Search results for: ergonomic interventions

Authors: Rama Umesh Pandey, Jyoti Yadav

Abstract:

Flooding is one of the waterborne disasters that causes extensive destruction in urban areas. Developing countries are at a higher risk of such damage and more than half of the global flooding events take place in Asian countries including India. Urban flooding is more of a human-induced disaster rather than natural. This is highly influenced by the anthropogenic factors, besides metrological and hydrological causes. Unplanned urbanization and poor management of cities enhance the impact manifold and cause huge loss of life and property in urban areas. It is an irony that urban areas have been facing water scarcity in summers and flooding during monsoon. This paper is an attempt to highlight the factors responsible for flooding in a city especially from an urban planning perspective and to suggest mitigating measures through spatial planning interventions. Analysis has been done in two stages; first is to assess the impacts of previous flooding events and second to analyze the factors responsible for flooding at macro and micro level in cities. Bhopal, a city in Central India having nearly two million population, has been selected for the study. The city has been experiencing flooding during heavy rains in monsoon. The factors responsible for urban flooding were identified through literature review as well as various case studies from different cities across the world and India. The factors thus identified were analyzed for both macro and micro level influences. For macro level, the previous flooding events that have caused huge destructions were analyzed and the most affected areas in Bhopal city were identified. Since the identified area was falling within the catchment of a drain so the catchment area was delineated for the study. The factors analyzed were: rainfall pattern to calculate the return period using Weibull’s formula; imperviousness through mapping in ArcGIS; runoff discharge by using Rational method. The catchment was divided into micro watersheds and the micro watershed having maximum impervious surfaces was selected to analyze the coverage and effect of physical infrastructure such as: storm water management; sewerage system; solid waste management practices. The area was further analyzed to assess the extent of violation of ‘building byelaws’ and ‘development control regulations’ and encroachment over the natural water streams. Through analysis, the study has revealed that the main issues have been: lack of sewerage system; inadequate storm water drains; inefficient solid waste management in the study area; violation of building byelaws through extending building structures ether on to the drain or on the road; encroachments by slum dwellers along or on to the drain reducing the width and capacity of the drain. Other factors include faulty culvert’s design resulting in back water effect. Roads are at higher level than the plinth of houses which creates submersion of their ground floors. The study recommends spatial planning interventions for mitigating urban flooding and strategies for management of excess rain water during monsoon season. Recommendations have also been made for efficient land use management to mitigate water logging in areas vulnerable to flooding.

Keywords: mitigating strategies, spatial planning interventions, urban flooding, violation of development control regulations

Procedia PDF Downloads 306

Authors: Abiodun Musbau Lawal, Benjamin Oladapo Olley

Abstract:

Long Distance Truck Drivers (LDTDs) have been found to be a high-risk group in the spread of HIV/AIDS globally; perhaps, due to their high Sexual Risk Behaviours (SRBs). Interventions for reducing SRBs in trucking population have not been fully exploited. A quasi-experimental control group pretest-posttest design was used to assess the efficacy of psycho-education and behavioural skills training in reducing SRBs among LDTDs. Sixteen drivers rivers were randomly assigned into either experimental or control groups using balloting technique. A questionnaire was used as an instrument for data collection. Repeated measures t-test and independent t-test were used to test hypotheses. The intervention had a significant effect on the SRBs among LDTDs at post-test(t{7}=6.01, p<.01) and at followup (t{7}=6.42, p<.01). No significant difference in sexual risk behaviour of LDTDs at post-test and at follow-up stage. Similarly, intervention had significant effects on sexual risk behaviour at post-test (t {14}=- 4.69, p<.05) and at follow-up (t {14}= -9.56, p < .05) respectively. At post-test and follow-up stages, drivers in experimental group reported reduced SRBs than those in the control group. Drivers in an experimental group reported lower sexual risk behaviour a week after intervention as well as at three months follow-up than those in the control group. It is concluded that HIV/AIDS preventive intervention that provides the necessary informational and behavioural skills content can significantly impact long distance truck drivers sexual risk behaviours.

Keywords: HIV/AIDS interventions, long distance truck drivers, Nigeria, sexual risk behaviours

Procedia PDF Downloads 455

Authors: Alok Kalra

Abstract:

Consumers and practitioners (medical herbalists, pharmacists, and aromatherapists) with strong and increased awareness about health and environment demand organically grown medicinal and aromatic plants (MAPs) to offer a valued product. As the system does not permit the use of synthetic fertilizers the use of nutrient rich organic manures is extremely important. CSIR-CIMAP has developed a complete recycling package for managing distillation and agro-waste of medicinal and aromatic plants for production of superior quality vermicompost involving microbes capable of producing high amounts of humic acid. The major benefits being faster composting period and nutrient rich vermicompost; a nutrient advantage of about 100-150% over the most commonly used organic manure (FYM). At CSIR-CIMAP, strains of microbial inoculants with multiple activities especially strains useful both as biofertilizers and biofungicide and consortia of microbes possessing diverse functional activities have been developed. CSIR-CIMAP has also initiated a program where a large number of accessions are being screened for identifying organic proficient genotypes in mints, ashwagandha, geranium and safed musli. Some of the natural plant growth promoters like calliterpenones from the plant Callicarpa macrophylla has been tested successfully for induction of rooting in stem cuttings and improving growth and yield of various crops. Some of the microbes especially the endophytes have even been identified improving the active constituents of medicinal and aromatic plants. The above said scientific interventions making organic farming a charming proposition would be discussed in details.

Keywords: organic agriculture, microbial inoculants, organic fertilizers, natural plant growth promoters

Procedia PDF Downloads 214

Authors: Yousef Daneshvar Rouyandozagh, Ece. K. Açikgöz

Abstract:

Conservation of historical urban patterns in the traditional neighborhoods is a part of creating integrated urban environments that are socially more sustainable. Urbanization reflects on life conditions and social, physical, economical characteristics of the society. In this regard, historical zones and traditional regions are affected by dramatic interventions on these characteristics. This article focuses on the Uch Dukkan neighborhood located in Ardabil City in Azarbaijani region of Iran, which has been up to such interventions that leaded its transformation from the past to the present. After introducing a brief inventory of the main elements of the historical zone and the neighborhood; this study explores the changes and transformations in different periods; and their impacts on the quality of the environment and its social sustainability. The survey conducted in the neighborhood as part of this research study revealed that the Uch Dukkan neighborhood and the unique architectural heritage that it possesses have become more inactive physically and functionally in a decade. This condition requires an exploration and comparison of the present and the expected transformations of the meaning of social space from the most private unit to the urban scale. From this token, it is argued that an architectural point of view that is based on space order; use and meaning of space as a social and cultural image, should not be ignored. Based on the interplay between social sustainability, collective memory, and the urban environment, study aims to make the invisible portion of ignorance clear, that ends up with a weakness in defining the collective meaning of the neighborhood as a historic urban district. It reveals that the spatial possessions of the neighborhood are valuable not only for their historical and physical characteristics, but also for their social memory that is to be remembered and constructed further.

Keywords: urban integrity, social sustainability, collective memory, social decay

Procedia PDF Downloads 268

Authors: Aline Fernandes Barata, Adriana Sansão Fontes

Abstract:

The overvaluation of the use of automobile has detrimentally affected the importance of pedestrians within the city and consequently its public spaces. As a way of treating contemporary urban paradigms, Tactical Urbanism aims to recover and activate spaces through fast and easily-applied actions that demonstrate the possibility of large-scale and long-term changes in cities. Tactical interventions have represented an important practice of redefining public spaces and urban mobility. The concept of Active Transportation coheres with the idea of sustainable urban mobility, characterizing the means of transportation through human propulsion, such as walking and cycling. This paper aims to debate the potential of Tactical Urbanism in promoting Active Transportation by revealing opportunities of transformation in the urban space of contemporary cities through initiatives that promote the protection and valorization of the presence of pedestrians and cyclists in cities, and that subvert the importance of motorized vehicles. In this paper, we present the character of these actions in two different ways: when they are used as tests for permanent interventions and when they have pre-defined start and end periods. Using recent initiatives to illustrate, we aim to discuss the role of small-scale actions in promoting and incentivizing a more active, healthy, sustainable and responsive urban way of life, presenting how some of them have developed through public policies. For that, we will present some examples of tactical actions that illustrate the encouragement of Active Transportation and trials to balance the urban opportunities for pedestrians and cyclists. These include temporary closure of streets, the creation of new alternatives and more comfortable areas for walking and cycling, and the subversion of uses in public spaces where the usage of cars are predominant.

Keywords: tactical urbanism, active transportation, sustainable mobility, non-motorized means

Procedia PDF Downloads 217

Authors: Bishal Saha, Musah Ahmed Rufai Muhyedeen, Jubeyer Hossain Joy, Muhammad Muhitur Rahman, Mohammad Shahedur Rahman, Md Arif Hasan, Syed Masiur Rahman

Abstract:

Greenhouse gas (GHG) emission is one of the critical problems of today’s world. Many countries have been taking many short- and long-term plans to reduce climate change mitigation. However, the potential of behavioral changes in addressing this problem is promising, as reported by many researchers. This paper presents a comprehensive literature review that focuses on ways to influence people’s behavior in their homes, workplace, and transportation to mitigate the emission directly or indirectly. This study will investigate different theories pertinent to planned behavior and the key elements for modifying behavior like biophilia, reinforcement to use optimum energy and recyclable products, proper application of greenhouse tax, modern technology, and sustainable design adaptation, transportation sharing, social and community norms, proper education and information, and financial incentives. There is a number of challenges associated with behavioral changes. Behavioral interventions have different actions varied by their type and need to combine various policy tools and great social marketing. Many interventions can reduce GHG emissions without any compromise with household well-being. This study will develop a landscape of prevailing theories of environmental psychology by identifying and reviewing the key themes and findings of this field of study. It will support especially the developing countries to reduce GHG emissions without significant capital investment. It is also expected that the behavioral changes will lead to the successful adoption of climate-friendly policies easily. This study will also generate new research questions and directions.

Keywords: behavioral changes, climate change mitigation, environmental psychology, greenhouse gas emission

Procedia PDF Downloads 202

Authors: Sze Yee Lee

Abstract:

The death of a sibling in childhood leads to significant impacts on both the personal and family development of the surviving siblings. Yet, the effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. In particular, there is a gap in the literature about the long term impacts on surviving siblings. This paper explores the experience of adult siblings encountering siblings’ death during childhood with the use of in-depth interviews. Through thematic analysis and in-depth interviews, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges, and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in a family atmosphere, family roles, family relationships, family communication, and parenting styles. More importantly, the author identifies (i) existing continuing bonds, (ii) crying, (iii) adequate social support, (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, 'child-centered' and 'family-centered' interventions for families with siblings' death in a Chinese context are discussed. With the use of age-appropriate language and children’s participation in the preparation of death and after-death arrangements, surviving siblings could be assisted in transforming bereavement into opportunities for growth. In addition, the bereaved family could better cope with grief with open communication platforms, adequate social support, and family education resources. Meanwhile, life-and-death education at both school and community levels could enhance the public’s awareness and understanding of the bereaved individuals to prevent creating further harm to them.

Keywords: children and adolescent bereavement, children-centered, family-centered, sibling’s death

Procedia PDF Downloads 89

Authors: Habtamu Fufa, Yemane Berhane

Abstract:

Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

Procedia PDF Downloads 448

Authors: Amir Reza Heydari, Yaser Jenab

Abstract:

Coronary artery disease, a common cardiovascular disease, is attributed to the accumulation of cholesterol-based plaques in the coronary arteries, leading to atherosclerosis. This disease is associated with risk factors such as smoking, hypertension, diabetes, and elevated cholesterol levels, contributing to severe clinical consequences, including acute coronary syndromes and myocardial infarction. Treatment approaches such as from lifestyle interventions to surgical procedures like percutaneous coronary intervention and coronary artery bypass surgery. These interventions often employ stents, including bare-metal stents (BMS), drug-eluting stents (DES), and bioresorbable vascular scaffolds (BVS), each with its advantages and limitations. Computational tools have emerged as critical in optimizing stent designs and assessing their performance. The aim of this study is to provide an overview of the computational methods of studies based on the finite element (FE) method in the field of coronary stenting and discuss the potential for development and clinical application of stent devices. Additionally, the importance of assessing the ability of computational models is emphasized to represent real-world phenomena, supported by recent guidelines from the American Society of Mechanical Engineers (ASME). Validation processes proposed include comparing model performance with in vivo, ex-vivo, or in vitro data, alongside uncertainty quantification and sensitivity analysis. These methods can enhance the credibility and reliability of in silico simulations, ultimately aiding in the assessment of coronary stent designs in various clinical contexts.

Keywords: atherosclerosis, materials, restenosis, review, validation

Procedia PDF Downloads 62

Authors: Abimbola Mobolanle Adu, Marcus Tayo Akinlade

Abstract:

This comprehensive study systematically dissects the intricate interplay between the removal of fuel subsidy and its multifaceted repercussions on Nigeria's educational system. Originating in the 1970s, the fuel subsidy policy initially conceived to curtail fuel costs and faced financial unsustainability. In 2023, President Bola Tinubu's administration announced its cessation. The resultant escalation in petroleum product prices precipitated challenges within the education sector, manifesting as heightened administrative costs, increased student fees, amplified dropout rates, and others. Employing a qualitative research methodology, grounded in Critical Theory, the study draws from diverse secondary sources and employs content analysis to unravel the intricate layers of this issue. Critical Theory provides a lens through which the power dynamics, socio-economic structures, and ideological influences shaping policy decisions can be critically examined, offering a deeper understanding of the multifaceted impact. Findings underscore the imperative for strategic interventions, advocating for investments in technology and the exploration of alternative energy sources. The paper concludes by emphasizing the pivotal role of education, advocating for nuanced policies to alleviate the impact on both private and public educational institutions. In essence, this research contributes nuanced insights into the labyrinthine dynamics between fuel subsidy policies and the educational sector, underscoring the exigency for meticulous interventions to fortify the nation's educational foundation.

Keywords: administration, education, fuel subsidy, policy, multilayered impact

Procedia PDF Downloads 33

Authors: Lilik Sudiajeng, Wiraga Wayan, Lanang Parwita I Gusti

Abstract:

This is the ongoing research started in 2013 with the final aim is to design the recharge wells both for housing and industry for ground water conservation in Bali - Indonesia. The research started in Denpasar Regency, one of the strategic areas in Bali. The research showed that there is some critical area of ground water resources, especially in north and west part of Denpasar Regency. It driven by the rapid increase of the tourism industry which is followed by the high rate of population, change of land use that leads to the decreasing of rain water catchment areas, and less awareness on preserve natural resources, including ground water. Focus Group Discussion concluded that in order to solve the problem of groundwater crisis, requires the contribution of all parties, started from making simple recharge well for housing. Because of the availability of land is limited and expensive, it is necessary to present an ergonomic shallow recharge well in accordance with the ability of the family or community. The ergonomics shallow recharge well is designed based on the data of hydrology and the characteristics of soil. The design is very flexible depending on the availability of land, environmentally friendly, energy efficient, culture-based, and affordable. To meet the recommended standard of ground water quality, then it equipped with a filtration and sedimentation ponds. Before design recharge wells is disseminated to the public, it is necessary to analyze the effectiveness of the wells to harvest and absorb rainwater into the ground.

Keywords: ergonomics, ground water resources, recharge well, sustainable

Procedia PDF Downloads 232

Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

Abstract:

Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

Procedia PDF Downloads 283

Authors: Christopher Latella, Ashlee M. Hendy, Dan Vander Westhuizen, Wei-Peng Teo

Abstract:

Introduction: Neural adaptations following resistance training interventions have been widely investigated, however the evidence regarding the mechanisms of early adaptation are less clear. Understanding neural responses from an acute resistance training session is pivotal in the prescription of frequency, intensity and volume in applied strength and conditioning practice. Therefore the primary aim of this study was to investigate the time course of neurophysiological mechanisms post training against current super compensation theory, and secondly, to examine whether these responses reflect neural adaptations observed with resistance training interventions. Methods: Participants (N=14) completed a randomised, counterbalanced crossover study comparing; control, strength and hypertrophy conditions. The strength condition involved 3 x 5RM leg extensions with 3min recovery, while the hypertrophy condition involved 3 x 12 RM with 60s recovery. Transcranial magnetic stimulation (TMS) and peripheral nerve stimulation were used to measure excitability of the central and peripheral neural pathways, and maximal voluntary contraction (MVC) to quantify strength changes. Measures were taken pre, immediately post, 10, 20 and 30 mins and 1, 2, 6, 24, 48, 72 and 96 hrs following training. Results: Significant decreases were observed at post, 10, 20, 30 min, 1 and 2 hrs for both training groups compared to control group for force, (p <.05), maximal compound wave; (p < .005), silent period; (p < .05). A significant increase in corticospinal excitability; (p < .005) was observed for both groups. Corticospinal excitability between strength and hypertrophy groups was near significance, with a large effect (η2= .202). All measures returned to baseline within 6 hrs post training. Discussion: Neurophysiological mechanisms appear to be significantly altered in the period 2 hrs post training, returning to homeostasis by 6 hrs. The evidence suggests that the time course of neural recovery post resistance training occurs 18-40 hours shorter than previous super compensation models. Strength and hypertrophy protocols showed similar response profiles with current findings suggesting greater post training corticospinal drive from hypertrophy training, despite previous evidence that strength training requires greater neural input. The increase in corticospinal drive and decrease inl inhibition appear to be a compensatory mechanism for decreases in peripheral nerve excitability and maximal voluntary force output. The changes in corticospinal excitability and inhibition are akin to adaptive processes observed with training interventions of 4 wks or longer. It appears that the 2 hr recovery period post training is the most influential for priming further neural adaptations with resistance training. Secondly, the frequency of prescribed resistance sessions can be scheduled closer than previous super compensation theory for optimal strength gains.

Keywords: neural responses, resistance training, super compensation, transcranial magnetic stimulation

Procedia PDF Downloads 260

Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

Abstract:

Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

Procedia PDF Downloads 64

Authors: Tim Crocker-Buque, Sandra Mounier-Jack, Natasha Howard

Abstract:

Background: Due to both the increasing scale and speed of urbanisation, urban areas in low and middle-income countries (LMICs) host increasingly large populations of under-immunized children, with the additional associated risks of rapid disease transmission in high-density living environments. Multiple interdependent factors are associated with these coverage disparities in urban areas and most evidence comes from relatively few countries, e.g., predominantly India, Kenya, Nigeria, and some from Pakistan, Iran, and Brazil. This study aimed to identify, describe, and assess the main tools used to measure or improve coverage of immunisation services in poor urban areas. Methods: Authors used a qualitative review design, including academic and non-academic literature, to identify tools used to improve coverage of public health interventions in urban areas. Authors selected and extracted sources that provided good examples of specific tools, or categories of tools, used in a context relevant to urban immunization. Diagnostic (e.g., for data collection, analysis, and insight generation) and programme tools (e.g., for investigating or improving ongoing programmes) and interventions (e.g., multi-component or stand-alone with evidence) were selected for inclusion to provide a range of type and availability of relevant tools. These were then prioritised using a decision-analysis framework and a tool selection guide for programme managers developed. Results: Authors reviewed tools used in urban immunisation contexts and tools designed for (i) non-immunization and/or non-health interventions in urban areas, and (ii) immunisation in rural contexts that had relevance for urban areas (e.g., Reaching every District/Child/ Zone). Many approaches combined several tools and methods, which authors categorised as diagnostic, programme, and intervention. The most common diagnostic tools were cross-sectional surveys, key informant interviews, focus group discussions, secondary analysis of routine data, and geographical mapping of outcomes, resources, and services. Programme tools involved multiple stages of data collection, analysis, insight generation, and intervention planning and included guidance documents from WHO (World Health Organisation), UNICEF (United Nations Children's Fund), USAID (United States Agency for International Development), and governments, and articles reporting on diagnostics, interventions, and/or evaluations to improve urban immunisation. Interventions involved service improvement, education, reminder/recall, incentives, outreach, mass-media, or were multi-component. The main gaps in existing tools were an assessment of macro/policy-level factors, exploration of effective immunization communication channels, and measuring in/out-migration. The proposed framework uses a problem tree approach to suggest tools to address five common challenges (i.e. identifying populations, understanding communities, issues with service access and use, improving services, improving coverage) based on context and available data. Conclusion: This study identified many tools relevant to evaluating urban LMIC immunisation programmes, including significant crossover between tools. This was encouraging in terms of supporting the identification of common areas, but problematic as data volumes, instructions, and activities could overwhelm managers and tools are not always suitably applied to suitable contexts. Further research is needed on how best to combine tools and methods to suit local contexts. Authors’ initial framework can be tested and developed further.

Keywords: health equity, immunisation, low and middle-income countries, poverty, urban health

Procedia PDF Downloads 125

Authors: Ana Luiza Blanco, Luiza de Pádua Penteado, Daniella Pires Nunes

Abstract:

Ageism is a widespread and prevalent phenomenon that affects older adults and directly affects healthy aging. Identifying the factors that contribute to ageism is important to discuss interventions that minimizes its social and emotional impact. To identify factors related with ageism in Brazilians older adults. Quantitative study, with a cross-sectional and analytical design. 134 older adults completed an online questionnaire about Sociodemographic and Health Characteristics, Discrimination (Ageism Survey), Depressive Symptoms (The Geriatric Depression Scale), Family Function (Family APGAR) and Loneliness. The Mann Whitney and Kruskal Wallis tests were used for data analysis, with a significance level of 5%. The mean age was 66.93 years (sd=0.50), mostly women (84.20%), married (52.60%) and with more than 12 years of schooling (75.93%). The results showed that older adults with a regular self-perception of health had higher median ageism scores when compared to individuals who rated their health as very good or good (p=0.006). The same occurred for individuals with depressive symptoms when compared to those without signs of depression (p=0.001). Regarding family function, it was observed that people with low family functionality tend to suffer more ageism than those with high functionality (p=0.017). Loneliness was also a factor related with the experience of ageism in this study. Lonely individuals had higher median ageism scores (p=0.002). There was relationship between ageism and self-perception of health, depressive symptoms, loneliness and dysfunctional family. Such findings demonstrate the importance of considering the psychosocial determinants of aging to reduce discrimination and promote healthy aging, focusing on social support and educational interventions.

Keywords: ageism, age stereotypes, healthy aging, social conditions

Procedia PDF Downloads 75

Authors: Maria Rodriguez-Gazquez, Sara Chaparro-Hernandez, Jose Rafael Gonzalez-Lopez

Abstract:

Introduction: Nurses are models in healthy behaviors for their patients. This is why it is important for these professionals to not only have a good knowledge of healthy behaviors but also practice. Today’s nursing students will be tomorrow’s professionals and to fulfill their role in caring they not only need knowledge, they also must maintain behaviors which enable them to improve and protect both the health of others and their own. This is why the university is a unique environment of opportunities to foster the maximum potential of health. To care for others we first have to take care of ourselves. It is important for these behaviors in Nursing students to be evaluated during the years of their university education in order to design timely interventions which improve the health behaviors of the future professionals. Aim: The objective of this study was to evaluate the lifestyles of first year nursing students of two Universities. Methodology: Cross-sectional study. In 2014, 140 first year Nursing students of two Universities Seville –US- (Spain -Europe, n=37) and Antioquia –UA- (Colombia -South America, n=93) self-reported the FANTASTIC Lifestyle checklist. Results: Findings reveal that (I) UA students doubled the percentage of dangerous or bad lifestyles with respect to the US students, (II) the lifestyles are not appropriate in 1 of 3 of nursing students in both Universities, (II) there are statistically significant differences for family support items (higher in US), positive thinkers (higher in UA), the use of safety belts and alcohol consumption before driving (higher in US). Discussion: The nursing students are mostly young people who are at a stage in which some of the most important behaviors for adult life can still be molded. It is necessary to develop educational interventions in their Nursing curricula to strengthen healthy behaviours during training. Nursing Schools not only have the duty to train professionals, but to also be agents that foster the health, welfare and quality of those who study and work there. It must encourage knowledge and skills oriented to healthy lifestyles.

Keywords: cross-sectional studies, life style, nursing students, questionnaires

Procedia PDF Downloads 253

Authors: Gizem Derya Demir, Ilayda Yankilic, Daglar Karamuftuoglu, Dante Dorantes

Abstract:

ABSTRACT HAPTIC ROBOTIC GLOVE FOR TELE-EXPLORATION OF EXPLOSIVE DEVICES Gizem Derya Demir, İlayda Yankılıç, Dağlar Karamüftüoğlu, Dante J. Dorantes-González Department of Mechanical Engineering, MEF University Ayazağa Cad. No.4, 34396 Maslak, Sarıyer, İstanbul, Turkey Nowadays, terror attacks are, unfortunately, a more common threat around the world. Therefore, safety measures have become much more essential. An alternative to providing safety and saving human lives is done by robots, such as disassembling and liquidation of bombs. In this article, remote exploration and manipulation of potential explosive devices from a safe-distance are addressed by designing a novel, simple and ergonomic haptic robotic glove. SolidWorks® Computer-Aided Design, computerized dynamic simulation, and MATLAB® kinematic and static analysis were used for the haptic robotic glove and finger design. Angle controls of servo motors were made using ARDUINO® IDE codes on a Makeblock® MegaPi control card. Simple grasping dexterity solutions for the fingers were obtained using one linear soft and one angle sensors for each finger, and six servo motors are used in total to remotely control a slave multi-tooled robotic hand. This project is still undergoing and presents current results. Future research steps are also presented.

Keywords: Dexterity, Exoskeleton, Haptics , Position Control, Robotic Hand , Teleoperation

Procedia PDF Downloads 146

Authors: Julius Adebayo John

Abstract:

The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.

Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis

Procedia PDF Downloads 138

Authors: Vicki R. Voskuil, Jorgie M. Watson

Abstract:

Despite the well-established health benefits of physical activity (PA), most adolescents do not meet guidelines recommending 60 minutes of moderate to vigorous physical activity (MVPA) each day. Adolescent girls engage in less PA than boys, a difference that increases with age. By the 9th grade, only 20% of girls report meeting recommendations for PA with lower percentages for black and Hispanic girls compared to white girls. The purpose of the study was to explore the physical activity (PA) behavior and needs of adolescent girls. Study aims included assessment of adolescent girls’ PA behavior; facilitators of and barriers to PA, PA needs, and acceptability of the Fitbit-Flex 2 activity tracker. This exploratory study used a qualitative and quantitative approach. The qualitative approach involved a focus group using a semi-structured interview technique. PA was measured using the Fitbit-Flex 2 activity tracker. Steps, distance, and active minutes were recorded for one week. A Fitbit survey was also administered to assess acceptability. SPSS Version 22.0 and ATLAS.ti Version 8 were used to analyze data. Girls in the ninth grade were recruited from a high school in the Midwest (n=11). Girls were excluded if they were involved in sports or other organized PA ≥ 3 days per week, had a health condition that prevented or limited PA, or could not read and write English. Participants received a Fitbit-Flex 2 activity tracker to wear for one week. At the end of the week, girls returned the Fitbit and participated in a focus group. Girls responded to open-ended questions regarding their PA behavior and shared their ideas for future intervention efforts aimed at increasing PA among adolescents. Girls completed a survey assessing their perceptions of the Fitbit. Mean age of the girls was 15.3 years (SD=0.44). On average girls took 6,520 steps and walked 2.73 miles each day. Girls stated their favorite types of PA were walking, riding bike, and running. Most girls stated they did PA for 30 minutes or more at a time once a day or every other day. The top 3 facilitators of PA reported by girls were friends, family, and transportation. The top 3 barriers included health issues, lack of motivation, and weather. Top intervention ideas were community service projects, camps, and using a Fitbit activity tracker. Girls felt the best timing of a PA program would be in the summer. Fitbit survey results showed 100% of girls would use a Fitbit on most days if they had one. Ten (91%) girls wore the Fitbit on all days. Seven (64%) girls used the Fitbit app and all reported they liked it. Findings indicate that PA participation for this sample is consistent with previous studies. Adolescent girls are not meeting recommended daily guidelines for PA. Fitbit activity trackers were positively received by all participants and could be used in future interventions aimed at increasing PA for adolescent girls. PA interventions that take place in the summer with friends and include community service projects may increase PA and be well received by this population.

Keywords: adolescents, girls, interventions, physical activity

Procedia PDF Downloads 209

Authors: Rishi Kanth Saripalle

Abstract:

Medical experts highly recommend to include physical activity in everyone’s daily routine irrespective of gender or age as it helps to improve various medical issues or curb potential issues. Simultaneously, experts are also diligently trying to provide various healthcare services (interventions, plans, exercise routines, etc.) for promoting healthy living and increasing physical activity in one’s ever increasing hectic schedules. With the introduction of wearables, individuals are able to keep track, analyze, and visualize their daily physical activities. However, there seems to be no common agreed standard for representing, gathering, aggregating and analyzing an individual’s physical activity data from disparate multiple sources (exercise pans, multiple wearables, etc.). This issue makes it highly impractical to develop any data-driven physical activity applications and healthcare programs. Further, the inability to integrate the physical activity data into an individual’s Electronic Health Record to provide a wholistic image of that individual’s health is still eluding the experts. This article has identified three primary reasons for this potential issue. First, there is no agreed standard, both structure and semantic, for representing and sharing physical activity data across disparate systems. Second, various organizations (e.g., LA fitness, Gold’s Gym, etc.) and research backed interventions and programs still primarily rely on paper or unstructured format (such as text or notes) to keep track of the data generated from physical activities. Finally, most of the wearable devices operate in silos. This article identifies the underlying problem, explores the idea of reusing existing standards, and identifies the essential modules required to move forward.

Keywords: electronic physical activity record, physical activity in EHR EIM, tracking physical activity data, physical activity data standards

Procedia PDF Downloads 264

Authors: Bernice Lottering, Yi-Wen Lin

Abstract:

Chronic pain and depression have an estimated 80% rate of comorbidity with unsatisfactory treatment interventions signifying the importance of developing effective therapeutic interventions for a serious chronic condition affecting a large majority of the global population. Chronic pain is defined as persistent pain presenting for over 3 months. This disease state increases the risk of developing depression in comparison to healthy individuals. In the current study, complete Freund’s adjuvant (CFA) was used to induce cell-mediated chronic inflammatory pain in a murine model. Significant mechanical and thermal hyperalgesia was induced, alongside observable depression-like behaviors. These conditions were attenuated through the use of electroacupuncture (EA). Similarly, these effects were also investigated with respect to the transient receptor potential vanilloid 1 (TRPV1), by analyzing the effects of TRPV1 gene deletion on the comorbidity of chronic pain and depression. The expression of the TRPV1 inflammatory response, and related downstream molecules, including protein kinases (PKs), mitogen-activated protein kinase (MAPKs), and transcriptional factors, were significantly reduced in the thalamus, prefrontal cortex (PFC), hippocampus, and periaqueductal gray (PAG) of CFA-treated mice. In addition, phosphorylated N-methyl-D-aspartate (NMDA) receptor 1 was also found to be reduced in the aforementioned areas, suggesting potential application and validity in a clinical setting. Our study determined the prospective therapeutic effects of EA in the treatment of chronic inflammatory pain and depression comorbidity and provides a novel and detailed mechanism underlying EA-mediated analgesia. These findings may be relevant in the utilization of clinical intervention approaches related to chronic pain and depression comorbidity.

Keywords: chronic pain, depression, NMDA, prefrontal cortex, TRPV1

Procedia PDF Downloads 114

Authors: Sebastian Kölbl, Thomas Reitmaier, Mathias Hartmann

Abstract:

Trial and error approaches to adapt wearable support structures to human physiology are time consuming and elaborate. However, during preliminary design, the focus lies on understanding the interaction between exoskeleton and the human body in terms of forces and moments, namely body mechanics. For the study at hand, a multi-body simulation approach has been enhanced to evaluate actual forces and moments in a human dummy model with and without a digital mock-up of an active exoskeleton. Therefore, different motion data have been gathered and processed to perform a musculosceletal analysis. The motion data are ground reaction forces, electromyography data (EMG) and human motion data recorded with a marker-based motion capture system. Based on the experimental data, the response of the human dummy model has been calibrated. Subsequently, the scalable human dummy model, in conjunction with the motion data, is connected with the exoskeleton structure. The results of the human-machine interaction (HMI) simulation platform are in particular resulting contact forces and human joint forces to compare with admissible values with regard to the human physiology. Furthermore, it provides feedback for the sizing of the exoskeleton structure in terms of resulting interface forces (stress justification) and the effect of its compliance. A stepwise approach for the setup and validation of the modeling strategy is presented and the potential for a more time and cost-effective development of wearable support structures is outlined.

Keywords: assistive devices, ergonomic design, inverse dynamics, inverse kinematics, multibody simulation

Procedia PDF Downloads 137

Authors: Jacqueline Zammit

Abstract:

Currently, a considerable number of individuals from different backgrounds are being drawn to Malta due to its favourable environment for business, investment, and employment. This influx has led to a growing interest among expats in learning Maltese as a second language (ML2) to enrich their experience of working and residing in Malta. However, the intricacies of Maltese grammar, particularly challenging for second language (L2) learners unfamiliar with Arabic, can pose difficulties in the learning process. Furthermore, it's worth noting that the teaching of ML2 is an emerging field with limited existing research on effective pedagogical strategies. The realm of second language acquisition (SLA) can be notably demanding for adults, requiring well-founded interventions to facilitate learning. Among these interventions, approaches grounded in empirical evidence have incorporated artistic and musical elements to augment SLA. Both art and music have proven roles in facilitating L2 communication, aiding vocabulary retention, and improving comprehension skills. This study aims to delve into the utilization of music and art as catalysts for enhancing the progress of adult learners in mastering ML2. The research employs a qualitative methodology, employing a sample selected through convenience sampling, which encompassed 37 adult learners of ML2. These participants engaged in individual interviews. The data derived from these interviews were subjected to thorough analysis. The outcomes of the study underscore the substantial positive influence exerted by art and music on the academic advancement of adult ML2 learners. Notably, it emerged from the participants' accounts that the current ML2 curricula lack the integration of art and music. Therefore, this study advocates for the incorporation of art and music components within both traditional classroom settings and online ML2 courses. The intention is to bolster the academic accomplishments of adult learners in the realm of Maltese as a second language, bridging the current gap between theory and practice.

Keywords: academic accomplishment, mature learners, visual art, learning Maltese as a second language, musical involvement, acquiring a second language

Procedia PDF Downloads 47

Authors: Shree Kumar Maharjan

Abstract:

Climate change has varied impacts on diverse livelihood sectors, which is more prominent at the community level. The stakeholders and local institutions have been supporting the communities either by building adaptive capacities and resilience or minimizing the impacts of different adaptation interventions. Some of these interventions are effective, whereas others need further dynamisms and exertions considering the complexity of the risks and vulnerabilities. Hence, consolidated efforts of concerned stakeholders are required to minimize and adapt the present and future impacts. This study digs out and analyses the perceptions of local stakeholders in climate change adaptation in Madi and Deukhuri valleys of Nepal through a questionnaire survey. The study has categorized the local stakeholders into 5 groups in the study sites – Farmers groups and cooperatives, Government, I/NGOs, Development banks and education and other organizations. The local stakeholders revealed flood, drought, cold wave and riverbank erosion as the major climatic risks and hazards found in the sites eventually impacting on the loss of agricultural production, loss of agricultural land and properties, loss of livestock, the emergence of diseases and pest. The stakeholders believed that most of the farmers dealing with these impacts based on their traditional knowledge and practices, followed by with the support of NGOs and with the help of neighbors and community. The major supports of the stakeholders to deal with these impacts were on training and awareness, risk analysis and minimization, livelihood improvement, financial support, coordination and networking and facilitation in policy formulation. The stakeholders emphasized primarily on capacity building, appropriate technologies, community-based planning and monitoring, prioritization to the poor and the marginalized and establishment of community fund respectively for building adaptive capacities.

Keywords: climate change adaptation, local stakeholders, Madi, Deukhuri, Nepal

Procedia PDF Downloads 164

Authors: Xi Vivien Wu, Emily Neo Kim Ang, Yi Jung Tung, Wenru Wang

Abstract:

Background and Objective: The increase in life expectancy and emphasis on self-reliance for the older adults are global phenomena. As such, lifelong learning in the community is considered a viable means of promoting successful and active aging. This systematic review aims to examine various lifelong learning programs for community-dwelling older adults and to synthesize the contents and outcomes of these lifelong learning programs. Methods: A systematic search was conducted in July to December 2016. Two reviewers were engaged in the process to ensure creditability of the selection process. Narrative description and analysis were applied with the support of a tabulation of key data including study design, interventions, and outcomes. Results: Eleven articles, which consisted of five randomized controlled trials and six quasi-experimental studies, were included in this review. Interventions included e-health literacy programs with the aid of computers and the Internet (n=4), computer and Internet training (n=3), physical fitness programs (n=2), music program (n=1), and intergenerational program (n=1). All studies used objective measurement tools to evaluate the outcomes of the study. Conclusion: The systematic review indicated lifelong learning programs resulted in positive outcomes in terms of physical health, mental health, social behavior, social support, self-efficacy and confidence in computer usage, and increased e-health literacy efficacy. However, the lifelong learning programs face challenges such as funding shortages, program cuts, and increasing costs. A comprehensive lifelong learning program could be developed to enhance the well-being of the older adults at a more holistic level. Empirical research can be done to explore the effectiveness of this comprehensive lifelong learning program.

Keywords: community-dwelling older adults, e-health literacy program, lifelong learning program, the wellbeing of the older adults

Procedia PDF Downloads 136

Authors: Iwan Cony Setiadi, Aulia M. T. Nasution

Abstract:

The multispectral imaging (MSI) technique has been used for skin analysis, especially for distant mapping of in-vivo skin chromophores by analyzing spectral data at each reflected image pixel. For ergonomic purpose, our multispectral imaging system is decomposed in two parts: a light source compartment based on LED with 11 different wavelenghts and a monochromatic 8-Bit CCD camera with C-Mount Objective Lens. The software based on GUI MATLAB to control the system was also developed. Our system provides 11 monoband images and is coupled with a software reconstructing hyperspectral cubes from these multispectral images. In this paper, we proposed a new method to build a hyperspectral reflectance cube based on artificial neural network algorithm. After preliminary corrections, a neural network is trained using the 32 natural color from X-Rite Color Checker Passport. The learning procedure involves acquisition, by a spectrophotometer. This neural network is then used to retrieve a megapixel multispectral cube between 380 and 880 nm with a 5 nm resolution from a low-spectral-resolution multispectral acquisition. As hyperspectral cubes contain spectra for each pixel; comparison should be done between the theoretical values from the spectrophotometer and the reconstructed spectrum. To evaluate the performance of reconstruction, we used the Goodness of Fit Coefficient (GFC) and Root Mean Squared Error (RMSE). To validate reconstruction, the set of 8 colour patches reconstructed by our MSI system and the one recorded by the spectrophotometer were compared. The average GFC was 0.9990 (standard deviation = 0.0010) and the average RMSE is 0.2167 (standard deviation = 0.064).

Keywords: multispectral imaging, reflectance cube, spectral reconstruction, artificial neural network

Procedia PDF Downloads 300

Authors: Hannah Bigelow, Marcus D. Gottlieb, Michelle Ogrodnik, Jeffrey, D. Graham, Barbara Fenesi

Abstract:

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders affecting approximately 6% of children worldwide. ADHD is characterized by a combination of persistent deficits including impaired inhibitory control, working memory and task-switching. Many children with ADHD also have comorbid mental health issues such as anxiety and depression. There are several treatment options to manage ADHD impairments, including drug and behavioural management therapy, but they all have drawbacks, such as worsening mood disturbances or being inaccessible to certain demographics. Both physical exercise and mindfulness meditation serve as alternative options to potentially help mitigate ADHD symptoms. Although there is extensive support for the benefits of long-term physical exercise or mindfulness meditation programs, there is insufficient research investigating how acute bouts (i.e., single, short bouts) can help children with ADHD. Thus, the current study aimed to understand how single, short bouts of exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in children with ADHD, as well as to directly compare the efficacy of these two interventions. The study used a a pre- post-test, within-subjects design to assess the effects of a 10-minute bout of moderate intensity exercise versus a 10-minute bout of mindfulness meditation (versus 10 minutes of a reading control) on the executive functioning and psycho-emotional well-being of 16 children and youth with ADHD aged 10-14 (male=11; White=80%). Participants completed all three interventions: 10 minutes of exercise, 10 minutes of mindfulness meditation, and 10 minutes of reading (control). Executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed before and after each intervention. Mindfulness meditation promoted executive functioning, while exercise enhanced positive mood and self-efficacy. Critically, this work demonstrates that a single, short bout of mindfulness meditation session can promote inhibitory control among children with ADHD. This is especially important for children with ADHD as inhibitory control deficits are among the most pervasive challenges that they face. Furthermore, the current study provides preliminary evidence for the benefit of acute exercise for promoting positive mood and general self-efficacy for children and youth with ADHD. These results may increase the accessibility of acute exercise for children with ADHD, providing guardians and teachers a feasible option to incorporate just 10 minutes of exercise to assist children emotionally. In summary, this research supports the use of acute exercise and mindfulness meditation on varying aspects of executive functioning and psycho-emotional well-being in children and youth with ADHD. This work offers important insight into how behavioural interventions could be personalized according to a child’s needs.

Keywords: attention-deficit hyperactivity disorder (ADHD), acute exercise, mindfulness meditation, executive functioning, psycho-emotional well-being

Procedia PDF Downloads 110

Authors: Deborah Weidner, Melissa Morgera

Abstract:

The model of care delivery in the Behavioral Health Network (BHN) is integrated across all five regions of Hartford Healthcare and thus spans the entirety of the state of Connecticut, with care provided in seven inpatient settings and over 30 ambulatory outpatient locations. While safety has been a core priority of the BHN in alignment with High Reliability practices, safety initiatives have historically been facilitated locally in each region or within each entity, with interventions implemented locally as opposed to throughout the network. To address this, the BHN introduced a network wide Safety Huddle during 2022. Launched in January, the BHN Safety Huddle brought together internal stakeholders, including medical and administrative leaders, along with executive institute leadership, quality, and risk management. By bringing leaders together and introducing a network-wide safety huddle into the way we work, the benefit has been an increase in awareness of safety events occurring in behavioral health areas as well as increased systemization of countermeasures to prevent future events. One significant discussion topic presented in huddles has pertained to environmental design and patient access to potentially dangerous items, addressing some of the most relevant factors resulting in harm to patients in inpatient and emergency settings for behavioral health patients. The safety huddle has improved visibility of potential environmental safety risks through the generation of over 15 safety alerts cascaded throughout the BHN and also spurred a rapid improvement project focused on standardization of patient belonging searches to reduce patient access to potentially dangerous items on inpatient units. Safety events pertaining to potentially dangerous items decreased by 31% as a result of standardized interventions implemented across the network and as a result of increased awareness. A second positive outcome originating from the BHN Safety Huddle was implementation of a recommendation to increase the emergency Narcan®(naloxone) supply on hand in ambulatory settings of the BHN after incidents involving accidental overdose resulted in higher doses of naloxone administration. By increasing the emergency supply of naloxone on hand in all ambulatory and residential settings, colleagues are better prepared to respond in an emergency situation should a patient experience an overdose while on site. Lastly, discussions in safety huddle spurred a new initiative within the BHN to improve responsiveness to assaultive incidents through a consultation service. This consult service, aligned with one of the network’s improvement priorities to reduce harm events related to assaultive incidents, was borne out of discussion in huddle in which it was identified that additional interventions may be needed in providing clinical care to patients who are experiencing multiple and/ or frequent safety events.

Keywords: quality, safety, behavioral health, risk management

Procedia PDF Downloads 64

Authors: Hanan Algarni

Abstract:

Background: Impairment of walking and balance skills has negative impact on functional independence and community participation after stroke. Gait recovery is considered a primary goal in rehabilitation by both patients and physiotherapists. Treadmill training coupled with virtual reality technology is a new emerging approach that offers patients with feedback, open and random skills practice while walking and interacting with virtual environmental scenes. Objectives: To synthesize the evidence around the effects of the VR treadmill training on gait speed and balance primarily, functional independence and community participation secondarily in stroke patients. Methods: Systematic review was conducted; search strategy included electronic data bases: MEDLINE, AMED, Cochrane, CINAHL, EMBASE, PEDro, Web of Science, and unpublished literature. Inclusion criteria: Participant: adult >18 years, stroke, ambulatory, without severe visual or cognitive impartments. Intervention: VR treadmill training alone or with physiotherapy. Comparator: any other interventions. Outcomes: gait speed, balance, function, community participation. Characteristics of included studies were extracted for analysis. Risk of bias assessment was performed using Cochrane's ROB tool. Narrative synthesis of findings was undertaken and summary of findings in each outcome was reported using GRADEpro. Results: Four studies were included involving 84 stroke participants with chronic hemiparesis. Interventions intensity ranged (6-12 sessions, 20 minutes-1 hour/session). Three studies investigated the effects on gait speed and balance. 2 studies investigated functional outcomes and one study assessed community participation. ROB assessment showed 50% unclear risk of selection bias and 25% of unclear risk of detection bias across the studies. Heterogeneity was identified in the intervention effects at post training and follow up. Outcome measures, training intensity and durations also varied across the studies, grade of evidence was low for balance, moderate for speed and function outcomes, and high for community participation. However, it is important to note that grading was done on few numbers of studies in each outcome. Conclusions: The summary of findings suggests positive and statistically significant effects (p<0.05) of VR treadmill training compared to other interventions on gait speed, dynamic balance skills, function and participation directly after training. However, the effects were not sustained at follow up in two studies (2 weeks-1 month) and other studies did not perform follow up measurements. More RCTs with larger sample sizes and higher methodological quality are required to examine the long term effects of VR treadmill effects on function independence and community participation after stroke, in order to draw conclusions and produce stronger robust evidence.

Keywords: virtual reality, treadmill, stroke, gait rehabilitation

Procedia PDF Downloads 260