Search results for: h-beam profile

Authors: Miesam Golzadeh Gangraj, Abbas Ganbari Niaki, Lila Bahrami

Abstract:

The main aim of this study is to investigate the effect of one session of Karate training (Kumite, speed Kata and strength Kata) on viscosity, fibrinogen and plasma lipid profile in young Karate player women. To this end, 40 individuals with required condition were selected and randomly placed in four groups. 10 mL forearm venous blood was taken before and immediately after a session of training for measuring variables. Data were analyzed using statistical methods (covariance, by consideration of group factor) and Bonfferoni post hoc test and the significant difference was determined in P ≤ 0.05. The variation of plasma fibrinogen concentration was not meaningful. The variation of plasma viscosity concentration was not meaningful in groups and between groups. The variation of cortisol concentration was meaningful before and after and between control and experimental groups; however, no difference was observed between three experimental groups. The variation of complete cholesterol, neither tri-glyceride nor intense lipoprotein, was meaningful and significant difference was just seen between control and Kumite groups. The results show that despite meaningful changes in fibrinogen levels, plasma viscosity has not been much affected that might be due to lack of variation in other effective variables such as TG, HDL and hematocrit. Based on the results of present study, it seems that the use of speed Kata seems to be more appropriate to increase the performance of Karate player than strength Karate.

Keywords: female karate player, viscosity, fibrinogen, cortisol, lactate di-dehydrogenase

Procedia PDF Downloads 184

Authors: Edna Ariste, Richard Standy Coqmar

Abstract:

Background: Acute respiratory infections are a major public health problem in the world, mainly in vulnerable populations such as newborns, children under five years of age, and the elderly. The objective of this study was to Characterize the cases of acute respiratory infections in infants and under 15 years old hospitalized at the Immaculée Conception Hospital in Cayes from January 1, 2019, to December 31, 2021. Methods: A retrospective descriptive study was conducted on the epidemiology profile of acute respiratory infections hospitalized in the pediatric ward at Immaculée Conception Hospital in Les Cayes from January 2019 to December 2021. The study population consisted of all newborns, infants, and children under 15 years of age diagnosed with respiratory infections at the pediatric service. Data were collected from the hospitalization registers and patient records of this unit. A database was created and used for data collection. Excel and Epi info 7.2 were used for data analysis. Results: A total of 588 cases were identified during the 2019-2021 year. 43.5% (256) were female, and 56.5% (332) were male. The average age was 4, 3. The most affected age group was 1-4 years. The male/female sex ratio was 1.2. The most frequent respiratory infections were respectively pneumonia 44.9%, bronchitis 16.5%, and respiratory distress 10.5%. The mortality rate recorded during this period was 4.4%. Conclusion: Acute respiratory infections are more frequent in young children. It is, therefore, necessary to practice hand hygiene. Reinforce the surveillance of severe acute respiratory infections.

Keywords: acute respiratory infections, pediatrics, cayes, haiti

Procedia PDF Downloads 87

Authors: Gadiri Sabiha

Abstract:

Introduction: Current allergy diagnostic tools using Multiplex technology have made it possible to increase the efficiency of the search for specific IgE. This opportunity is provided by the newly developed “Alex Biochip”, consisting of a panel of 282 allergens in native and molecular form, a CCD inhibitor, and the potential for detecting cross-reactive allergens. We evaluated the performance of this technology in detecting cross-reactivity in previously explored patients. Material/Method: The sera of 39 patients presenting sensitization and polysensitization profiles were explored. The search for specific IgE is carried out by the Alex ® IgE Biochip, and the results are analyzed by nature and by molecular family of allergens using specific software. Results/Discussion: The analysis gave a particular profile of cross-reactivity allergens: 33% for the Ole e1 family, 31% for NPC2, 26% for storage proteins, 20% for Tropomyosin, 10% for LTPs, 10% for Arginine Kinase and 10% for Uteroglobin CCDs were absent in all patients. The “Ole e1” allergen is responsible for a pollen-pollen cross allergy. The storage proteins found and LTP are not species-specific, causing cross-pollen-food allergy. The nDer p2 of the NPC2 family is responsible for cross-reactivity between mite species. Conclusion: The cross-reactivities responsible for mixed syndromes at diagnosis in our patients were dominated by pollen-pollen and pollen-food syndromes. They allow the identification of severity factors linked to the prognosis and the best-adapted immunotherapy.

Keywords: specific IgE, allergy, cross reactivity, molecular allergens

Procedia PDF Downloads 67

Authors: Minakshi Jain, Sachin Yadav

Abstract:

Gram Panchayat is the smallest unit of Democracy in India. Grassroots Democracy has been further strengthened by implementation of the 73rd Constitutional Amendment act (CAA) in 1992. To analyse the impact of grassroots democracy the three villages are selected, which have the representation of each section of the society. The selected villages belongs to the same block and district of Haryana state. Villages are selected to access the marginalized group such as women and other backward class. These groups are isolated and do not participate in the grassroots level development process. The caste continue to be a relevant factor in determining the rural leadership. The earlier models of Panchayati Raj failed to benefit the marginalized groups of the society. The 73rd CAA, advocates a uniform three tier system of Panchayat at District level (Zilla Panchayat), Taluka/Block level (Block Panchayat), and village level (Gram Panchayat). The socio-economic profile of representatives in each village is important factor in rural development. The study will highlight the socio-economic profile of elected members at gram Panchayat level, Block Level and District level. The analysis reveals that there is a need to educate and develop the capacity and capability of the elected representative. Training must be imparted to all of them to enable them to function as per provision in the act. The paper will analyse the impact of act on rural development than propose some measures to further strengthen the Panchayati Raj Institution (PRI’s) at grassroots level.

Keywords: democracy, rural development, marginalized people, function

Procedia PDF Downloads 326

Authors: Tagouelbe Tiho, Amissa Augustin Adima, Yao Casimir Brou, Nabayo Traore, Gouha Firmin Kouassi, Thierry Roland Kouame, Maryline Kouba

Abstract:

The work aimed to study Borassus aethiopum Mart (B.a) dried pulp nutritional value for its incorporation in human and poultry diets. Firstly, the mature fruit macro-composition was assessed. Secondly, the pulp was dried at 40, 50, 60, 70, and 80ᵒC. Thereafter, the analysis was performed for fat, protein, total sugars, Ca, P, Mg, and fatty acid profile monitoring. As a result, the fruits weighed 1,591.35, delivered 516.73, and 677.82 grams of pulp and seeds, respectively. Mainly, increasing heat adversely affected the outputs. Consequently, the fat results were 14.12, 12.97, 8.93, 8.89ᶜ, and 5.56%; protein contents were 11.64, 10.15, 8.97, 8.84, and 8.42%; total sugar deliveries were 6.28, 6.05, 5.26, 5.02, and 4.76% (P < 0.01). Thereafter, the metabolizable energies were 3,785.22; 3,834.28; 3,616.62; 3,667.03; and 3,608.33 kcal/kg (DM). Additionally, Calcium (Ca) contents were 0.51, 0.55, 0.69, 0.77, and 0.81%, while phosphorus (P) mean was 0.17%, and the differences were not significant (P < 0.01). So, the Ca/P ratios were 2.79, 3.04, 4.10, 4.71, and 4.95. Finally, fatty acids (FA) assessments revealed 22.33 saturated (SFA), 77.67 unsaturated (UFA), within which 67.59% were monounsaturated (MUFA). Interestingly, the rising heat depressed n-6/n-3 ratios that were 1.1, 1.1, 0.45 and 0.38, respectively at 40, 50, 70 and 80ᵒC. In short, drying did not only enhance the product shelf life but it also improved the nutritional value. Thus, B.a mature fruit pulps dried at 70ᵒC are good functional foods, with more than 66% MUFA, and energy source for human and poultry nutrition.

Keywords: Borassus aethiopum Mart, fatty acids, metabolizable energy, minerals, protein

Procedia PDF Downloads 172

Authors: Mrunal Phatak, Suvarna Raut

Abstract:

Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aims of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex matched controls so as to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls ( group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3, and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising of 62 newly diagnosed hypothyroid women and the Control group having 62 women with normal thyroid profile. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e. total 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in total 64 ears (51.61%). A significant increase was seen in Wave V latency, IPL I-V, and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears in cases. Positive correlation of Wave V latency of Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). Negative correlation of wave V amplitude of Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as the mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both the ears. Significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). Negative correlation with T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. Positive correlation of ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centres. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests the impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.

Keywords: deafness, pure tone audiometry, brain stem auditory evoked potential, hyopothyroidism

Procedia PDF Downloads 133

Authors: Isabel Cristina Ortiz Trujillo, Lina Maria Martinez Sanchez, Felipe Hernández Restrepo, Daniel Gallego Gonzalez, Natalia Vargas Grisales, Camilo Andrés Agudelo Vélez

Abstract:

Chorioamnionitis, is a pregnancy infection, causes different fetal and maternal symptoms. Streptococcus agalactiae present in the normal vaginal microflora of some women, favouring its abnormal multiplication during pregnancy, causing perinatal morbidity and mortality. Objective. Describe the clinical and epidemiological profile of the patients with diagnosis of clinical chorioanmionitis. Methodology. Descriptive, cross-sectional study. The population was patients with diagnosis of clinical chorioanmionitis. The information was taken from the medical records. The research was approved by the Ethics Committee. We used the program SPSS ® version 17.0 (SPSS Inc; Chicago, Illinois, USA) for the information analysis, descriptive statistics were used. Results. 78 patients in total with clinical chorioamnionitis, with a mean age of 26.3 ±5, 8 years old, the 69.2% primigravid women. 2.6% of women had positive culture for Streptococcus agalactiae in urine sample during current pregnancy and 30.7% had received some kind of antibiotics during current pregnancy. The 57.7% had 37 to 40 weeks of gestation in the current pregnancy it was calculated more frequently by ultrasound (66.7% in first quarter, 11.5% in the second and 1.9% in the third). In a 60.3% way of termination of pregnancy was vaginal and a 35.9 percent were caesarean section. Among the women in the study, a 30.8% had premature rupture of membranes. Conclusion. The chorioamnionitis continues to be an important cause of antibiotic use during pregnancy or labour and the decision to do a caesarean, with highest percentage in pregnancies-preterm and preterm premature rupture of membranes.

Keywords: chorioamnionitis, Streptococcus agalactiae, pregnancy complications, infectious

Procedia PDF Downloads 422

Authors: Belal Mohamadi Kalesar, Raouf Hasanpour

Abstract:

Proper placement of Distributed Generation (DG) units such as wind turbine generators in distribution system are still very challenging issue for obtaining their maximum potential benefits because inappropriate placement may increase the system losses. This paper proposes Particle Swarm Optimization (PSO) technique for optimal placement of wind based DG (WDG) in the primary distribution system to reduce energy losses and voltage profile improvement with four different wind levels modeling in year duration. Also, wind turbine is modeled as a DFIG that will be operated at unity power factor and only one wind turbine tower will be considered to install at each bus of network. Finally, proposed method will be implemented on widely used 69 bus power distribution system in MATLAB software environment under four scenario (without, one, two and three WDG units) and for capability test of implemented program it is supposed that all buses of standard system can be candidate for WDG installing (large search space), though this program can consider predetermined number of candidate location in WDG placement to model financial limitation of project. Obtained results illustrate that wind speed increasing in some months will increase output power generated but this can increase / decrease power loss in some wind level, also results show that it is required about 3MW WDG capacity to install in different buses but when this is distributed in overall network (more number of WDG) it can cause better solution from point of view of power loss and voltage profile.

Keywords: wind turbine, DG placement, wind levels effect, PSO algorithm

Procedia PDF Downloads 448

Authors: Arlan S. Freitas, Leila M. Carvalho, Adriana L. Soares, Arnoud Neto, Marta S. Madruga, Elza I. Ida, Massami Shimokomaki

Abstract:

The objective of this work was to evaluate the influence of microclimatic profile of broiler transport trucks under commercial conditions over the breast meat quality and DOA (Death On Arrival) in a tropical Brazilian regions as the North East where routinely the season is divided into dry and wet seasons. The temperature remains fairly constant and obviously the relative humidity changes accordingly. Three loads of 4,100 forty seven days old broiler were monitored from farm to slaughterhouse in a distance of 4.3 km, morning period of October 2015 rainy days. The profile of the environmental variables inside the container truck throughout the journey was obtained by the installation of thermo anemometers in 6 different locations by monitoring the heat index (HI), air velocity (AV), temperature (T), and relative humidity (RH). Meat qualities were evaluated by determining the occurrence of PSE (pale, soft, exudative) meat and DFD (dark, firm dry) meat. The percentage of birds DOA per loaded truck was determined by counting the dead broiler during the hanging step at the slaughtering plant. The analysis of variance was performed using statistical software (Statistica 8 for windows, Statsoft 2007, Tulsa, OK, USA). The Tukey significance test (P<0.05) was applied to compare means from microenvironmental data, PSE, DFD and DOA. Fillet samples were collected at 24h post mortem for pH e color (L*, a* e b*) determination through the CIELAB system. Results showed the occurrence of 2.98% of PSE and 0.66% de DFD and only 0.016% of DOA and overall the most uncomfortable container location was at the truck frontal inferior presenting 6.25% of PSE. DFD of 2.0% were obtained from birds located at central and inferior rear locations. These values were unexpected in comparison to other results obtained in our laboratories in previous experiments carried out within the country south state. The results reported herein were lower in every aspect. Reasonable explanation would be the shorter distance, wet conditions throughout around 15-20 min journeys and lower T and RH values as observed in samples taken from the rear location as higher DFD values were obtained. These facts mean the animals were not under heat stressful condition but in fact under cold stress conditions as the result of DFD suggested in association to the lower number of DOA.

Keywords: cold stress, DFD, microclimatic profile, PSE

Procedia PDF Downloads 235

Authors: Chia-li Wang

Abstract:

The surge of service and commerce platforms, such as e-commerce and internet-of-things, have rapidly changed our lives. How to avoid the congestion and get the job done in the platform is now a common problem that many people encounter every day. This requires platform users to make decisions about when to enter the platform. To that end, we investigate the strategic entering time of a simple platform containing random numbers of buyers and sellers of some item. Upon a trade, the buyer and the seller gain respective profits, yet they pay the cost of waiting in the platform. To maximize their expected payoffs from trading, both buyers and sellers can choose their entering times. This creates an interesting and practical framework of a game that is played among buyers, among sellers, and between them. That is, a strategy employed by a player is not only against players of its type but also a response to those of the other type, and, thus, a strategy profile is composed of strategies of buyers and sellers. The players' best response, the Nash equilibrium (NE) strategy profile, is derived by a pair of differential equations, which, in turn, are used to establish its existence and uniqueness. More importantly, its structure sheds valuable insights of how the entering strategy of one side (buyers or sellers) is affected by the entering behavior of the other side. These results provide a base for the study of dynamic pricing for stochastic demand-supply imbalances. Finally, comparisons between the social welfares (the sum of the payoffs incurred by individual participants) obtained by the optimal strategy and by the NE strategy are conducted for showing the efficiency loss relative to the socially optimal solution. That should help to manage the platform better.

Keywords: double-sided queue, non-cooperative game, nash equilibrium, price of anarchy

Procedia PDF Downloads 86

Authors: Esmaeil Zabihi, Seyed Hossein Alavi

Abstract:

The purpose of this study is a comparison of movement and physical fitness in athlete's male students in altitude and sea-level. The samples consist of 450 subjects in altitude and sea-level in Iran in years of 2013 which were selected randomly from the population. We investigated the effect of high altitude on the tests activity profile of youth high altitude and sea level residents. Methods 450 Sea Level (Mahmood Abad) and 450 Altitude-resident (Shahre-Kord) athlete students tests of physical fitness near sea level (-5 m) and in Altitude (2100 m). This study is Descriptive Research (causal-comparative research). The tests of physical fitness include pull-ups test, sit-ups test, agility test(4 9), 45 sprint test, 1600 m running, long jump, and flexibility test. For determining of different between the physical fitness of altitude and sea-level students was used t-test (P ≤ 0.05). The result of this study show that there is no significant difference between the average of pull-ups test, flexibility, 45 sprints, and agility (4 9) test of students in sea-level and altitude. But there is a significant difference between the average of sit-ups, 1600 m running and long jump in altitude. The students of altitude have higher power rather than sea-level. But the students of sea-level have stronger abdominal muscles and cardio-respiratory endurance rather than altitude. High altitude reduces the distance covered by youth athlete students during tests. Neither acclimatisation nor lifelong residence at high altitude protects against detrimental effects of altitude on tests activity profile.

Keywords: physical fitness, sea level, altitude areas, AAHPERD test

Procedia PDF Downloads 438

Authors: Jéssica F. Rodrigues, Amanda C. Andrade, Sabrina C. Bastos, Sandra B. Coelho, Ana Carla M. Pinheiro

Abstract:

Currently, there is a great demand for the use of natural sweeteners due to the harmful effects of the high sugar and artificial sweeteners consumption on the health. Miracle fruit, which is known for its unique ability to modify the sour taste in sweet taste, has been shown to be a good alternative sweetener. However, it has a high production cost, being important to optimize lower contents to be used. Thus, the aim of this study was to assess the effect of different miracle fruit contents on the temporal (Time-intensity - TI and Temporal Dominance of Sensations - TDS) sensory profile and overall linking of lemonade, to determine the better content to be used as a natural sweetener in sour beverages. TI and TDS results showed that the concentrations of 150 mg, 300 mg and 600 mg miracle fruit were effective in reducing the acidity and promoting the sweet perception in lemonade. Furthermore, the concentrations of 300 mg and 600 mg obtained similar profiles. Through the acceptance test, the concentration of 300 mg miracle fruit was shown to be an efficient substitute for sucrose and sucralose in lemonade, once they had similar hedonic values between ‘I liked it slightly’ and ‘I liked it moderately’. Therefore, 300mg miracle fruit consists in an adequate content to be used as a natural sweetener of lemonade. The results of this work will help the food industry on the efficient application of a new natural sweetener- the Miracle fruit extract in sour beverages, reducing costs and providing a product that meets the consumer desires.

Keywords: acceptance, natural sweetener, temporal dominance of sensations, time-intensity

Procedia PDF Downloads 249

Authors: Paua Ketan, Bhagate Rajkumar, Adiga Ganesh, M. Kiran

Abstract:

Low gear noise is an important sound quality feature in modern passenger cars. Annoying gear noise from the gearbox is influenced by the gear design, gearbox shaft layout, manufacturing deviations in the components, assembly errors and the mounting arrangement of the complete gearbox. Geometrical deviations in the form of profile and lead errors are often present on the flanks of the inspected gears. Ghost frequencies of a gear are very challenging to identify in standard gear measurement and analysis process due to small wavelengths involved. In this paper, gear whine noise occurring at non-integral multiples of gear mesh frequency of passenger car gearbox is investigated and the root cause is identified using the displacement deviation analysis (DDA) method. DDA method is applied to identify ghost frequency excitations on the flanks of gears arising out of generation grinding. Frequency identified through DDA correlated with the frequency of vibration and noise on the end-of-line machine as well as vehicle level measurements. With the application of DDA method along with standard lead profile measurement, gears with ghost frequency geometry deviations were identified on the production line to eliminate defective parts and thereby eliminate ghost frequency noise from a vehicle. Further, displacement deviation analysis can be used in conjunction with the manufacturing process simulation to arrive at suitable countermeasures for arresting the ghost frequency.

Keywords: displacement deviation analysis, gear whine, ghost frequency, sound quality

Procedia PDF Downloads 146

Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

Abstract:

Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

Procedia PDF Downloads 333

Authors: Syed Amer Mahmood, Rao Mansor Ali Khan

Abstract:

This study deals with the remote sensing analysis of tectonic deformation and its implications to understand the regional uplift conditions in the lower Jhelum and eastern Potwar. Identification and mapping of active structures is an important issue in order to assess seismic hazards and to understand the Quaternary deformation of the region. Digital elevation models (DEMs) provide an opportunity to quantify land surface geometry in terms of elevation and its derivatives. Tectonic movement along the faults is often reflected by characteristic geomorphological features such as elevation, stream offsets, slope breaks and the contributing drainage area. The river profile analysis in this region using SRTM digital elevation model gives information about the tectonic influence on the local drainage network. The steepness and concavity indices have been calculated by power law of scaling relations under steady state conditions. An uplift rate map is prepared after carefully analysing the local drainage network showing uplift rates in mm/year. The active faults in the region control local drainages and the deflection of stream channels is a further evidence of the recent fault activity. The results show variable relative uplift conditions along MBT and Riasi and represent a wonderful example of the recency of uplift, as well as the influence of active tectonics on the evolution of young orogens.

Keywords: quaternary deformation, SRTM DEM, geomorphometric indices, active tectonics and MBT

Procedia PDF Downloads 348

Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

Abstract:

Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

Procedia PDF Downloads 24

Authors: Lalit Kishore, Randhir Singh

Abstract:

Diabetic nephropathy (DN) is the major cause of morbidity among diabetic patients. In this study, the effect of Bacopa monnieri Linn. (Brahmi, BM), was studied in a Streptozotocin (STZ)-induced experimental rat model of DN. Diabetic nephropathy was induced in Male Wistar rats (body weight- 300± 10 gms) by single intra-peritoneal injection of STZ (45mg/kg, i.p.) after 15 min of Nicotinamide (230 mg/kg) administration. Different doses of alcoholic extract i.e. 100, 200 and 400 mg/kg was given for 45 days by oral gavage after induction of DN. Blood glucose level, serum insulin, glycosylated haemoglobin, renal parameters (serum urea, uric acid, creatinine and BUN) and lipid profile (total cholesterol, triglycerides, HDL, LDL and VLDL levels) were measured. Concentration of thiobarbituric acid reactive species (TBARS) and levels of antioxidant enzymes of reduced glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) were evaluated in the kidney, liver and pancreas. At the end of treatment period the alcoholic extract of BM reduced the elevated level of blood glucose, serum insulin, renal parameters, lipid levels, TBARS, AGE’s in kidney and significantly increased body weight, HDL and antioxidant enzymes in dose dependent manner as compared to diabetic control animals. These results suggested the BM possesses significant renoprotective activity.

Keywords: AGE's, lipid profile, oxidative stress, renal parameters

Procedia PDF Downloads 323

Authors: Eriberto R. Astorga Jr., Herbert D. Vertucio, Evelyn M. Polison

Abstract:

This study was conducted in order to determine the analysis with regards to the Characterization of Self-Esteem of EARIST Students according to their origin of self-esteem and low self-esteem as well as its causes. The respondents of this study are three thousand three hundred twenty three (3,323) randomly selected students from eight colleges of EARIST such as Arts and Sciences, Education, Public Administration and Criminology, Business Administration, Hospitality Management, Architecture and Fine Arts, Engineering, and Industrial Technology. A survey was conducted by using a validated questionnaire for information gathering about respondents profile and different factors relating to self-esteem of students such as self-origin, familial and social relationship, financial situation and education. Frequency, percentage, ranking and standards deviation, standard t-test and ANOVA were applied to investigate the differences of the answers of the respondents to the origin of their self-esteem and the reasons for low self-esteem. The results revealed that there are no significant differences in the origin of their self-esteem and the reasons of low esteem as to the eight group of respondent’s. Moreover, most causes of low esteem are caused by hearing a comment or experiencing an incident that has a negative impact student mentally and emotionally, poor health, being bullied, lack of support from family, friends, and job loss, experiencing verbal and sexual abuse and are in a violent relationship, feelings of isolation, divorce, dysfunctional family, death and lack of achievement at work and at school, trying to conform to stereotypes and prove our independence from our parents.

Keywords: characterization, plan of action, profile, self-esteem

Procedia PDF Downloads 175

Authors: Abdelhammid Chibane

Abstract:

Often, for architectural reasons or designs, several buildings have a non-uniform profile in elevation. Depending on the configuration of the construction and the arrangements structural elements, the non-uniform profile in elevation (the recess) is considered concept of a combination of non-uniform distributions of strength, stiffness, weight and geometry along the height of irregular structures. Therefore, this type of configuration can induce irregular distribution load causing a serious concentration stresses at the discontinuity. This therefore requires a serious behavioral treatment buildings in an earthquake. If appropriate measures are not taken into account, structural irregularity may become a major source of damage during earthquakesEarth. In the past, several research investigations have identified differences in dynamic response of irregular and regular porches. Among the most notable differences are the increments of displacements and ductility applications in floors located above the level of the shoulder and an increase in the contribution of the higher modes cisaillement1 efforts, ..., 10. The para -ssismiques codes recommend the methods of analysis Dynamic (or modal history) to establish the forces of calculation instead of the static method equivalent, which is basically applicable only to regular structures without major discontinuities in the mass, rigidity and strength along the height 11, 12 .To investigate the effects of irregular profiles on the structures, the main objective of this study was the assessment of the inelastic response, in terms of applications of ductility four types of non-uniform multi-stage structures subjected to relatively severe earthquakes. In the This study, only the parallel responses are analyzed setback.

Keywords: buildings, concentration stresses, ductility, ductility, designs, irregular structures

Procedia PDF Downloads 262

Authors: Arnaldo G. de Oliveira, Jr, Matthieu Tubino

Abstract:

The transesterification process of triglycerides with alcohols that occurs during the biodiesel synthesis causes continuous changes in several physical properties of the reaction mixture, such as refractive index, viscosity and density. Amongst them, density can be an useful parameter to monitor the reaction, in order to predict the composition of the reacting mixture and to verify the conversion of the oil into biodiesel. In this context, a system was constructed in order to continuously determine changes in the density of the reacting mixture containing soybean oil, methanol and sodium methoxide (30 % w/w solution in methanol), stirred at 620 rpm at room temperature (about 27 °C). A polyethylene pipe network connected to a peristaltic pump was used in order to collect the mixture and pump it through a coil fixed on the plate of an analytical balance. The collected mass values were used to trace a curve correlating the mass of the system to the reaction time. The density variation profile versus the time clearly shows three different steps: 1) the dispersion of methanol in oil causes a decrease in the system mass due to the lower alcohol density followed by stabilization; 2) the addition of the catalyst (sodium methoxide) causes a larger decrease in mass compared to the first step (dispersion of methanol in oil) because of the oil conversion into biodiesel; 3) the final stabilization, denoting the end of the reaction. This density variation profile provides information that was used to predict the composition of the mixture over the time and the reaction rate. The precise knowledge of the duration of the synthesis means saving time and resources on a scale production system. This kind of monitoring provides several interesting features such as continuous measurements without collecting aliquots.

Keywords: biodiesel, density measurements, online continuous monitoring, synthesis

Procedia PDF Downloads 576

Authors: Khairul Zahreen Mohd Arof, Rahimah Muhamad

Abstract:

Oil palm fiber (OPF) is a fibrous material produced from the waste of palm oil industry which is suitable to be used in construction industry. The applications of OPF in concrete can reduce the material costs and enhance concrete behavior. Dog-bone test provides significant results for investigating the behavior of fiber reinforced concrete under tensile loading. It is able to provide stress-strain profile, modulus of elasticity, stress at cracking point and total crack width. In this research, dog-bone tests have been conducted to analyze total crack width, stress-strain profile, and modulus of elasticity of OPFC. Specimens are in a dog-bone shape with a long notch in the middle as compared to the end, to ensure cracks occur only within the notch. Tests were instrumented using a universal testing machine Shimadzu 300kN, a linear variable differential transformer and two strain gauges. A total of nine specimens with different fibers at fiber volume fractions of 0.75%, 1.00%, and 1.25% have been tested to analyze the behavior under tensile loading. Also, three specimens of plain concrete fiber have been tested as control specimens. The tensile test of all specimens have been carried out for concrete age exceed 28 days. It shows that OPFC able to reduce total crack width. In addition, OPFC has higher cracking stress than plain concrete. The study shows plain concrete can be improved with the addition of OPF.

Keywords: cracks, crack width, dog-bone test, oil palm fiber concrete

Procedia PDF Downloads 344

Authors: Michelle Odudu

Abstract:

Ghana and Nigeria are known for their high levels of Occupational Fraud in public offices. The governments of both countries have emphasised their commitment to reducing the losses caused to the state by pledging their allegiance to the counter-fraud agencies to help tackle Occupational Fraud. Yet it seems that the prosecution of such cases is ineffective as high-profile fraudsters can operate with immunity and their cases remain unprosecuted. This research project was based on in-depth examinations of 50 occupational fraud cases involving high-profile individuals in both countries. In doing so, it established the characteristics of those who were prosecuted; the extent to which prosecutions were effectively managed; the barriers to effective prosecutions; and the similarities or differences between the occurrences in both countries. The aim of the project is to examine the practice of and barriers to prosecution of large-scale occupational fraud of those in senior public positions in Ghana and Nigeria. The study drew on the experiences of stakeholders such as defence and prosecution barristers, academics, and fraud analysts via semi-structured interviews and questionnaires. 13 interviews were conducted in Ghana and in Nigeria, where respondents were recruited using a snowball approach. Questionnaires were physically distributed: 20 of the staff at EOCO and 10 to NGO staff in Ghana; 6 and 5 came back, respectively. The empirical data collected suggests that there is no lack of will on the agencies’ part to at least commence proceedings. However, various impediments hamper a successful completion of prosecution. Challenges were more evident in Nigeria, where agencies are less effective at retrieving stolen assets and changing social norms. This is further compounded by several cultural and political factors, which create limitations leaving many cases ‘still pending’.

Keywords: comparative, prosecution, punishment, international, whitecollar, fraud

Procedia PDF Downloads 133

Authors: Baljinder Singh, Navneet Sharma

Abstract:

Chromium is an essential nutrient involved in normal carbohydrate and lipid metabolism. It influences glucose metabolism by potentiating the action as taking part in insulin signal amplification mechanism. A placebo-controlled single blind, prospective study was carried out to investigate the effect of chromium supplementation on blood glucose, HbA1C and lipid profile in newly onset patients with type-2 diabetes. Total 40 newly onset type-2 diabetics were selected and after one month stabilization further randomly divided into two groups viz. study group and placebo group. The study group received 9 gm brewer’s yeast (42 μ Cr) daily and the other placebo group received yeast devoid of chromium for 3 months. Subjects were instructed not to change their normal eating and living habits. Fasting blood glucose, HbA1C and lipid profile were analyzed at beginning and completion of the study. Results revealed that fasting blood glucose level significantly reduced in the subjects consuming yeast supplemented with chromium (197.65±6.68 to 103.68±6.64 mg/dl; p<0.001). HbA1C values improved significantly from 9.51±0.26% to 6.86±0.28%; p<0.001 indicating better glycaemic control. In experimental group total cholesterol, TG and LDL levels were also significantly reduced from 199.66±3.11 to 189.26±3.01 mg/dl; p<0.02, 144.94±8.31 to 126.01±8.26; p<0.05 and 119.19±1.71 to 99.58±1.10; p<0.001 respectively. These data demonstrate beneficial effect of chromium supplementation on glycaemic control and lipid variables in subjects with newly onset type-2 diabetes.

Keywords: type-2 diabetes, chromium, glucose, HbA1C

Procedia PDF Downloads 242

Authors: Hussaini Tunde Subairu

Abstract:

Small and Medium Enterprises (SMEs) sectors serve as catalyst for employment generation, national growth, poverty reduction and economic development in developing and developed countries. However, in Nigeria despite copious and plethora of government policies and stimulus schemes directed at SMEs, the sector is still characterized by high rate of failure and discontinuities. This study therefore investigated owners/managers profile, firms characteristics and external factors as possible determinants of SMEs growth from selected SMEs in Kwara State. Primary data were sourced from 200 SMEs respondents registered with the National Association of Small and Medium Enterprises (NASMES) in Kwara State Central Senatorial District. Multiple Regressions Analysis (MRA) was used to analyze the relationship between dependent and independent variables, and pair wise correlation was employed to examine the relationship among independent variables. The Analysis of Variable (ANOVA) was employed to indicate the overall significant of the model The findings revealed that Analysis of variance (ANOVA) put the value of F-statistics at 420.45 and p-value at 0.000 was significant. The values of R2 and Adjusted R2 of 0.9643 and 0.9620 respectively suggested that 96 percent of variations in employment growth were explained by the explanatory variables. The level of technical and managerial education has t- value of 24.14 and p-value of 0.001, length of managers/owners experience in similar trade with t- value of 21.37 and p-value of 0.001, age of managers/owners with t- value of 42.98 and p-value of 0.001, firm age with t- value of 25.91 and p-value of 0.001, numbers of firms in a cluster with t- value of 7.20 and p-value of 0.001, access to formal finance with t-value of 5.56 and p-value of 0.001, firm technology innovation with t- value of 25.32 and p-value of 0.01, institutional support with t- value of 18.89 and p-value of 0.01, globalization with t- value of 9.78 and p-value of 0.01, and infrastructure with t-value of 10.75 and p-value of 0.01. The result also indicated that initial size has t-value of -1.71 and p-value of 0.090 which is consistent with Gibrat’s Law. The study concluded that owners/managers profile, firm specific characteristics and external factors substantially influenced employment growths of SMEs in the study area. Therefore, policy implication should enhance human capital development of SMEs owners/managers, and strengthen fiscal policy thrust through imposition on tariff regime to minimize effect of globalization. Governments at all level must support SMEs growth radically and enhance institutional support for SMEs growth and radically and significantly upgrading key infrastructure as rail/roads, rail, telecommunications, water and power.

Keywords: external factors, firm specific characteristics, owners / manager profile, small and medium enterprises

Procedia PDF Downloads 244

Authors: Nayera E. Hassan, Sahar A. El-Masry, Rokia A. El Banna, Mones M. Abu Shady, Muhammad Al-Tohamy, Manal Mouhamed Ali, Mehrevan M. Abd El-Moniem, Mona Anwar

Abstract:

Association between vitamin D, adiponectin and obesity is a matter of debate, as they play important role in linking obesity with different cardiometabolic risk factors. Objectives: Evaluation of the association between metabolic risk factors with both adiponectin and vitamin D levels and that between adiponectin and vitamin D among obese Egyptian children. Subjects and Methods: This case-control cross-sectional study consisted of 65 obese and 30 healthy children, aged 8-11 years. 25-hydroxy vitamin D (25(OH) D) level, serum adiponectin, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) were measured. Results: The mean 25(OH) D levels in the obese and control groups were 29.9± 10.3 and 39.7 ± 12.7 ng/mL respectively (P < 0.001). The mean 25(OH) D and adiponectin levels in the obese were lower than that in the control group (P < 0.0001). 25(OH) D were inversely correlated with body mass index (BMI), triglyceride, total cholesterol and LDL-cholesterol (LDL-C), while adiponectin level were inversely correlated with systolic blood pressure (SBP), and diastolic blood pressure (DBP), and positively correlated with HDL-C. However, there is no relation between 25(OH) D and adiponectin levels among obese children and total sample. Conclusion: In spite of strong association between vitamin D and adiponectin levels with metabolic risk factors and obesity, there is no relation between 25(OH) D and adiponectin levels. In obese children, there are significant negative correlations between 25(OH) D with lipid profile, and between adiponectin levels with blood pressure. At certain adiponectin level, the relation between it and BMI disappears.

Keywords: 25-hydroxy vitamin D, adiponectin, lipid profile, blood pressure, children

Procedia PDF Downloads 370

Authors: Hend Ben Tkhayat , Khaled Al Zahabi, Husam Younes

Abstract:

Introduction: Vildagliptin (VG), a dipeptidyl peptidase-4 inhibitor (DPP-4), was proven to be an active agent for the treatment of type 2 diabetes. VG works by enhancing and prolonging the activity of incretins which improves insulin secretion and decreases glucagon release, therefore lowering blood glucose level. It is usually used with various classes, such as insulin sensitizers or metformin. VG is currently only marketed as an immediate-release tablet that is administered twice daily. In this project, we aim to formulate an extended-release with a zero-order profile tableted lipid microparticles of VG that could be administered once daily ensuring the patient’s convenience. Method: The spray-congealing technique was used to prepare VG microparticles. Compritol® was heated at 10 oC above its melting point and VG was dispersed in the molten carrier using a homogenizer (IKA T25- USA) set at 13000 rpm. VG dispersed in the molten Compritol® was added dropwise to the molten Gelucire® 50/13 and PEG® (400, 6000, and 35000) in different ratios under manual stirring. The molten mixture was homogenized and Carbomer® amount was added. The melt was pumped through the two-fluid nozzle of the Buchi® Spray-Congealer (Buchi B-290, Switzerland) using a Pump drive (Master flex, USA) connected to a silicone tubing wrapped with silicone heating tape heated at the same temperature of the pumped mix. The physicochemical properties of the produced VG-loaded microparticles were characterized using Mastersizer, Scanning Electron Microscope (SEM), Differential Scanning Calorimeter (DSC) and X‐Ray Diffractometer (XRD). VG microparticles were then pressed into tablets using a single punch tablet machine (YDP-12, Minhua pharmaceutical Co. China) and in vitro dissolution study was investigated using Agilent Dissolution Tester (Agilent, USA). The dissolution test was carried out at 37±0.5 °C for 24 hours in three different dissolution media and time phases. The quantitative analysis of VG in samples was realized using a validated High-Pressure Liquid Chromatography (HPLC-UV) method. Results: The microparticles were spherical in shape with narrow distribution and smooth surface. DSC and XRD analyses confirmed the crystallinity of VG that was lost after being incorporated into the amorphous polymers. The total yields of the different formulas were between 70% and 80%. The VG content in the microparticles was found to be between 99% and 106%. The in vitro dissolution study showed that VG was released from the tableted particles in a controlled fashion. The adjustment of the hydrophilic/hydrophobic ratio of excipients, their concentration and the molecular weight of the used carriers resulted in tablets with zero-order kinetics. The Gelucire 50/13®, a hydrophilic polymer was characterized by a time-dependent profile with an important burst effect that was decreased by adding Compritol® as a lipophilic carrier to retard the release of VG which is highly soluble in water. PEG® (400,6000 and 35 000) were used for their gelling effect that led to a constant rate delivery and achieving a zero-order profile. Conclusion: Tableted spray-congealed lipid microparticles for extended-release of VG were successfully prepared and a zero-order profile was achieved.

Keywords: vildagliptin, spray congealing, microparticles, controlled release

Procedia PDF Downloads 121

Authors: T. Costa, D. Narvaez, K. Melo, M. Villalva

Abstract:

Installation of micro-generators based on renewable energy in power distribution system has increased in recent years, with the main renewable sources being solar and wind. Due to the intermittent nature of renewable energy sources, such micro-generators produce time-varying energy which does not correspond at certain times of the day to the peak energy consumption of end users. For this reason, the use of energy storage units next to the grid contributes to the proper leveling of the buses’ voltage level according to Brazilian energy quality standards. In this work, the effect of the addition of a photovoltaic solar generator and a store of energy in the busbar voltages of an electric system is analyzed. The consumption profile is defined as the average hourly use of appliances in a common residence, and the generation profile is defined as a function of the solar irradiation available in a locality. The power summation method is validated with analytical calculation and is used to calculate the modules and angles of the voltages in the buses of an electrical system based on the IEEE standard, at each hour of the day and with defined load and generation profiles. The results show that bus 5 presents the worst voltage level at the power consumption peaks and stabilizes at the appropriate range with the inclusion of the energy storage during the night time period. Solar generator maintains improvement of the voltage level during the period when it receives solar irradiation, having peaks of production during the 12 pm (without exceeding the appropriate maximum levels of tension).

Keywords: energy storage, power distribution system, solar generator, voltage level

Procedia PDF Downloads 141

Authors: Yasuyuki Takahashi, Hirotaka Shimada, Takao Kanzaki

Abstract:

A Dual-detector SPECT system is widely by use of myocardial SPECT studies. With 180-degree (180°) acquisition, reconstructed images are distorted in the posterior wall of myocardium due to the lack of sufficient data of posterior projection. We hypothesized that quality of myocardial SPECT images can be improved by the addition of data acquisition of only a few posterior projections to ordinary 180° acquisition. The proposed acquisition method (180° plus acquisition methods) uses the dual-detector SPECT system with a pair of detector arranged in 90° perpendicular. Sampling angle was 5°, and the acquisition range was 180° from 45° right anterior oblique to 45° left posterior oblique. After the acquisition of 180°, the detector moved to additional acquisition position of reverse side once for 2 projections, twice for 4 projections, or 3 times for 6 projections. Since these acquisition methods cannot be done in the present system, actual data acquisition was done by 360° with a sampling angle of 5°, and projection data corresponding to above acquisition position were extracted for reconstruction. We underwent the phantom studies and a clinical study. SPECT images were compared by profile curve analysis and also quantitatively by contrast ratio. The distortion was improved by 180° plus method. Profile curve analysis showed increased of cardiac cavity. Analysis with contrast ratio revealed that SPECT images of the phantoms and the clinical study were improved from 180° acquisition by the present methods. The difference in the contrast was not clearly recognized between 180° plus 2 projections, 180° plus 4 projections, and 180° plus 6 projections. 180° plus 2 projections method may be feasible for myocardial SPECT because distortion of the image and the contrast were improved.

Keywords: 180° plus acquisition method, a few posterior projections, dual-detector SPECT system, myocardial SPECT

Procedia PDF Downloads 296

Authors: Haydar Kepekçi, Baha Zafer, Hasan Rıza Güven

Abstract:

Noise disturbance is one of the major factors considered in the fast development of aircraft technology. This paper reviews the flow field, which is examined on the 2D NACA0015 and 3D NACA0012 blade profile using SST k-ω turbulence model to compute the unsteady flow field. We inserted the time-dependent flow area variables in Ffowcs-Williams and Hawkings (FW-H) equations as an input and Sound Pressure Level (SPL) values will be computed for different angles of attack (AoA) from the microphone which is positioned in the computational domain to investigate effect of augmentation of unsteady 2D and 3D airfoil region noise level. The computed results will be compared with experimental data which are available in the open literature. As results; one of the calculated Cp is slightly lower than the experimental value. This difference could be due to the higher Reynolds number of the experimental data. The ANSYS Fluent software was used in this study. Fluent includes well-validated physical modeling capabilities to deliver fast, accurate results across the widest range of CFD and multiphysics applications. This paper includes a study which is on external flow over an airfoil. The case of 2D NACA0015 has approximately 7 million elements and solves compressible fluid flow with heat transfer using the SST turbulence model. The other case of 3D NACA0012 has approximately 3 million elements.

Keywords: 3D blade profile, noise disturbance, aeroacoustics, Ffowcs-Williams and Hawkings (FW-H) equations, k-ω-SST turbulence model

Procedia PDF Downloads 212

Authors: Marica Pidor-Quingco, Francis Cabatingan

Abstract:

Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

Procedia PDF Downloads 136