Search results for: group acceptance sampling plan
9168 The Restoration of the Old District in the Urbanization: The Case Study of Samsen Riverside Community, Dusit District, Bangkok
Authors: Tikhanporn Punluekdej, Saowapa Phaithayawat
Abstract:
The objectives of this research are: 1) to discover the mechanism in the restoration process of the old district, and 2) to study the people participation in the community with related units. This research utilizes qualitative research method together with the tools used in the study of historical and anthropological disciplines. The research revealed that the restoration process of the old district started with the needs of the local people in the community. These people are considered as a young generation in the community. The leading group of the community played a vital role in the restoration process by igniting the whole idea and followed by the help from those who have lived in the area of more than fifty years. The restoration process is the genuine desire of the local people without the intervention of the local politics. The core group would coordinate with the related units in which there were, for instance, the academic institutions in order to find out the most dominant historical features of the community including its settlement. The Crown Property Bureau, as the sole-owner of the land, joined the restoration in the physical development dimension. The restoration was possible due to the cooperation between local people and related units, under the designated plans, budget, and social activities.Keywords: restoration, urban area, old district, people participation
Procedia PDF Downloads 4139167 The Effect of Early Skin-To-Skin Contact with Fathers on Their Supporting Breastfeeding
Authors: Shu-Ling Wang
Abstract:
Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in
Procedia PDF Downloads 2179166 Disability Management and Occupational Health Enhancement Program in Hong Kong Hospital Settings
Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok
Abstract:
Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.Keywords: disability management, occupational health, return to work, occupational medicine
Procedia PDF Downloads 2139165 Regenerative Therapeutic Effect of Statin Nanoparticle-Loaded Adipose-Derived Stem Cells on Myocardial Infarction
Authors: Masaaki Ii, Takashi Saito, Yasuhiko Tabata, Shintaro Nemoto
Abstract:
Background: Clinical trials of autologous adipose-derived stem cell (AdSC) therapy for ischemic heart diseases (IHD) are now on-going. We have investigated the hypothesis that combination of AdSCs and statin, an agent with pleiotropic effects, could augment the therapeutic effect on myocardial infarction (MI). Methods and Results: Human AdSC functions with different doses of simvastatin-conjugated nanoparticle (STNP) uptake were evaluated by in vitro assays. STNP promoted the migration activity without changing the proliferation activity, and also up-regulated growth factors. Next, MI was induced by LAD ligation in nude mice, and the mice were assigned in the following groups 3 days after MI: 1) PBS (control), 2) NP-AdSCs (50000 cells), 3) STNP, and 4) STNP-AdSCs (50000 cells). Cardiac functional recovery assessed by echocardiography was improved at 4 weeks after surgery in STNP-AdSC group. Masson’s trichrome-stained sections revealed that LV fibrosis length was reduced, and the number of TUNEL-positive cardiomyocytes was less in STNP-AdSC group. Surprisingly, a number of de novo endogenous Nkx-2.5/GATA4 positive immature cardiomyocytes as well as massive vascular formation were observed in outer layer of infarcted myocardium despite of a few recruited/retained transfused STNP-AdSCs 4 weeks after MI in STNP-AdSC group. Finally, massive myocardial regeneration was observed 8 weeks after MI. Conclusions: Intravenously injected small number of statin nanoparticle-loaded hAdSCs exhibited a potent therapeutic effect inducing endogenous cardiac tissue regeneration.Keywords: statin, drug delivery system, stem cells, cardiac regeneration
Procedia PDF Downloads 1889164 Lived Experiences of Parents in Disciplining Their Children
Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol
Abstract:
Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.Keywords: parents, disciplinary strategy, parental effects, pediatric nursing
Procedia PDF Downloads 4559163 Effect of Endurance Exercise Training on Blood Pressure in Elderly Female Patients with Hypertension
Authors: Elham Ahmadi
Abstract:
This study is conducted with the aim of investigating the effect of moderate physical activity (60% of maximal heart rate-MHR) on blood pressure in an elderly female with hypertension. Hypertension is considered a modifiable risk factor for cardiovascular disease through physical activity. The purpose and significance of this study were to investigate the role of exercise as an alternative therapy since some patients exhibit sensitivity/intolerance to some drugs. Initially, 65 hypertensive females (average age = 49.7 years) (systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) and 25 hypertensive females as a control group (average age = 50.3 years and systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) were selected. The subjects were divided based on their age, duration of disease, physical activity, and drug consumption. Then, blood pressure and heart rate (HR) were measured in all of the patients using a sphygmomanometer (pre-test). The exercise sessions consisted of warm-up, aerobic activity, and cooling down (total duration of 20 minutes for the first session up to 55 minutes in the last session). At the end of the 12th session (mid-test) and final session (24th session), blood pressure was measured for the last time (post-test). The control group was without any exercise during the study. The results were analyzed using a t-test. Our results indicated that moderate physical activity was effective in lowering blood pressure by 6.4/5.6–mm Hg for SBP and 2.4/4.3mm Hg for DBP in hypertensive patients, irrespective of age, duration of disease, and drug consumption ( P<.005). The control group indicates no changes in BP. Physical activity programs with moderate intensity (approximately at 60% MHR), three days per week, can be used not only as a preventive measure for diastolic hypertension (DBP>90 mmHg high blood pressure) but also as an alternative to drug therapy in the treatment of hypertension, as well.Keywords: endurance exercise, elderly female, hypertension, physical activity
Procedia PDF Downloads 989162 Comparison of Gestational Diabetes Influence on the Ultrastructure of Rectus Abdominis Muscle in Women and Rats
Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge
Abstract:
Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis
Procedia PDF Downloads 2949161 The Book of Lies: The Christian Bible's Colonialism over and Appropriation of Occultism
Authors: Samantha Huff
Abstract:
This research seeks to examine the relationship between occultism and the traditional religion of Christianity. The focus of this particular project is to deconstruct occultism and occult religion: how it develops, where it is applied, how and when it is applied. The next step is to make connections between the structure of occultism and the structure of Christianity. Do Christianity and the Occult appear, textually, the same way? What does that mean culturally? This project seeks to examine the historical similarities of occultism and Christianity practices and tradition, and how, as a whole, Christianity appropriates and colonializes occultism through examination into the Christian Bible and popular occult texts: The Book of the Law by Aleister Crowley and The Secret Doctrine: The Synthesis of Science, Religion, and Philosophy by Helena Petrovna Blavatsky. Through examining occultism and Christianity and applying it to popular cultural theories (Ritual Space by Nick Couldry, Muted Group Theory by Shirley Ardener, and Mythologies by Roland Barethes), it is entirely possible to see how Christianity appropriates occultism and uses their stronghold on society as a means to colonialize occult traditions and practices.Keywords: appropriation, Christianity, colonialism, cultural theory, muted group theory, mythologies, occultism, ritual space
Procedia PDF Downloads 1549160 Discovering Groundbreaking Geopolymer-Based Materials with Versatile Designs, Ideal for the Construction and Infrastructure Industry
Authors: Maryam Kiani
Abstract:
Geopolymer has gained significant prominence worldwide and is now widely regarded as a potential alternative to conventional Portland cement. Nevertheless, for it to be widely accepted and incorporated into national and international standards, it is crucial to establish precise definitions and dependable mix design methodologies for geopolymer materials. The lack of a common definition and methodology has led to inconsistencies and perplexity across various areas of research. Addressing this concern is imperative for several reasons. To overcome the existing inconsistencies and confusion, concerted efforts should be made to establish clear definitions and robust mix design methodologies for geopolymer materials. This can be achieved through collaborative research, knowledge sharing, and engagement with industry experts. By doing so, we can pave the way for the widespread acceptance and utilization of geopolymer materials, revolutionizing the construction and infrastructure industry in a sustainable and environmentally friendly manner. The primary goal of this article is to offer clear explanations regarding the different meanings of geopolymer and the various methodologies used in geopolymer processes. Its main aim is to improve comprehension of both unary and binary geopolymer systems. By thoroughly exploring existing research, this article strives to illuminate the diverse methods and techniques utilized in the exciting field of geopolymer science.Keywords: geopolymer, nanomaterials, structural materials, mechanical properties
Procedia PDF Downloads 1159159 ‘Obuntu Bulamu’: Parental Peer to Peer Support for Inclusion of Children with Disabilities in Central Uganda
Authors: Ruth Nalugya, Claire Nimusiima, Elizabeth Kawesa, Harriet Nambejja, Geert van Hove, Janet Seeley, Femke Bannink Mbazzi
Abstract:
Background: ‘Obuntu bulamu’, an intervention for children, parents, and teachers to improve the participation and inclusion of children with disabilities (CwD) through peer-to-peer support, was developed and tested in central Uganda between 2017 and 2019. The intervention consisted of children, parents, and teachers' training sessions and peer to peer support activities directed at disability inclusion using an African disability framework. In this paper, we discuss parent participation in and parent evaluation of the ‘Obuntu bulamu’ intervention. Methods: This qualitative Afrocentric intervention study was implemented in 10 communities in the Wakiso district in Central Uganda. We purposely selected children aged 8 to 14 years with different impairments, their peers, and parents, with different levels of household income and familial support, who were enrolled in primary schools in the ten communities with on average three children with disabilities per community. Sixty four parents (33 parents of CwDs and 31 peers) participating in the ‘Obuntu bulamu’ study were interviewed at baseline and endline. Two focus group discussions were held with parents at the midline. Parents also participated in a consultative meeting about the intervention design at baseline, and two evaluation workshops held at midline and endline. Thematic data analysis of the interview and focus group data was conducted. Results: Findings showed parents found the group-based activities inspiring and said they built hope and confidence. Parents felt the intervention was acceptable, culturally appropriate, and supportive as it built on values and practices from their own traditions. Parents reported the intervention enhanced a sense of togetherness and belonging through the group meetings and follow-up activities. Parents also mentioned that the training helped them develop more positive attitudes towards CwD and disability inclusion. Parents felt that the invention increased a child’s participation and inclusion at home, school, and in communities. Conclusion: The Obuntu bulamu peer to peer support intervention is an acceptable, culturally appropriate intervention that has the potential to improve the inclusion of CwD. A larger randomized control trial is needed to evaluate the impact of the intervention model.Keywords: inclusion, participation, inclusive education, peer support, belonging, Ubuntu, ‘Obuntu bulamu’
Procedia PDF Downloads 1069158 Sensitivity Analysis of Movable Bed Roughness Formula in Sandy Rivers
Authors: Mehdi Fuladipanah
Abstract:
Sensitivity analysis as a technique is applied to determine influential input factors on model output. Variance-based sensitivity analysis method has more application compared to other methods because of including linear and non-linear models. In this paper, van Rijn’s movable bed roughness formula was selected to evaluate because of its reasonable results in sandy rivers. This equation contains four variables as: flow depth, sediment size,bBed form height and bed form length. These variable’s importance was determined using the first order of Fourier Amplitude Sensitivity Test. Sensitivity index was applied to evaluate importance of factors. The first order FAST based sensitivity indices test, explain 90% of the total variance that is indicating acceptance criteria of FAST application. More value of this index is indicating more important variable. Results show that bed form height, bed form length, sediment size and flow depth are more influential factors with sensitivity index: 32%, 24%, 19% and 15% respectively.Keywords: sdensitivity analysis, variance, movable bed roughness formula, Sandy River
Procedia PDF Downloads 2619157 Capacity Enhancement for Agricultural Workers in Mangosteen Product
Authors: Cholpassorn Sitthiwarongchai, Chutikarn Sriviboon
Abstract:
The two primary objectives of this research were (1) to examine the current knowledge and actual circumstance of agricultural workers about mangosteen product processing; and (2) to analyze and evaluate ways to develop capacity of mangosteen product processing. The population of this study was 15,125 people who work in the agricultural sector, in this context, mangosteen production, in the eastern part of Thailand that included Chantaburi Province, Rayong Province, Trad Province and Pracheenburi Province. The sample size based on Yamane’s calculation with 95% reliability was therefore 392 samples. Mixed method was employed included questionnaire and focus group discussion with Connoisseurship Model used in order to collect quantitative and qualitative data. Key informants were used in the focus group including agricultural business owners, academic people in agro food processing, local academics, local community development staff, OTOP subcommittee, and representatives of agro processing industry professional organizations. The study found that the majority of the respondents agreed with a high level (in five-rating scale) towards most of variables of knowledge management in agro food processing. The result of the current knowledge and actual circumstance of agricultural human resource in an arena of mangosteen product processing revealed that mostly, the respondents agreed at a high level to establish 7 variables. The guideline to developing the body of knowledge in order to enhance the capacity of the agricultural workers in mangosteen product processing was delivered in the focus group discussion. The discussion finally contributed to an idea to produce manuals for mangosteen product processing methods, with 4 products chosen: (1) mangosteen soap, (2) mangosteen juice, (3) mangosteen toffee, and (4) mangosteen preserves or jam.Keywords: capacity enhancement, agricultural workers, mangosteen product processing, marketing management
Procedia PDF Downloads 2149156 The Integration of Apps for Communicative Competence in English Teaching
Authors: L. J. de Jager
Abstract:
In the South African English school curriculum, one of the aims is to achieve communicative competence, the knowledge of using language competently and appropriately in a speech community. Communicatively competent speakers should not only produce grammatically correct sentences but also produce contextually appropriate sentences for various purposes and in different situations. As most speakers of English are non-native speakers, achieving communicative competence remains a complex challenge. Moreover, the changing needs of society necessitate not merely language proficiency, but also technological proficiency. One of the burning issues in the South African educational landscape is the replacement of the standardised literacy model by the pedagogy of multiliteracies that incorporate, by default, the exploration of technological text forms that are part of learners’ everyday lives. It foresees learners as decoders, encoders, and manufacturers of their own futures by exploiting technological possibilities to constantly create and recreate meaning. As such, 21st century learners will feel comfortable working with multimodal texts that are intrinsically part of their lives and by doing so, become authors of their own learning experiences while teachers may become agents supporting learners to discover their capacity to acquire new digital skills for the century of multiliteracies. The aim is transformed practice where learners use their skills, ideas, and knowledge in new contexts. This paper reports on a research project on the integration of technology for language learning, based on the technological pedagogical content knowledge framework, conceptually founded in the theory of multiliteracies, and which aims to achieve communicative competence. The qualitative study uses the community of inquiry framework to answer the research question: How does the integration of technology transform language teaching of preservice teachers? Pre-service teachers in the Postgraduate Certificate of Education Programme with English as methodology were purposively selected to source and evaluate apps for teaching and learning English. The participants collaborated online in a dedicated Blackboard module, using discussion threads to sift through applicable apps and develop interactive lessons using the Apps. The selected apps were entered on to a predesigned Qualtrics form. Data from the online discussions, focus group interviews, and reflective journals were thematically and inductively analysed to determine the participants’ perceptions and experiences when integrating technology in lesson design and the extent to which communicative competence was achieved when using these apps. Findings indicate transformed practice among participants and research team members alike with a better than average technology acceptance and integration. Participants found value in online collaboration to develop and improve their own teaching practice by experiencing directly the benefits of integrating e-learning into the teaching of languages. It could not, however, be clearly determined whether communicative competence was improved. The findings of the project may potentially inform future e-learning activities, thus supporting student learning and development in follow-up cycles of the project.Keywords: apps, communicative competence, English teaching, technology integration, technological pedagogical content knowledge
Procedia PDF Downloads 1699155 Cellular Senescence and Neuroinflammation Following Controlled Cortical Impact Traumatic Brain Injury in Juvenile Mice
Authors: Zahra F. Al-Khateeb, Shenel Shekerzade, Hasna Boumenar, Siân M. Henson, Jordi L. Tremoleda, A. T. Michael-Titus
Abstract:
Traumatic brain injury (TBI) is the leading cause of disability and death in young adults and also increases the risk ofneurodegeneration. The mechanisms linking moderate to severe TBI to neurodegeneration are not known. It has been proposed that cellular senescence inductionpost-injury could amplify neuroinflammation and induce long-term changes. The impact of these processes after injury to an immature brain has not been characterised yet. We carried out a controlled cortical impact injury (CCI) in juvenile 1 month-old male CD1 mice. Animals were anesthetised and received a unilateral CCI injury. The sham group received anaesthesia and had a craniotomy. A naïve group had no intervention. The brain tissue was analysed at 5 days and 35 days post-injury using immunohistochemistry and markers for microglia, astrocytes, and senescence. Compared tonaïve animals, injured mice showed an increased microglial and astrocytic reaction early post-injury, as reflected in Iba1 and GFAP markers, respectively; the GFAP increase persisted in the later phase. The senescence analysis showed a significant increase inγH2AX-53BP1 nuclear foci, 8-oxoguanine, p19ARF, p16INK4a, and p53 expression in naïve vs. sham groups and naïve vs. CCI groups, at 5 dpi. At 35 days, the difference was no longer statistically significant in all markers. The injury induced a decrease p21 expression vs. the naïve group, at 35 dpi. These results indicate the induction of a complex senescence response after immature brain injury. Some changes occur early and may reflect the activation/proliferation of non-neuronal cells post-injury that had been hindered, whereas changes such as p21 downregulation may reflect a delayed response and pro-repair processes.Keywords: cellular senescence, traumatic brain injury, brain injury, controlled cortical impact
Procedia PDF Downloads 1409154 In-situ Oxygen Enrichment for UCG
Authors: Adesola O. Orimoloye, Edward Gobina
Abstract:
Membrane separation technology is still considered as an emerging technology in the mining sector and does not yet have the widespread acceptance that it has in other industrial sectors. Underground Coal Gasification (UCG), wherein coal is converted to gas in-situ, is a safer alternative to mining method that retains all pollutants underground making the process environmentally friendly. In-situ combustion of coal for power generation allows access to more of the physical global coal resource than would be included in current economically recoverable reserve estimates. Where mining is no longer taking place, for economic or geological reasons, controlled gasification permits exploitation of the deposit (again a reaction of coal to form a synthesis gas) of coal seams in situ. The oxygen supply stage is one of the most expensive parts of any gasification project but the use of membranes is a potentially attractive approach for producing oxygen-enriched air. In this study, a variety of cost-effective membrane materials that gives an optimal amount of oxygen concentrations in the range of interest was designed and tested at diverse operating conditions. Oxygen-enriched atmosphere improves the combustion temperature but a decline is observed if oxygen concentration exceeds optimum. Experimental result also reveals the preparatory method, apparatus and performance of the fabricated membrane.Keywords: membranes, oxygen-enrichment, gasification, coal
Procedia PDF Downloads 3259153 Investigation of Antidepressant Activity of Dracaena Trifasciata in Rats
Authors: Samiah Rehman, Kashmira J. Gohil
Abstract:
Objective: Dracaena trifascaita extract (DTE) possesses strong antioxidant and anti-inflammatory properties that play a vital role in the treatment of mental disorders like depression. The present study was designed to evaluate the antidepressant effects of hydroalcoholic extracts of DT on behavioral models of depression. Methodology: Animals were randomly divided into 6 groups of 5 each: Group 1 and 2 received distilled water and standard drug, imipramine: 25mg/kg, respectively. Groups 4, 5 and 6 received DTE treatment orally at doses of 200 ,400 and 600mg/ kg, respectively, for 14 days. Time of immobility was noted by force swimming test (FST)and tail suspension test (TST) on the 1st,7th and 14th days. Results: The time of immobility was reduced in the treatment group as compared to the control and standard. DTE600 mg/kg showed the highest and most significant antidepressant effects as compared to the standard drug imipramine. (25mg/kg). Conclusion: DTE has good potential as an alternative therapy for depression.Keywords: Dracaena trifasciata, antidepressants, force swimming test, tail suspension test, herbal drug of depression
Procedia PDF Downloads 749152 Evidence-Based Health System Strengthening in Urban India: Drawing Insights from Rapid Assessment Study
Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna
Abstract:
Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.Keywords: city health plan, health system, rapid assessment, urban mission
Procedia PDF Downloads 1709151 The Impact of Type Two Diabetes and Comorbid Conditions on Self-Identity and Self-Management Practices
Authors: Virginia Maskill, Philippa Seaton, Marie Crowe, Maree Inder
Abstract:
A diagnosis of a chronic condition, including Type 2 diabetes can significantly impact an individual’s self-identity which in turn can have considerable implications on how they adapt to, and self-manage their condition. This paper reports on the findings from a qualitative PhD study of forty participants diagnosed with Type 2 diabetes mellitus and comorbid conditions. The primary objective of the study explored the impact conditions had on self-identity and the relationship with self-management practices. Participants were recruited from a larger study which explored the effectiveness of a therapeutic intervention on glycemic control. Interviews were audio-recorded, transcribed verbatim and analysed utilising a narrative thematic analysis methodological approach including a transitional conceptual framework. The majority of participants experienced a loss of their normal self and struggled to integrate diabetes and comorbid conditions into their self-identity. Acceptance, knowledge and integration of conditions were often found to directly influence self-management practices with individuals commonly experiencing four transitional phases from the onset of diagnosis. Successful negotiation of these four phases was influenced by a range of variables which also impacted on an individual’s self-identity and in turn their self-management practices.Keywords: comorbidity, type two diabetes, self-identity, self-management
Procedia PDF Downloads 3329150 Malaysian Retirement Savings Behavior
Authors: Haneffa M. G.
Abstract:
Retirement preparedness among Malaysian working individuals found to be poor. Prior research proven women consistently have lower retirement confidence as compared to men. Retirement planning still become the vague issues due to saving for the golden years are being stepsided by many people. Most of them think that their contributions in companies and government retirement plan is enough to comfort them in their golden years. The Employee Provident Fund (EPF) claims that most of nearly retired person have inadequate fund to retire. Therefore, this paper aims to discuss the saving behavior of younger cohort of working individuals towards retirement planning in Malaysia. A theoretical framework is developed to understand the relationship between demographic characteristics, financial education, goal clarity, perceived religiosity and retirement savings behavior.Keywords: retirement planning, savings behavior, perceived religiosity, goal clarity, Malaysia
Procedia PDF Downloads 2839149 Association between Physical Composition, Swimming Performance and Somatotype of Male Competitive Swimmers of Age Group 10-13 Years
Authors: Ranjit Singh
Abstract:
Body fat % lean body mass and body type play vital role in sports performance. A sports person who is having optional body composition can show its performance flawlessly whereas other who is not physical fit may be more prone to injury. Competitive swimming is an association of plethora of aspects like morphological, physiological, biochemical, biomechanical and psychological. The primary key of the present research is to examine the correlation among selected morphological dimensions such as height, weight, body fat%, lean body mass, somatotype and swimming performance. The present study also focused to investigate by potential deficiencies if any and to find out remedial measures to curb the training stresses. Thirty (age group 10-14 years) swimmers undergoing training under skilled and professional coaches were selected in the present study. The morphological variables and performance criterion like 50 meter swimming time and speed were calculated by using standard training methodology. Correlation coefficient among body composition, somatotype and performance variables were assessed by using standard statistical package SPSS. Mean height, weight, fat% and lean body mass of the present group is 150.97±8.68 cm, 44.0±9.34 kg., 15.97±4.42 % and 37.10±8.77 kg respectively. Somatotype of the young swimmers of this research is revealed ectomorphic mesomorph. The analysis of the results Illustrated that swimming performance is significantly correlated (p<0.05) with height, body weight, mesomorphoic component and lean body mass. Body fat is significantly and negatively correlated (p<0.05) with mesomorphic component, lean body mass and swimming speed. From this present study, it can be concluded that along with techniques and tactics other the physical attributes also play significant role in swimming performance which can help the swimmers to excel in higher level of competition and swimmers having improved morphological qualities can ultimately perform well.Keywords: body fat, mass, mesomorphic component, somatotype
Procedia PDF Downloads 2369148 Measurement of Nasal Septal Cartilage in Adult Filipinos Using Computed Tomography
Authors: Miguel Limbert Ramos, Joseph Amado Galvez
Abstract:
Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty
Procedia PDF Downloads 1599147 Strategy Research for the Development of Thematic Commercial Streets - Based On the Survey of Eight Typical Thematic Commercial Streets in Harbin
Authors: Wang Zhenzhen, Wang Xu, Hong Liangping
Abstract:
The construction of thematic commercial streets has been on the hotspot with the rapid development of cities. In order to improve the image and competitiveness of cities, many cities are building or rebuilding thematic commercial streets. However, many contradictions and problems have emerged during this process. Therefore, it is significant, for both the practice and the research, to analyse the development of thematic commercial streets and provide some useful suggestions. Through the deep research and comparative study of the eight typical thematic commercial streets in Harbin, this paper summarize the current situations, laws and influencing factors of the development of these streets, and then put forward some suggestions about the plan, constructions and developments of the thematic commercial streets.Keywords: thematic commercial streets, laws of the development, influence factors, the constructions and developments, degrees of aggregation
Procedia PDF Downloads 3779146 The Evaluation of Adjuvant Effects of CD154 in a Subunit Vaccine against Classical Swine Fever Virus
Authors: Yu-Chieh Chen, Li-Yun Wang, Chi-Chih Chen, Huy Hùng Đào, Ya-Mei Chen, Ming-Chu Cheng, Wen-Bin Chung, Hso-Chi Chaung, Guan-Ming Ke
Abstract:
Many recent researches have demonstrated that CD154, a protein primarily expressed on activated T cell molecules, has potentially acted as a molecular adjuvant to improve the immunogenicity of subunit vaccines against viral infections. Classical swine fever (CSF) affects the swine industry worldwide that is one of the most devastating and highly contagious pig diseases. It is listed by the World Organization for Animal Health (OIE) as an infectious animal disease that must be reported. Although pigs vaccinated with subunit vaccines can be differentially diagnosed from those infected animals, subunit vaccines usually need adjuvants to enhance and elicit immune responses. In this study, CD154 was linked with CSFV E2 sequences and then expressed in CHO cells to produce the fusion protein as E2-CD154. The porcine specific CpG adjuvant was also used in one of the formulations. The specific pathogen-free pigs (SPF) at the age of 4-week-old were randomly separated into four groups, vaccinated with E2-CpG, E2-CD154, E2-CD154-CpG or the commercial Bayovac® CSF-E2 vaccine and boosted two weeks after primary vaccination. The results showed that the percentages of CD4+ and CD4+IL2+ in peripheral blood mononuclear cells (PBMC) in E2-CD154 vaccinated piglets seven days after primary vaccination were gained by 1-5% relative to the control group. In addition, the percentages of CD4+IFNγ+ T cells had slightly edged up 0.1-0.3% compared with the control group. Also, increased E2-specific IFNγ levels had edged up CD4+CD8+ T cells found in E2-CD154 and E2-CD154-CpG groups, particularly in the E2-CD154-CpG group. These results implicate that CD154 may enhance cellular immunity and synergistically act with species-specific CpG adjuvant as a dual-phase adjuvant. Therefore, the CD154 may be beneficial as a promising adjuvant in subunit vaccines.Keywords: CD154, CpG adjuvant, cellular immunity, subunit vaccine, pig
Procedia PDF Downloads 699145 Efficacy of Chia Seed Oil Supplemented Ice-Cream against Hypercholesterolemia
Authors: Naureen Naeem, M. S. Aslam
Abstract:
Chia seeds found to be a rich source of dietary fiber contain oil which is high in omega 6 and omega 3 fatty acids and helpful in the control of cardiovascular diseases. Owing to its spectacular significance, present research had been designed to explore its effect on cholesterol level of the individuals after consumption of chia seed oil supplemented ice cream. The project was designed in such a manner that fat of ice cream was replaced with chia seed oil in different proportions i.e., 25%, 50%, 75%, 100%. After physico-chemical and sensory evaluation of ice cream, best treatment was selected and used for efficacy trials. After baseline line study and thorough inclusion criteria 10 individuals were selected and divided into two groups. One group treated as control and the other was given chia seed oil supplemented l(50%) ice cream. Significant decrease in cholesterol level was observed in the treated group. 18% decrease in cholesterol level was observed at 40th day followed by 8% at 20th day. Similarly 20% decrease in LDL cholesterol with 14% increase in HDL cholesterol. It was recommended that further trials be conducted with sophisticated techniques to completely replace saturated fat in ice cream with unsaturated fats and to study its effect in hyperglycemia and oxidative stress.Keywords: hypercholesterolemia, chia seed oil, HDL, triglycerides
Procedia PDF Downloads 3099144 Least Support Orthogonal Matching Pursuit (LS-OMP) Recovery Method for Invisible Watermarking Image
Authors: Israa Sh. Tawfic, Sema Koc Kayhan
Abstract:
In this paper, first, we propose least support orthogonal matching pursuit (LS-OMP) algorithm to improve the performance, of the OMP (orthogonal matching pursuit) algorithm. LS-OMP algorithm adaptively chooses optimum L (least part of support), at each iteration. This modification helps to reduce the computational complexity significantly and performs better than OMP algorithm. Second, we give the procedure for the invisible image watermarking in the presence of compressive sampling. The image reconstruction based on a set of watermarked measurements is performed using LS-OMP.Keywords: compressed sensing, orthogonal matching pursuit, restricted isometry property, signal reconstruction, least support orthogonal matching pursuit, watermark
Procedia PDF Downloads 3399143 Developing Alternatives: Citizens Perspectives on Causes and Ramification of Political Conflict in Ivory Coast from 2002 - 2009
Authors: Suaka Yaro
Abstract:
This article provides an alternative examination of the causes and the ramifications of the Ivorian political conflict from 2002 to 2009. The researcher employed a constructivist epistemology and qualitative study based upon fieldwork in different African cities interviewing Ivorians outside and within Ivory Coast. A purposive sampling of fourteen participants was selected. A purposive sampling was used to select fourteen respondents. The respondents were selected based on their involvement in Ivorian conflict. Their experiences on the causes and effects of the conflict were tapped for analysis. Qualitative methodology was used for the study. The data collection instruments were semi-structured interview questions, open-ended semi-structured questionnaire, and documentary analysis. The perceptions of these participants on the causes, effects and the possible solution to the endemic conflict in their homeland hold key perspectives that have hitherto been ignored in the whole debate about the Ivorian political conflict and its legacies. Finally, from the synthesized findings of the investigation, the researcher concluded that the analysed data revealed that the causes of the conflict were competition for scarce resources, bad governance, media incitement, xenophobia, incessant political power struggle and the proliferation of small firearms entering the country. The effects experienced during the conflict were the human rights violation, destruction of property including UN premises and displaced people both internally and externally. Some recommendations made include: Efforts should be made by the government to strengthen good relationship among different ethnic groups and help them adapt to new challenges that confront democratic developments in the country. The government should organise the South African style of Truth and Reconciliation Commission to revisit the horrors of the past in order to heal wounds and prevent future occurrence of the conflict. Employment opportunities and other income generating ventures for Ivorian should be created by the government by attracting local and foreign investors. The numerous rebels should be given special skills training in other for them to be able to live among the communities in Ivory Coast. Government of national unity should be encouraged in situation like this.Keywords: displaced, federalism, pluralism, identity politics, grievance, eligibility, greed
Procedia PDF Downloads 2249142 The Impact of Neonatal Methamphetamine on Spatial Learning and Memory of Females in Adulthood
Authors: Ivana Hrebickova, Maria Sevcikova, Romana Slamberova
Abstract:
The present study was aimed at evaluation of cognitive changes following scheduled neonatal methamphetamine exposure in combination with long-term exposure in adulthood of female Wistar rats. Pregnant mothers were divided into two groups: group with indirect exposure (methamphetamine in dose 5 mg/ml/kg, saline in dose 1 ml/kg) during early lactation period (postnatal day 1–11) - progeny of these mothers were exposed to the effects of methamphetamine or saline indirectly via the breast milk; and the second group with direct exposure – all mothers were left intact for the entire lactation period, while progeny was treated with methamphetamine (5 mg/ml/kg) by injection or the control group, which was received needle pick (shame, not saline) at the same time each day of period of application (postnatal day 1–11). Learning ability and memory consolidation were tested in the Morris Water Maze, which consisted of three types of tests: ‘Place Navigation Test ‘; ‘Probe Test ‘; and ‘Memory Recall Test ‘. Adult female progeny were injected daily, after completion last trial with saline or methamphetamine (1 mg/ml/kg). We compared the effects of indirect/direct neonatal methamphetamine exposure and adult methamphetamine treatment on cognitive function of female rats. Statistical analyses showed that neonatal methamphetamine exposure worsened spatial learning and ability to remember the position of the platform. The present study demonstrated that direct methamphetamine exposure has more significant impact on process of learning and memory than indirect exposure. Analyses of search strategies (thigmotaxis, scanning) used by females during the Place Navigation Test and Memory Recall Test confirm all these results.Keywords: methamphetamine, Morris water maze, neonatal exposure, strategies, Wistar rats
Procedia PDF Downloads 2669141 The Study of Elementary School Teacher’s Behavior of Using E-books by UTAUT Model
Authors: Tzong-Shing Cheng, Chen Pei Chen, Shu-Wei Chen
Abstract:
The purpose of this research is to apply Unified Theory of Acceptance and Use of Technology (UTAUT) model to investigate the factors that influence elementary school teacher’s behavior of using e-books. Based on the literature review, a questionnaire was modified and used to test the elementary school teachers in Changhua. A total of 420 questionnaires were administered and 364 of them were returned, including 328 valid and 36 invalid questionnaires. The effective response rate is 78%. The methods of data analysis include descriptive statistics, factor analysis, Pearson’s correlation coefficient, one way analysis of variance (ANOVA) and simple regression analysis. The results show that: 1. There were significant difference in the Elementary school teachers’ “Performance Expectancy”, “Effort Expectancy”, “Social Influence”, and “Facilitating Conditions” depending on their different “Demographic Variables”. 2. “Performance Expectancy” and “Behavioral Intention to Use” are positively correlated. 3. “Effort Expectancy” and “Behavioral Intention to Use” are positively correlated. 4. There was no significant relationship between “Social Influence” and “Behavioral Intention to Use”. 5. There was significant relationship between “Facilitating Conditions” and “Use Behavior”.Keywords: e-books, UTAUT, elementary school teacher, behavioral intention to use
Procedia PDF Downloads 6159140 Serological Screening of Cytomegalovirus Infection among Sudanese Patients with Leukemia, Breast and Prostate Cancers at Radiation-Isotope Center in Khartoum
Authors: Abuelquasim. M. Hassan, Namarig .S. Mohammed, Samah F. Mohammed, Wafaa. A. Mohammed, Wafaa M. Edriss, Amel A. Ahmed, Elfadil M. Abass
Abstract:
Introduction: Cytomegalovirus (CMV), a common virus, usually causes asymptomatic infections in immunocompetent hosts; however, it may lead to serious complications especially in cancer patients. Objectives: This study was conducted to determine the seroprevalence of human cytomegalovirus (HCMV) among leukemia, breast and prostate cancer patients attending at Radiation Isotope-Center-Khartoum (RICK) from April to August 2016. Material and Methods: A total of 91 subjects were included: 30 leukemic, 22 breast cancer and 29 prostate cancer patients.10 of them were healthy and used as control group, serum samples were collected and tested for CMV IgG & IgM using enzyme-linked immune sorbent assay (ELISA). Result: Of the control group, 9/10 (9.9%) were seropositive for CMV IgG and 1/10 (1.09%) were sero positive for IgM. Also, all cancer groups demonstrated presence of IgG antibody classes as: The percentage of positive results in prostate, breast cancer and leukemia were 35.8 %, 37.2%, and 35.3% respectively. Conclusion: There was no significant correlation between leukemia, breast, prostate and HCMV.Keywords: cytomegalovirus, serodiagnostic, breast cancer, leukemia
Procedia PDF Downloads 3869139 Arterial Line Use for Acute Type 2 Respiratory Failure
Authors: C. Scurr, J. Jeans, S. Srivastava
Abstract:
Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line
Procedia PDF Downloads 429