mitrofanoff channel

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Authors: Hua Cao, Laurent Peyrodie, Olivier Agnani, Cecile Donze

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Multiple sclerosis (MS) is a disease, which affects the central nervous system, and causes balance problem. In clinical, this disorder is usually evaluated using static posturography. Some linear or nonlinear measures, extracted from the posturographic data (i.e. center of pressure, COP) recorded during a balance test, has been used to analyze postural control of MS patients. In this study, the trend (TREND) and the sample entropy (SampEn), two nonlinear parameters were chosen to investigate their relationships with the expanded disability status scale (EDSS) score. Forty volunteers with different EDSS scores participated in our experiments with eyes open (EO) and closed (EC). TREND and two types of SampEn (SampEn1 and SampEn2) were calculated for each combined COP’s position signal. The results have shown that TREND had a weak negative correlation to EDSS while SampEn2 had a strong positive correlation to EDSS. Compared to TREND and SampEn1, SampEn2 showed a better significant correlation to EDSS and an ability to discriminate the MS patients in the EC case. In addition, the outcome of the study suggests that the multi-dimensional nonlinear analysis could provide some information about the impact of disability progression in MS on dynamics of the COP data.

Keywords: balance, multiple sclerosis, nonlinear analysis, postural sway

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Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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Authors: Narin Ozturk, Xiao-Mei Li, Sylvie Giachetti, Francis Levi, Alper Okyar

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P-glycoprotein (P-gp, MDR1, ABCB1) is a transmembrane protein acting as an ATP-dependent efflux pump and functions as a biological barrier by extruding drugs and xenobiotics out of cells in healthy tissues especially in intestines, liver and brain as well as in tumor cells. The circadian timing system controls a variety of biological functions in mammals including xenobiotic metabolism and detoxification, proliferation and cell cycle events, and may affect pharmacokinetics, toxicity and efficacy of drugs. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer drug that is active against many cancers, and its pharmacokinetics depend on P-gp. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus with respect to the intestinal P-gp expression rhythms in mdr1a::Luc mice using Real Time-Biolumicorder (RT-BIO) System. Mdr1a::Luc male mice were synchronized with 12 h of Light and 12 h of Dark (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding Light onset). After 1-week baseline recordings, everolimus (5 mg/kg/day x 14 days) was administered orally at ZT1-resting period- and ZT13-activity period- to mdr1a::Luc mice singly housed in an innovative monitoring device, Real Time-Biolumicorder units which let us monitor real-time and long-term gene expression in freely moving mice. D-luciferin (1.5 mg/mL) was dissolved in drinking water. Mouse intestinal mdr1a::Luc oscillation profile reflecting P-gp gene expression and locomotor activity pattern were recorded every minute with the photomultiplier tube and infrared sensor respectively. General behavior and clinical signs were monitored, and body weight was measured every day as an index of toxicity. Drug-induced body weight change was expressed relative to body weight on the initial treatment day. Statistical significance of differences between groups was validated with ANOVA. Circadian rhythms were validated with Cosinor Analysis. Everolimus toxicity changed as a function of drug timing, which was least following dosing at ZT13, near the onset of the activity span in male mice. Mean body weight loss was nearly twice as large in mice treated with 5 mg/kg everolimus at ZT1 as compared to ZT13 (8.9% vs. 5.4%; ANOVA, p < 0.001). Based on the body weight loss and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13. Both rest-activity and mdr1a::Luc expression displayed stable 24-h periodic rhythms before everolimus and in both vehicle-treated controls. Real-time bioluminescence pattern of mdr1a revealed a circadian rhythm with a 24-h period with an acrophase at ZT16 (Cosinor, p < 0.001). Mdr1a expression remained rhythmic in everolimus-treated mice, whereas down-regulation was observed in P-gp expression in 2 of 4 mice. The study identified the circadian pattern of intestinal P-gp expression with an unprecedented precision. The circadian timing depending on the P-gp expression rhythms may play a crucial role in the tolerability/toxicity of everolimus. The circadian changes in mdr1a genes deserve further studies regarding their relevance for in vitro and in vivo chronotolerance of mdr1a-transported anticancer drugs. Chronotherapy with P-gp-effluxed anticancer drugs could then be applied according to their rhythmic patterns in host and tumor to jointly maximize treatment efficacy and minimize toxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, mdr1a::Luc mice, p-glycoprotein

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Authors: Jean-Francois Feller

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The analysis of the volatolome emitted by the human body with a sensor array (e-nose) is a method for clinical applications full of promises to make an olfactive fingerprint characteristic of people's health state. But the amount of volatile organic compounds (VOC) to detect, being in the range of parts per billion (ppb), and their diversity (several hundred) justifies developing ever more sensitive and selective vapor sensors to improve the discrimination ability of the e-nose, is still of interest. Quantum resistive vapour sensors (vQRS) made with nanostructured conductive polymer nanocomposite transducers have shown a great versatility in both their fabrication and operation to detect volatiles of interest such as cancer biomarkers. However, it has been shown that their chemo-resistive response was highly dependent on the quality of the inter-particular junctions in the percolated architecture. The present work investigates the effectiveness of poly(hedral oligomeric silsesquioxane) acting as a nanospacer to amplify the disconnectability of the conducting network and thus maximize the vQRS's sensitivity to VOC.

Keywords: volatolome, quantum resistive vapour sensor, nanostructured conductive polymer nanocomposites, olfactive diagnosis

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Authors: Muhammad Awais Afzal, Lorena Tuchscherr De Hauschopp, Christian Hübner

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Introduction: Autophagy is an evolutionarily conserved lysosome-dependent degradation pathway, which can be induced by extrinsic and intrinsic stressors in living systems to adapt to fluctuating environmental conditions. In the context of inflammatory stress, autophagy contributes to the elimination of invading pathogens, the regulation of innate and adaptive immune mechanisms, and regulation of inflammasome activity as well as tissue damage repair. Lysosomes can be recycled from autolysosomes by the process of autophagic lysosome reformation (ALR), which depends on the presence of several proteins including Spatacsin. Thus ALR contributes to the replenishment of lysosomes that are available for fusion with autophagosomes in situations of increased autophagic turnover, e.g., during bacterial infections, inflammatory stress or sepsis. Objectives: We aimed to assess whether ALR plays a role for cell survival in an in-vitro bacterial infection model. Methods: Mouse embryonic fibroblasts (MEFs) were isolated from wild-type mice and Spatacsin (Spg11-/-) knockout mice. Wild-type MEFs and Spg11-/- MEFs were infected with Staphylococcus aureus (multiplication of infection (MOI) used was 10). After 8 and 16 hours of infection, cell viability was assessed on BD flow cytometer through propidium iodide intake. Bacterial intake by cells was also calculated by plating cell lysates on blood agar plates. Results: in-vitro infection of MEFs with Staphylococcus aureus showed a marked decrease of cell viability in ALR deficient Spatacsin knockout (Spg11-/-) MEFs after 16 hours of infection as compared to wild-type MEFs (n=3 independent experiments; p < 0.0001) although no difference was observed for bacterial intake by both genotypes. Conclusion: Suggesting that ALR is important for the defense of invading pathogens e.g. S. aureus, we observed a marked increase of cell death in an in-vitro infection model in cells with compromised ALR.

Keywords: autophagy, autophagic lysosome reformation, bacterial infections, Staphylococcus aureus

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Authors: Fateme Hadadian, Behnam Khaledi Paveh, Hosein Feizi

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Background: High number of patients with end-stage renal disease worldwide, and Iran and the patients required hemodialysis, As well as symptoms and treatment process and its impact on quality of life The researcher had to take a step towards solving these problems. Methods: In randomized clinical trial in 60 hemodialysis patients admitted to hospital hemodialysis Imam Reza (AS) were studied. Using questionnaires dialysis patients' QOL, quality of life was measured in patients and controls were divided randomly into two groups. Benson's relaxation method for the experimental group and two months at home, once per day, respectively and the control group received no special action. Immediately after the end of the period with was used for evaluating the quality of life in both the experimental and control groups were survey and data using independent t-test were used for statistical analysis. Results: The general dimensions of quality of life scores before and after intervention, there was significant difference (P=0/001). But this difference was not significant after QOL (P=0/2). Between QOL scores before and after treatment between the two groups was statistically significant (P=0/02). Conclusion: Benson relaxation has the desired effect on quality of life in hemodialysis patients and can be used as a useful method to enhance the quality of life in hemodialysis patients, implementation and training will be given.

Keywords: hemodialysis, quality of life, Benson muscle relaxation, biomedicine

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Authors: Ji Wen Sun, Nan Ping Shen, Yi Bei Wu

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This study used Nursing Interventions Classification (NIC-6th) to identify the interventions performed in a pediatric cardiology unit, and then to analysis its frequency, time and difficulty, so as to give a brief review on what our nurses have done. The research team selected a 35 beds pediatric cardiology unit, and drawn all the nursing interventions in the nursing record from our hospital information system (HIS) from 1 October 2015 to 30 November 2015, using NIC-6th to do the matching and then counting their frequencies. Then giving each intervention its own time and difficulty code according to NIC-6th. The results showed that nurses in pediatric cardiology unit performed totally 43 interventions from 5394 statements, and most of them were in RN(basic) education level needed and less than 15 minutes time needed. There still had some interventions just needed by a nursing assistant but done by nurses, which should call for nurse managers to think about the suitable staffing. Thus, counting the summary of the product of frequency, time and difficulty for each intervention of each nurse can know one's performance. Acknowledgement Clinical Management Optimization Project of Shanghai Shen Kang Hospital Development Center (SHDC2014615); Hundred-Talent Program of Construction of Nursing Plateau Discipline (hlgy16073qnhb).

Keywords: nursing interventions, nursing interventions classification, nursing record, pediatric cardiology

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Authors: Hyunjung Lim, Jeonghun Nam, Hyuk Choi

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High-throughput separation is an essential technique for cancer research and diagnosis. Here, we propose a viscoelastic microfluidic device for sheathless, high-throughput isolation of circulating tumor cells (CTCs) from white blood cells. Here, we demonstrate a viscoelastic method for separation and concentration of CTCs using closed-loop microfluidics. Our device is a rectangular straight channel with a low aspect ratio. Also, to achieve high-efficiency, high-throughput processing, we used a polymer solution with low viscosity. At the inlet, CTCs and white blood cells (WBCs) were randomly injected into the microchannel. Due to the viscoelasticity-induced lateral migration to the equilibrium positions, large CTCs could be collected from the side outlet while small WBCs were removed at the center outlet. By recirculating the collected CTCs from the side outlet back to the sample reservoir, continuous separation and concentration of CTCs could be achieved with high separation efficiency (~ 99%). We believe that our device has the potential to be applied in resource-limited clinical settings.

Keywords: circulating tumor cell, closed-loop microfluidics, concentration, separation, viscoelastic fluid

Procedia PDF Downloads 153

Authors: Hai Zeng, Anqing Liu, Shuguang Dan, Ying Zhang, Yan Li, Zihang Zeng

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Children are strong; the country strong, the development of children Basketball is a strategic advantage. Common forms of basketball equipment has been difficult to meet the needs of young children teaching the game of basketball, basketball development for 3-6 years old children in the form of appropriate teaching aids is a breakthrough basketball game teaching children bottlenecks, improve teaching critical path pleasure, but also the development of early childhood basketball a necessary requirement. In this study, literature, questionnaires, focus group interviews, comparative analysis, for domestic and foreign use of 12 kinds of basketball teaching aids (cloud computing MINI basketball, adjustable basketball MINI, MINI basketball court, shooting assist paw print ball, dribble goggles, dribbling machine, machine cartoon shooting, rebounding machine, against the mat, elastic belt, ladder, fitness ball), from fun and improve early childhood shooting technique, dribbling technology, as well as offensive and defensive rebounding against technology conduct research on conversion technology. The results show that by using appropriate forms of teaching children basketball aids, can effectively improve children's fun basketball game, targeted to improve a technology, different types of aids from different perspectives enrich the connotation of children basketball game. Recommended for children of color psychology, cartoon and environmentally friendly material production aids, and increase research efforts basketball aids children, encourage children to sports teachers aids applications.

Keywords: appropriate forms of children basketball, auxiliary equipment, appli, MINI basketball, 3-6 years old children, teaching

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Authors: Rylle Evan Gabriel Zamora, Micah Dennise Malia, Abygail Deniese Villabona

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When examining studies on aggression, the studies about individual aggression vastly outnumbers those studies on group aggression. Given the nature of aggression to be violent and cyclical, and the amount violent events that have occurred in the near present, the study of group aggression is relevant now more than ever. This discrepancy is parallel with the number of valid and reliable psychological tests that measure group aggression. Throughout history, one of the biggest causes of group based violence and aggression is religion. This is particularly true within the context of the Philippines as there are a large number of religious groups. Thus, this study aimed to develop a standardized test that measures an individual’s tendency to be aggressive to those who are in conflict with his or her religious beliefs. This study employs a test development design that employs a qualitative phase to ensure the validity of the scale. Thus, the study was divided into three phases. First is a pilot test wherein an instrument was designed from existing literature which was then administered to 173 respondents from the four largest religious groups in the Philippines. After extensive factor analysis and reliability testing, new items were then formed from the qualitative data collected from eight participants, consisting of two individuals per religious group. The final testing integrates all statistically significant items from the first phase, and the newly formed items from the second phase, which was then administered to 200 respondents. The results were then tested further for reliability using Cronbach’s alpha and validity through factor analysis. The items that were proven to be significant were then combined to create a final instrument that may be used by future studies.

Keywords: religious aggression, group aggression, test development, psychological assessment, social psychology

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Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

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Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

Procedia PDF Downloads 385