Search results for: functional outcome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4821

Search results for: functional outcome

861 Challenging Clinical Scenario of Blood Stream Candida Infections – An Indian Experience

Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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860 Development and Psychometric Validation of the Hospitalised Older Adults Dignity Scale for Measuring Dignity during Acute Hospital Admissions

Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

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Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

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859 Children in Conflict: Institutionalization as a Rehabilitative Mechanism in Jammu and Kashmir

Authors: Moksha Singh

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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.

Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation

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858 Problems concerning Formation of Institutional Framework for Electronic Democracy in Georgia

Authors: Giorgi Katamadze

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Open public service and accountability towards citizens is an important feature of democratic state based on rule of law. Effective use of electronic resources simplifies bureaucratic procedures, makes direct communications, helps exchange information, ensures government’s openness and in general helps develop electronic/digital democracy. Development of electronic democracy should be a strategic dimension of Georgian governance. Formation of electronic democracy, its functional improvement should become an important dimension of the state’s information policy. Electronic democracy is based on electronic governance and implies modern information and communication systems, their adaptation to universal standards. E-democracy needs involvement of governments, voters, political parties and social groups in an electronic form. In the last years the process of interaction between the citizen and the state becomes simpler. This process is achieved by the use of modern technological systems which gives to a citizen a possibility to use different public services online. For example, the website my.gov.ge makes interaction between the citizen, business and the state more simple, comfortable and secure. A higher standard of accountability and interaction is being established. Electronic democracy brings new forms of interactions between the state and the citizen: e-engagement – participation of society in state politics via electronic systems; e-consultation – electronic interaction among public officials, citizens and interested groups; e-controllership – electronic rule and control of public expenses and service. Public transparency is one of the milestones of electronic democracy as well as representative democracy as only on mutual trust and accountability can democracy be established. In Georgia, institutional changes concerning establishment and development of electronic democracy are not enough. Effective planning and implementation of a comprehensive and multi component e-democracy program (central, regional, local levels) requires telecommunication systems, institutional (public service, competencies, logical system) and informational (relevant conditions for public involvement) support. Therefore, a systematic project of formation of electronic governance should be developed which will include central, regional, municipal levels and certain aspects of development of instrumental basis for electronic governance.

Keywords: e-democracy, e-governance, e-services, information technology, public administration

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857 State of Conservation of the British Colonial Architectural Heritage of Karachi: Case Study of Damage Mapping of Empress Market Building

Authors: Tania Ali Soomro

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In 1839, the British, after the annexation of the port city of Karachi, established a new urban centre consisting of various quarters and introduced new settlements there. These quarters were out of the boundaries of fortified native old area and now contain much of the oldest parts of the city and signify the colonial history of Karachi, in particular the Saddar Bazaar and the neighboring areas of Kharadar and Mithadar. These quarters bestow a mix of functional typology built in a hybrid form of construction - an adaptation of the western architectural attributes to regional requirements and characteristics. This approach is referred to as the Anglo Vernacular, Colonial or the Domestic Gothic architectural form. This research paper investigates the historical and architectural value of one such property: the Empress Market designed by then Municipal Architect, Ar. James Strachan in 1889 as a commemorative monument for the jubilee of Her Majesty the Queen Victoria; Empress of British India, at that time. This paper presents information on the present conservation status of the market building and highlights its role as a catalyst to the community interconnection. This building has survived to present day and functioned well, despite undergoing numerous transformations. A detailed analysis of the bio-degradation (Natural-Chemical dissolution of material) and the bio-deterioration (Manmade-Negative state change of the material) of the building, based on the examination of the prevailing causes of these bio-alterations is carried out, and is presented in form of a damage atlas containing both the categories of bio-alteration/ changes occurred to the building over the time. The research methodology followed in this paper starts with the available archival analysis, physical observation, photographic documentation, the statistics review and the interviews with the direct and indirect stakeholders. The results and findings of this research portray that these bio-alterations and changes are the essential part of the life cycle of Empress Market building which illustrate the historic development of the premise and therefore ought to be given due importance (depending upon their condition) while developing the conservation plan for the building.

Keywords: British colonial architecture, bio-alteration, bio-degradation, bio-deterioration, domestic gothic architectural form

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856 The LMPA/Epoxy Mixture Encapsulation of OLED on Polyimide Substrate

Authors: Chuyi Ye, Minsang Kim, Cheol-Hee Moon

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The organic light emitting diode(OLED), is a potential organic optical functional materials which is considered as the next generation display technology with the advantages such as all-solid state, ultra-thin thickness, active luminous and flexibility. Due to the development of polymer-inorganic substrate, it becomes possible to achieve the flexible OLED display. However the organic light-emitting material is very sensitive to the oxygen and water vapor, and the encapsulation requires water vapor transmission rate(WVTR) and oxygen transmission rate(OTR) as lower as 10-6 g/(m2.d) and 10-5 cm3/(m2.d) respectively. In current situation, the rigorous WVTR and OTR have restricted the application of the OLED display. Traditional epoxy/getter or glass frit approaches, which have been widely applied on glass-substrate-based devices, are not suitable for transparent flexible organic devices, and mechanically flexible thin-film approaches are required. To ensure the OLED’s lifetime, the encapsulation material of the OLED package is very important. In this paper, a low melting point alloy(LMPA)-epoxy mixture in the encapsulation process is introduced. There will be a phase separation when the mixture is heated to the melting of LMPA and the formation of the double line structure between two substrates: the alloy barrier has extremely low WVTR and OTR and the epoxy fills the potential tiny cracks. In our experiment, the PI film is chosen as a flexible transparent substrate, and Mo and Cu are deposited on the PI film successively. Then the two metal layers are photolithographied to the sealing pattern line. The Mo is a transition layer between the PI film and Cu, at the same time, the Cu has a good wettability with the LMPA(Sn-58Bi). At last, pattern is printed with LMPA layer and applied voltage, the gathering Joule heat melt the LMPA and form the double line structure and the OLED package is sealed in the same time. In this research, the double-line encapsulating structure of LMPA and epoxy on the PI film is manufactured for the flexible OLED encapsulation, and in this process it is investigated whether the encapsulation satisfies the requirement of WVTR and OTR for the flexible OLED.

Keywords: encapsulation, flexible, low melting point alloy, OLED

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855 Ecofriendly Approach for the Management of Red Cotton Bug Dysdercus koenigii by Botanicals

Authors: S: Kayesth, K. K. Gupta

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The indiscriminate use of insecticides causes environmental contamination, adversely affects non-target organisms and develops resistance among insects and pests. There has always been felt a need for methods of control which can overcome these environmental and other ecological issues. The present study was designed to evaluate the effect of different plants volatiles on survival, longevity, growth, development and reproduction of Dysdercus koenigii. The hexane extract of three different plants (Catharanthus roseus, Ocimum sanctum and Lantana camara) was used. The fifth instars were exposed to hexane extract with concentrations of 10%, 5%, 2.5%, 1.25%, 0.1%, 0.5%, 0.25%, 0.13% and 0.06% while adults were treated with 10%, 5%, 2.5% and 1.25%. 1-ml of each of these concentrations was used to make a thin film in sterilized glass jars of 500 ml capacity. Fifteen newly emerged fifth instar nymphs and ten pairs of adult bugs were treated separately with the extracts for 24 hour exposure to the plant volatiles. The effect of these plant extract was observed and readings were recorded for 23 days. Survival and longevity of both fifth instars and adults were in correlation with the concentrations of the plant extracts. The extracts did not influence growth of fifth instars significantly but impaired their development significantly at higher concentrations. The treated nymphs at higher concentrations either could not moult or died and those which could moult moulted into supranumery instars, adultoids or adults with wing deformities. The supranumery insects retained the nymphal characters except increased body size and wing pads. The adultoids had wing deformities and non-functional reproductive organs. Adultoids exhibited courtship and mounting attempts but were not able to mate. At lower concentrations from 0.1 to 0.06% the fifth instars developed into adults with fewer deformities. At these concentrations, the fecundity and fertility of these adults were drastically reduced. On the contrary, the treated adults also had reduced fecundity and fertility compared to control. Among three plant extracts Ocimcum was most toxic for both fifth instars and adults in terms of survival and longevity. Catharanthus, Ocimum and Lantana appeared to have potential molecules which possessed insect juvenile hormone like activity. Potential application of these plant extracts in IPM was discussed.

Keywords: Catharanthus, Ocimum, Lantana, Dysdercus koenigii

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854 Designing a Combined Outpatient and Day Treatment Eating Disorder Program for Adolescents and Transitional Aged Youth: A Naturalistic Case Study

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

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853 Endoscopic Stenting of the Main Pancreatic Duct in Patients With Pancreatic Fluid Collections After Pancreas Transplantation

Authors: Y. Teterin, S. Suleymanova, I. Dmitriev, P. Yartcev

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Introduction: One of the most common complications after pancreas transplantation are pancreatic fluid collections (PFCs), which are often complicated not only by infection and subsequent disfunction of the pancreatoduodenal graft (PDG), but also with a rather high mortality rate of recipients. Drainage is not always effective and often requires repeated open surgical interventions, which worsens the outcome of the surgery. Percutaneous drainage of PFCs combined with endoscopic stenting of the main pancreatic duct of the pancreatoduodenal graft (MPDPDG) showed high efficiency in the treatment of PFCs. Aims & Methods: From 01.01.2012 to 31.12.2021 at the Sklifosovsky Research Institute for Emergency Medicine were performed 64 transplantations of PDG. In 11 cases (17.2%), the early postoperative period was complicated by the formation of PFCs. Of these, 7 patients underwent percutaneous drainage of pancreonecrosis with high efficiency and did not required additional methods of treatment. In the remaining 4 patients, drainage was ineffective and was an indication for endoscopic stenting of the MPDPDG. They were the ones who made up the study group. Among them were 3 men and 1 woman. The mean age of the patients was 36,4 years.PFCs in these patients formed on days 1, 12, 18, and 47 after PDG transplantation. We used a gastroscope to stent the MPDPDG, due to anatomical features of the location of the duodenoduodenal anastomosis after PDG transplantation. Through the endoscope channel was performed selective catheterization of the MPDPDG, using a catheter and a guidewire, followed by its contrasting with a water-soluble contrast agent. Due to the extravasation of the contrast, was determined the localization of the defect in the PDG duct system. After that, a plastic pancreatic stent with a diameter of 7 Fr. and a length of 7 cm. was installed along guidewire. The stent was installed in such a way that its proximal edge completely covered the defect zone, and the distal one was determined in the intestinal lumen. Results: In all patients PDG pancreaticography revealed extravasation of a contrast in the area of the isthmus and body of the pancreas, which required stenting of the MPDPDG. In 1 (25%) case, the patient had a dislocation of the stent into the intestinal lumen (III degree according to Clavien-Dindo (2009)). This patient underwent repeated endoscopic stenting of the MPDPDG. On average 23 days after endoscopic stenting of the MPDPDG, the drainage tubes were removed and after approximately 40 days all patients were discharged in a satisfactory condition with follow-up endocrinologist and surgeon consultation. Pancreatic stents were removed after 6 months ± 7 days. Conclusion: Endoscopic stenting of the main pancreatic duct of the donor pancreas is by far the most highly effective and minimally invasive method in the treatment of PFCs after transplantation of the pancreatoduodenal complex.

Keywords: pancreas transplantation, endoscopy surgery, diabetes, stenting, main pancreatic duct

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852 The Igbo People's Dual Religion Identity on Rite of Marriage in Imo State

Authors: Henry Okechukwu Onyeiwu, Arfah Ab. Majid

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To fully understand the critical role of marriage in society, it is important to view it as a social institution that provides some basic social needs for society. A ‘social institution’ is the network of shared meanings, norms, definitions, expectations, and understandings held by the members of society. It is what guides and governs how the members of the society are expected to act and interact, what is socially desirable and legitimate, what they should be striving for, and so on. One of the major social institutions is marriage. Marriage is and has often focused on children and what is best for them because the rising generation literally is the future of every society. However, according to the aforementioned definition, which notes that marriage may also be a union between two persons of the same sex with legal support, this study stands with the definitions that are based on marriage being a union between a man and woman that is the most appropriate in Igbo land and not the other way round. The issue to be evaluated concerns marriage as it associates with Igbo Catholic Christians in Nigeria. Pasts of Igbo culture should be better organized into the Christian faith. Igbo Christians actually convey a significant number of their customary thoughts, customs, and social qualities, particularly regarding marriage, in the aftermath of switching to Christianity. The analyst agrees that marriage among Igbo Christians warrants adequate evolution. This study, therefore, concentrates on the Igbo community’s interpretation of the concept of culture and religion and the religious implications of traditional marriage and Christian marriage ceremonies in Igbo. The research design of this study is a qualitative design that provides in-depth information on the dual religious identity of the Igbo people on the rite of marriage in Imo state. The study population was composed of both male and female members from each selected local government area in Imo State. Thematic analysis was used to elaborate on the result from the respondents. This survey found that reputation is a major concern for Ibo people. Parental discomfort can lead to the use of coping strategies such as displacement, in which parents pass on their own vulnerable sentiments to their children. Those who participate in marriage negotiations feel the pain of their parents because they are unable to communicate their own feelings. As a result, participants experience increased stress and a range of negative emotions related to their marriage, including worry, dissatisfaction, and ambivalence. It was concluded that when it comes to Igbo culture, marriage is seen as a need for the continuation of the family’s lineage of descent, according to the outcome. The Task at hand was to discover how the locals preparing to get married define the impending transition. Imo State is home to the practice of Igba-nkwu, where the woman is either inherited or taken in the place of another.

Keywords: Igbo, culture, Christianity, traditional marriage, Christian wedding

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851 A Systematic Review of Efficacy and Safety of Radiofrequency Ablation in Patients with Spinal Metastases

Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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850 Insulin-Producing Cells from Adult Human Bone Marrow Mesenchymal Stem Cells Control Chemically-Induced Diabetes in Dogs

Authors: Maha Azzam, Mahmoud Gabr, Mahmoud Zakaria, Ayman Refaie, Amani Ismail, Sherry Khater, Sylvia Ashamallah, Mohamed Ghoniem

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Evidence was provided that human bone marrow-derived mesenhymal stem cells (HBM-MSCs) could be differentiated to form insulin-producing cells (IPCs). Transplantation of these cells was able to cure chemically-induced diabetes in nude mice. The efficacy of these cells to control diabetes in large animals was carried out to evaluate the sufficient number of cells needed/Kg body weight and to determine the functional longevity in vivo. Materials/Methods: Ten male mongrel dogs weighing 15-20 Kg were used in this study. Diabetes was chemically-induced in 7 dogs by a mixture of alloxan and streptozotocin. Three non-diabetic served as normal controls. Differentiated HBM-MSCs (5 million/Kg) were encapsulated in theracyte capsules and transplanted beneath the rectus sheath. Each dog received 2 capsules. One dog died 4 days postoperative from inhalation pneumonia. The remaining 6 dogs were followed up for 6-18 months. Results: Four dogs became normoglycemic within 6-8 weeks with normal glucose tolerance curves providing evidence that the transplanted cells were glucose-sensitive and insulin-responsive. In the remaining 2 dogs, fasting blood glucose was reduced but did not reach euglycemic levels. The sera of all transplanted dogs contained human insulin and c-peptide but negligible levels of canine insulin. When the HBM-MSCs loaded capsules were removed, rapid return of diabetic state was noted. The harvested capsules were examined by immunofluorescence. IPCs were seen and co-expression of with c-peptide was confirmed. Furthermore, all the pancreatic endocrine genes were expressed by the transplanted cells. Conclusions: This study provided evidence that theracyte capsules could protect the xenogenic HBM-MSCs from the host immune response. This is an important issue when clinical stem cell therapy is considered for definitive treatment for T1DM.

Keywords: diabetes, mesenchymal stem cells, dogs, Insulin-producing cells

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849 Digital Value Co-Creation: The Case of Worthy a Virtual Collaborative Museum across Europe

Authors: Camilla Marini, Deborah Agostino

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Cultural institutions provide more than service-based offers; indeed, they are experience-based contexts. A cultural experience is a special event that encompasses a wide range of values which, for visitors, are primarily cultural rather than economic and financial. Cultural institutions have always been characterized by inclusivity and participatory practices, but the upcoming of digital technologies has put forward their interest in collaborative practices and the relationship with their audience. Indeed, digital technologies highly affected the cultural experience as it was conceived. Especially, museums, as traditional and authoritative cultural institutions, have been highly challenged by digital technologies. They shifted by a collection-oriented toward a visitor-centered approach, and digital technologies generated a highly interactive ecosystem in which visitors have an active role, shaping their own cultural experience. Most of the studies that investigate value co-creation in museums adopt a single perspective which is separately one of the museums or one of the users, but the analysis of the convergence/divergence of these perspectives is still emphasized. Additionally, many contributions focus on digital value co-creation as an outcome rather than as a process. The study aims to provide a joint perspective on digital value co-creation which include both museum and visitors. Also, it deepens the contribution of digital technologies in the value co-creation process, addressing the following research questions: (i) what are the convergence/divergence drivers on digital value co-creation and (ii) how digital technologies can be means of value co-creation? The study adopts an action research methodology that is based on the case of WORTHY, an educational project which involves cultural institutions and schools all around Europe, creating a virtual collaborative museum. It represents a valuable case for the aim of the study since it has digital technologies at its core, and the interaction through digital technologies is fundamental, all along with the experience. Action research has been identified as the most appropriate methodology for researchers to have direct contact with the field. Data have been collected through primary and secondary sources. Cultural mediators such as museums, teachers and students’ families have been interviewed, while a focus group has been designed to interact with students, investigating all the aspects of the cultural experience. Secondary sources encompassed project reports and website contents in order to deepen the perspective of cultural institutions. Preliminary findings highlight the dimensions of digital value co-creation in cultural institutions from a museum-visitor integrated perspective and the contribution of digital technologies in the value co-creation process. The study outlines a two-folded contribution that encompasses both an academic and a practitioner level. Indeed, it contributes to fulfilling the gap in cultural management literature about the convergence/divergence of service provider-user perspectives but it also provides cultural professionals with guidelines on how to evaluate the digital value co-creation process.

Keywords: co-creation, digital technologies, museum, value

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848 Compromising Quality of Life in Low-Income Settlements: The Case of Ashrayan Prakalpa, Khulna

Authors: Salma Akter, Md. Kamal Uddin

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Quality of life is a vast and comprehensive concept refers overall well-being of society. Current research and efforts of policymakers and planners are concerned to increase the urban quality of life through the sustainable development of city and country. While such efforts effectively improve the quality of life of urban dwellers through improved social, economic and housing infrastructures, very little has been paid to improve low-income settlement users more specifically government provided shelter projects. The top-down shelter policies and its objective indicators (physical design elements and physical environmental elements) indicators on low-income groups merely can ensure grassroots needs, aspiration and well-being refer as subjective qualities obliged to compromise with the quality of life. This research, therefore, aims to measure the quality of life of such government-provided low-income settlements. To do so, a conceptual framework has been developed to measure quality of life with arguing that quality of life depends on both objective and subjective indicators and needs to measure across three scales of living environment refers to macro (community), meso (neighborhood or shelter/built environment), and micro (family). The top-down shelter project, Dakshin Chandani Mahal Ashrayan Prakalpa is a resettlement/housing project of Government of Bangladesh for providing shelters and human resources development activities like education, microcredit, and training programme to landless, homeless and rootless people has been taken as case study. The study area is located at Dighalia Upazila, Khulna Bangladesh. In terms of methodology, this research is primarily exploratory and adopts a case study method and deductive approach for evaluating the quality of life. Data have been obtained from relevant literature review, key informant interview, focus group discussion, necessary drawings, photographs and participant observation across dwelling, neighborhood, and community level. Findings have revealed that Shelter users mostly compromise the quality of life at community level due to insufficient physical design elements and facilities while neighborhood and dwelling level have been manifested similar result like former ones. Thus, the outcome of this study can be beneficial for a global-level understating of the compromising the ‘quality of life’ under top-down shelter policy. Locally, for instance, in the context of Bangladesh, it can help policymakers and concerned authorities to formulate the shelter policies and take initiatives to improve the well-being of marginalized.

Keywords: Ashrayan Prakalpa, compromise, displaced people, quality of life

Procedia PDF Downloads 217
847 Computational Approach to Cyclin-Dependent Kinase 2 Inhibitors Design and Analysis: Merging Quantitative Structure-Activity Relationship, Absorption, Distribution, Metabolism, Excretion, and Toxicity, Molecular Docking, and Molecular Dynamics Simulations

Authors: Mohamed Moussaoui, Mouna Baassi, Soukayna Baammi, Hatim Soufi, Mohammed Salah, Rachid Daoud, Achraf EL Allali, Mohammed Elalaoui Belghiti, Said Belaaouad

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The present study aims to investigate the quantitative structure-activity relationship (QSAR) of a series of Thiazole derivatives reported as anticancer agents (hepatocellular carcinoma), using principally the electronic descriptors calculated by the density functional theory (DFT) method and by applying the multiple linear regression method. The developed model showed good statistical parameters (R²= 0.725, R²ₐ𝒹ⱼ= 0.653, MSE = 0.060, R²ₜₑₛₜ= 0.827, Q²𝒸ᵥ = 0.536). The energy of the highest occupied molecular orbital (EHOMO) orbital, electronic energy (TE), shape coefficient (I), number of rotatable bonds (NROT), and index of refraction (n) were revealed to be the main descriptors influencing the anti-cancer activity. Additional Thiazole derivatives were then designed and their activities and pharmacokinetic properties were predicted using the validated QSAR model. These designed molecules underwent evaluation through molecular docking (MD) and molecular dynamic (MD) simulations, with binding affinity calculated using the MMPBSA script according to a 100 ns simulation trajectory. This process aimed to study both their affinity and stability towards Cyclin-Dependent Kinase 2 (CDK2), a target protein for cancer disease treatment. The research concluded by identifying four CDK2 inhibitors - A1, A3, A5, and A6 - displaying satisfactory pharmacokinetic properties. MDs results indicated that the designed compound A5 remained stable in the active center of the CDK2 protein, suggesting its potential as an effective inhibitor for the treatment of hepatocellular carcinoma. The findings of this study could contribute significantly to the development of effective CDK2 inhibitors.

Keywords: QSAR, ADMET, Thiazole, anticancer, molecular docking, molecular dynamic simulations, MMPBSA calculation

Procedia PDF Downloads 107
846 Environmental Aspects of Alternative Fuel Use for Transport with Special Focus on Compressed Natural Gas (CNG)

Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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The history of gaseous fuel use in the motive power of vehicles dates back to the second half of the nineteenth century, and thus the beginnings of the automotive industry. The engines were powered by coal gas and became the prototype for internal combustion engines built so far. It can thus be considered that this construction gave rise to the automotive industry. As the socio-economic development advances, so does the number of motor vehicles. Although, due to technological progress in recent decades, the emissions generated by internal combustion engines of cars have been reduced, a sharp increase in the number of cars and the rapidly growing traffic are an important source of air pollution and a major cause of acoustic threat, in particular in large urban agglomerations. One of the solutions, in terms of reducing exhaust emissions and improving air quality, is a more extensive use of alternative fuels: CNG, LNG, electricity and hydrogen. In the case of electricity use for transport, it should be noted that the environmental outcome depends on the structure of electricity generation. The paper shows selected regulations affecting the use of alternative fuels for transport (including Directive 2014/94/EU) and its dynamics between 2000 and 2015 in Poland and selected EU countries. The paper also gives a focus on the impact of alternative fuels on the environment by comparing the volume of individual emissions (compared to the emissions from conventional fuels: petrol and diesel oil). Bearing in mind that the extent of various alternative fuel use is determined in first place by economic conditions, the article describes the price relationships between alternative and conventional fuels in Poland and selected EU countries. It is pointed out that although Poland has a wealth of experience in using methane alternative fuels for transport, one of the main barriers to their development in Poland is the extensive use of LPG. In addition, a poorly developed network of CNG stations in Poland, which does not allow easy transport, especially in the northern part of the country, is a serious problem to a further development of CNG use as fuel for transport. An interesting solution to this problem seems to be the use of home CNG filling stations: Home Refuelling Appliance (HRA, refuelling time 8-10 hours) and Home Refuelling Station (HRS, refuelling time 8-10 minutes). The team is working on HRA and HRS technologies. The article also highlights the impact of alternative fuel use on energy security by reducing reliance on imports of crude oil and petroleum products.

Keywords: alternative fuels, CNG (Compressed Natural Gas), CNG stations, LNG (Liquefied Natural Gas), NGVs (Natural Gas Vehicles), pollutant emissions

Procedia PDF Downloads 227
845 A Simulation-Based Study of Dust Ingression into Microphone of Indoor Consumer Electronic Devices

Authors: Zhichao Song, Swanand Vaidya

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Nowadays, most portable (e.g., smartphones) and wearable (e.g., smartwatches and earphones) consumer hardware are designed to be dustproof following IP5 or IP6 ratings to ensure the product is able to handle potentially dusty outdoor environments. On the other hand, the design guideline is relatively vague for indoor devices (e.g., smart displays and speakers). While it is generally believed that the indoor environment is much less dusty, in certain circumstances, dust ingression is still able to cause functional failures, such as microphone frequency response shift and camera black spot, or cosmetic dissatisfaction, mainly the dust build up in visible pockets and gaps which is hard to clean. In this paper, we developed a simulation methodology to analyze dust settlement and ingression into known ports of a device. A closed system is initialized with dust particles whose sizes follow Weibull distribution based on data collected in a user study, and dust particle movement was approximated as a settlement in stationary fluid, which is governed by Stokes’ law. Following this method, we simulated dust ingression into MEMS microphone through the acoustic port and protective mesh. Various design and environmental parameters are evaluated including mesh pore size, acoustic port depth-to-diameter ratio, mass density of dust material and inclined angle of microphone port. Although the dependencies of dust resistance on these parameters are all monotonic, smaller mesh pore size, larger acoustic depth-to-opening ratio and more inclined microphone placement (towards horizontal direction) are preferred for dust resistance; these preferences may represent certain trade-offs in audio performance and compromise in industrial design. The simulation results suggest the quantitative ranges of these parameters, with more pronounced effects in the improvement of dust resistance. Based on the simulation results, we proposed several design guidelines that intend to achieve an overall balanced design from audio performance, dust resistance, and flexibility in industrial design.

Keywords: dust settlement, numerical simulation, microphone design, Weibull distribution, Stoke's equation

Procedia PDF Downloads 107
844 Management of Postoperative Pain, Intercultural Differences Among Registered Nurses: Czech Republic and Kingdom of Saudi Arabia

Authors: Denisa Mackova, Andrea Pokorna

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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.

Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia

Procedia PDF Downloads 180
843 Spatial Structure of First-Order Voronoi for the Future of Roundabout Cairo Since 1867

Authors: Ali Essam El Shazly

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The Haussmannization plan of Cairo in 1867 formed a regular network of roundabout spaces, though deteriorated at present. The method of identifying the spatial structure of roundabout Cairo for conservation matches the voronoi diagram with the space syntax through their geometrical property of spatial convexity. In this initiative, the primary convex hull of first-order voronoi adopts the integral and control measurements of space syntax on Cairo’s roundabout generators. The functional essence of royal palaces optimizes the roundabout structure in terms of spatial measurements and the symbolic voronoi projection of 'Tahrir Roundabout' over the Giza Nile and Pyramids. Some roundabouts of major public and commercial landmarks surround the pole of 'Ezbekia Garden' with a higher control than integral measurements, which filter the new spatial structure from the adjacent traditional town. Nevertheless, the least integral and control measures correspond to the voronoi contents of pollutant workshops and the plateau of old Cairo Citadel with the visual compensation of new royal landmarks on top. Meanwhile, the extended suburbs of infinite voronoi polygons arrange high control generators of chateaux housing in 'garden city' environs. The point pattern of roundabouts determines the geometrical characteristics of voronoi polygons. The measured lengths of voronoi edges alternate between the zoned short range at the new poles of Cairo and the distributed structure of longer range. Nevertheless, the shortest range of generator-vertex geometry concentrates at 'Ezbekia Garden' where the crossways of vast Cairo intersect, which maximizes the variety of choice at different spatial resolutions. However, the symbolic 'Hippodrome' which is the largest public landmark forms exclusive geometrical measurements, while structuring a most integrative roundabout to parallel the royal syntax. Overview of the symbolic convex hull of voronoi with space syntax interconnects Parisian Cairo with the spatial chronology of scattered monuments to conceive one universal Cairo structure. Accordingly, the approached methodology of 'voronoi-syntax' prospects the future conservation of roundabout Cairo at the inferred city-level concept.

Keywords: roundabout Cairo, first-order Voronoi, space syntax, spatial structure

Procedia PDF Downloads 501
842 The Impact of Electrospinning Parameters on Surface Morphology and Chemistry of PHBV Fibers

Authors: Lukasz Kaniuk, Mateusz M. Marzec, Andrzej Bernasik, Urszula Stachewicz

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Electrospinning is one of the commonly used methods to produce micro- or nano-fibers. The properties of electrospun fibers allow them to be used to produce tissue scaffolds, biodegradable bandages, or purification membranes. The morphology of the obtained fibers depends on the composition of the polymer solution as well as the processing parameters. Interesting properties such as high fiber porosity can be achieved by changing humidity during electrospinning. Moreover, by changing voltage polarity in electrospinning, we are able to alternate functional groups at the surface of fibers. In this study, electrospun fibers were made of natural, thermoplastic polyester – PHBV (poly(3-hydroxybutyric acid-co-3-hydrovaleric acid). The fibrous mats were obtained using both positive and negative voltage polarities, and their surface was characterized using X-ray photoelectron spectroscopy (XPS, Ulvac-Phi, Chigasaki, Japan). Furthermore, the effect of the humidity on surface morphology was investigated using scanning electron microscopy (SEM, Merlin Gemini II, Zeiss, Germany). Electrospun PHBV fibers produced with positive and negative voltage polarity had similar morphology and the average fiber diameter, 2.47 ± 0.21 µm and 2.44 ± 0.15 µm, respectively. The change of the voltage polarity had a significant impact on the reorientation of the carbonyl groups what consequently changed the surface potential of the electrospun PHBV fibers. The increase of humidity during electrospinning causes porosity in the surface structure of the fibers. In conclusion, we showed within our studies that the process parameters such as humidity and voltage polarity have a great influence on fiber morphology and chemistry, changing their functionality. Surface properties of polymer fiber have a significant impact on cell integration and attachment, which is very important in tissue engineering. The possibility of changing surface porosity allows the use of fibers in various tissue engineering and drug delivery systems. Acknowledgment: This study was conducted within 'Nanofiber-based sponges for atopic skin treatment' project., carried out within the First TEAM programme of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund, project no POIR.04.04.00-00- 4571/18-00.

Keywords: cells integration, electrospun fiber, PHBV, surface characterization

Procedia PDF Downloads 118
841 Biological Regulation of Endogenous Enzymatic Activity of Rainbow Trout (Oncorhynchus Mykiss) with Protease Inhibitors Chickpea in Model Systems

Authors: Delgado-Meza M., Minor-Pérez H.

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Protease is the generic name of enzymes that hydrolyze proteins. These are classified in the subgroup EC3.4.11-99X of the classification enzymes. In food technology the proteolysis is used to modify functional and nutritional properties of food, and in some cases this proteolysis may cause food spoilage. In general, seafood and rainbow trout have accelerated decomposition process once it has done its capture, due to various factors such as the endogenous enzymatic activity that can result in loss of structure, shape and firmness, besides the release of amino acid precursors of biogenic amines. Some studies suggest the use of protease inhibitors from legume as biological regulators of proteolytic activity. The enzyme inhibitors are any substance that reduces the rate of a reaction catalyzed by an enzyme. The objective of this study was to evaluate the reduction of the proteolytic activity of enzymes in extracts of rainbow trout with protease inhibitors obtained from chickpea flour. Different proportions of rainbow trout enzyme extract (75%, 50% and 25%) and extract chickpea enzyme inhibitors were evaluated. Chickpea inhibitors were obtained by mixing 5 g of flour in 30 mL of pH 7.0 phosphate buffer. The sample was centrifuged at 8000 rpm for 10 min. The supernatant was stored at -15°C. Likewise, 20 g of rainbow trout were ground in 20 mL of phosphate buffer solution at pH 7.0 and the mixture was centrifuged at 5000 rpm for 20 min. The supernatant was used for the study. In each treatment was determined the specific enzymatic activity with the technique of Kunitz, using hemoglobin as substrate for the enzymes acid fraction and casein for basic enzymes. Also biuret protein was quantified for each treatment. The results showed for fraction of basic enzymes in the treatments evaluated, that were inhibition of endogenous enzymatic activity. Inhibition values compared to control were 51.05%, 56.59% and 59.29% when the proportions of endogenous enzymes extract rainbow trout were 75%, 50% and 25% and the remaining volume used was extract with inhibitors. Treatments with acid enzymes showed no reduction in enzyme activity. In conclusion chickpea flour reduced the endogenous enzymatic activity of rainbow trout, which may favor its application to increase the half-life of this food. The authors acknowledge the funding provided by the CONACYT for the project 131998.

Keywords: rainbouw trout, enzyme inhibitors, proteolysis, enzyme activity

Procedia PDF Downloads 423
840 Autonomy Supportive Coaching to Achieve Health Literacy

Authors: E. Knisel, H. Rupprich, A. Heissel

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Health Literacy is defined as the degree to which people have the capacity to obtain and understand information to make health decisions. Illustrated are three levels of health literacy: (1) Functional literacy refers to the transmission of information about e. g. physical activity and nutrition; (2) interactive literacy implies the development of personal and social skills to adopt health-related behaviour and (3) critical health literacy indicates advanced cognitive skills connected with personal empowerment to critically analyse health information, to define self-determined goals and taking action in various situations accordingly. The achievement of the third level refers to self-determination and autonomy which should be outcomes of exercise programs for overweight children as health-related behaviour change will occur and persist if it is autonomously motivated. Method: We adopted a quasi-experimental design with group (autonomy supportive coaching, control) and session (pre-test, intervention, post-test, and follow-up-test). Overweight and obese children and adolescents at the age of 8-14 years (N=40) received a 6-month (20 sessions) exercise program with autonomy supportive coaching implemented by the coaches and sandwiched between pre-test and post-test. All participants (N=92) completed the German version of the Basic Needs Satisfaction Scale Sport and Exercise. Additionally, we assessed the engagement in the exercise program by the MVPA (Moderate-to-Vigorous Physical Activity) and by the adherence and drop-out-rate. Results: Participants in the intervention group perceived their autonomy as moderate in the post-test and the follow-up-test. However, the psychological intervention failed to develop a high autonomy, as both groups show moderate perceived autonomy from the pre-test to the post-test. Participants in the intervention group were higher engaged in MVPA in the exercise program and they attend the program more regularly. Discussion: Young overweight and obese children and adolescents can acquire autonomy using autonomy supporting coaching. However, research identifying the extent they achieve critical health literacy is required to implement an autonomy-supportive coaching style into exercise programs for this target group.

Keywords: autonomy support, coaching, health literacy, health promotion

Procedia PDF Downloads 487
839 Primary Health Care Vital Signs Profile in Malaysia: Challenges and Opportunities

Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

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Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

Procedia PDF Downloads 131
838 The Effectiveness of an Educational Program on Awareness of Cancer Signs, Symptoms, and Risk Factors among School Students in Oman

Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

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Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

Procedia PDF Downloads 86
837 A Qualitative Assessment of the Internal Communication of the College of Comunication: Basis for a Strategic Communication Plan

Authors: Edna T. Bernabe, Joshua Bilolo, Sheila Mae Artillero, Catlicia Joy Caseda, Liezel Once, Donne Ynah Grace Quirante

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Internal communication is significant for an organization to function to its full extent. A strategic communication plan builds an organization’s structure and makes it more systematic. Information is a vital part of communication inside the organization as this lays every possible outcome—be it positive or negative. It is, therefore, imperative to assess the communication structure of a particular organization to secure a better and harmonious communication environment in any organization. Thus, this research was intended to identify the internal communication channels used in Polytechnic University of the Philippines-College of Communication (PUP-COC) as an organization, to identify the flow of information specifically in downward, upward, and horizontal communication, to assess the accuracy, consistency, and timeliness of its internal communication channels; and to come up with a proposed strategic communication plan of information dissemination to improve the existing communication flow in the college. The researchers formulated a framework from Input-Throughout-Output-Feedback-Goal of General System Theory and gathered data to assess the PUP-COC’s internal communication. The communication model links the objectives of the study to know the internal organization of the college. The qualitative approach and case study as the tradition of inquiry were used to gather deeper understanding of the internal organizational communication in PUP-COC, using Interview, as the primary methods for the study. This was supported with a quantitative data which were gathered through survey from the students of the college. The researchers interviewed 17 participants: the College dean, the 4 chairpersons of the college departments, the 11 faculty members and staff, and the acting Student Council president. An interview guide and a standardized questionnaire were formulated as instruments to generate the data. After a thorough analysis of the study, it was found out that two-way communication flow exists in PUP-COC. The type of communication channel the internal stakeholders use varies as to whom a particular person is communicating with. The members of the PUP-COC community also use different types of communication channels depending on the flow of communication being used. Moreover, the most common types of internal communication are the letters and memoranda for downward communication, while letters, text messages, and interpersonal communication are often used in upward communication. Various forms of social media have been found out to be of use in horizontal communication. Accuracy, consistency, and timeliness play a significant role in information dissemination within the college. However, some problems have also been found out in the communication system. The most common problem are the delay in the dissemination of memoranda and letters and the uneven distribution of information and instruction to faculty, staff, and students. This has led the researchers to formulate a strategic communication plan which aims to propose strategies that will solve the communication problems that are being experienced by the internal stakeholders.

Keywords: communication plan, downward communication, internal communication, upward communication

Procedia PDF Downloads 518
836 Synthesis and Characterization of Mixed ligand complexes of Bipyridyl and Glycine with Different Counter Anions as Functional Antioxidant Enzyme Mimics

Authors: Mohamed M. Ibrahim, Gaber A. M. Mersal, Salih Al-Juaid, Samir A. El-Shazly

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A series of mixed ligand complexes, viz., [Cu(BPy)(Gly)X]Y {X = Cl (1), Y = 0; X = 0, Y = ClO4- (2); X = H2O, Y = NO3- (3); X = H2O, Y = CH3COO- (4); and [Cu(BPy)(Gly)-(H2O)]2(SO4) (5) have been synthesized. Their structures and properties were characterized by elemental analysis, thermal analaysis, IR, UV–vis, and ESR spectroscopy, as well as electrochemical measurements including cyclic voltammetry, electrical molar conductivity, and magnetic moment measurements. Complexes 1 and 2 formed slightly distorted square-pyramidal coordination geometries of CuN3OCl and CuN3O2, respectively in which the N,O-donor glycine and N,N-donor bipyridyl bind at the basal plane with chloride ion or water as the axial ligand. Complex 3 shows square planar CuN3O coordination geometry, which exhibits chemically significant hydrogen bonding interactions besides showing coordination polymer formation. The superoxide dismutase and catalase-like activities of all complexes were tested and were found to be promising candidates as durable electron-transfer catalyst being close to the efficiency of the mimicking enzymes displaying either catalase or tyrosinase activity to serve for complete reactive oxygen species (ROS) detoxification, both with respect to superoxide radicals and related peroxides. The DNA binding interaction with super coiled pGEM-T plasmid DNA was investigated by using spectral (absorption and emission) titration and electrochemical techniques. The results revealed that DNA intercalate with complexes 1 and 2 through the groove binding mode. The calculated intrinsic binding constant (Kb) of 1 and 2 were 4.71 and 2.429 × 105 M−1, respectively. Gel electrophoresis study reveals the fact that both complexes cleave super coiled pGEM-T plasmid DNA to nicked and linear forms in the absence of any additives. On the other hand, the interaction of both complexes with DNA, the quasi-reversible CuII/CuI redox couple slightly improves its reversibility with considerable decrease in current intensity. All the experimental results indicate that the bipyridyl mixed copper(II) complex (1) intercalate more effectively into the DNA base pairs.

Keywords: enzyme mimics, mixed ligand complexes, X-ray structures, antioxidant, DNA-binding, DNA cleavage

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835 Five Years Analysis and Mitigation Plans on Adjustment Orders Impacts on Projects in Kuwait's Oil and Gas Sector

Authors: Rawan K. Al-Duaij, Salem A. Al-Salem

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Projects, the unique and temporary process of achieving a set of requirements have always been challenging; Planning the schedule and budget, managing the resources and risks are mostly driven by a similar past experience or the technical consultations of experts in the matter. With that complexity of Projects in Scope, Time, and execution environment, Adjustment Orders are tools to reflect changes to the original project parameters after Contract signature. Adjustment Orders are the official/legal amendments to the terms and conditions of a live Contract. Reasons for issuing Adjustment Orders arise from changes in Contract scope, technical requirement and specification resulting in scope addition, deletion, or alteration. It can be as well a combination of most of these parameters resulting in an increase or decrease in time and/or cost. Most business leaders (handling projects in the interest of the owner) refrain from using Adjustment Orders considering their main objectives of staying within budget and on schedule. Success in managing the changes results in uninterrupted execution and agreed project costs as well as schedule. Nevertheless, this is not always practically achievable. In this paper, a detailed study through utilizing Industrial Engineering & Systems Management tools such as Six Sigma, Data Analysis, and Quality Control were implemented on the organization’s five years records of the issued Adjustment Orders in order to investigate their prevalence, and time and cost impact. The analysis outcome revealed and helped to identify and categorize the predominant causations with the highest impacts, which were considered most in recommending the corrective measures to reach the objective of minimizing the Adjustment Orders impacts. Data analysis demonstrated no specific trend in the AO frequency in past five years; however, time impact is more than the cost impact. Although Adjustment Orders might never be avoidable; this analysis offers’ some insight to the procedural gaps, and where it is highly impacting the organization. Possible solutions are concluded such as improving project handling team’s coordination and communication, utilizing a blanket service contract, and modifying the projects gate system procedures to minimize the possibility of having similar struggles in future. Projects in the Oil and Gas sector are always evolving and demand a certain amount of flexibility to sustain the goals of the field. As it will be demonstrated, the uncertainty of project parameters, in adequate project definition, operational constraints and stringent procedures are main factors resulting in the need for Adjustment Orders and accordingly the recommendation will be to address that challenge.

Keywords: adjustment orders, data analysis, oil and gas sector, systems management

Procedia PDF Downloads 164
834 The Aesthetic Reconstruction of Post-Burn Eyebrow Alopecia with Bilateral Superficial Temporal Artery Island Scalp Flap

Authors: Kumar Y., Suman D., Sumathi

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Introduction: Burns to the face account for between one-fourth and one-third of all burns. The loss of an eyebrow due to a burn or infection can have negative physical and psychological consequences for patients because eyebrows have a critical functional and aesthetic role on the face. Plastic surgeons face unique challenges in reconstructing eyebrows due to their complex anatomy and variations within genders. As a general rule, there are three techniques for reconstructing the eyebrow: superficial temporal artery island flap, a composite graft from the scalp, and mini or micro follicular grafts from the scalp. In situations where a sufficient amount of subcutaneous tissue is not available and the defect is big such as the case of burns, flaps like the superficial temporal artery scalp flap remain reliable options. In 2018, a 17-year-old female patient presented to the department of Burns Plastic and reconstructive Surgery of Guru Teg Bahadur Hospital, Delhi, India. A scald-burn injury to the face occurred two years before admission, resulting in bilateral eyebrow loss. We reconstructed the bilateral eyebrows using bilateral scalp island flaps based on the posterior branch of the superficial temporal artery. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance, which was consistent with preoperative expectations and the patient stated that she was more comfortable with her social relationships. Among the current treatment procedures, the superficial temporal artery island flap continues to be a versatile option for reconstructing the eyebrows after alopecia, especially in cases of burns. Results: During the 30 days follow-up period, the scalp island flap remained vascularised with normal hair growth, without complications. The reconstructed eyebrows successfully assumed a desirable shape and exhibited a natural appearance; the patient stated that she was more comfortable with her social relationships. Conclusion: In this case report, we demonstrated how scalp island flaps pedicled by the superficial temporal artery could be performed very safely and reliably to create new eyebrows.

Keywords: alopecia, burns, eyebrow, flap, superficial temporal artery

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833 Floating Populations, Rooted Networks Tracing the Evolution of Russeifa City in Relation to Marka Refugee Camp

Authors: Dina Dahood Dabash

Abstract:

Refugee camps are habitually defined as receptive sites, transient spaces of exile and nondescript depoliticized places of exception. However, such arguments form partial sides of reality, especially in countries that are geopolitically challenged and rely immensely on international aid. In Jordan, the dynamics brought with the floating population of refugees (Palestinian amongst others) have resulted in spatial after-effects that cannot be easily overlooked. For instance, Palestine refugee camps have turned by time into socioeconomic centers of gravity and cores of spatial evolution. Yet, such a position is not instantaneous. Amongst various reasons, it can be related, according to this paper, to a distinctive institutional climate that has been co-produced by the refugees, host community and the state. This paper aims to investigate the evolution of urban and spatial regulations in Jordan between 1948 and 1995, more specifically, state regulations, community regulations and refugee-self-regulation that all dynamically interacted that period. The paper aims to unpack the relations between refugee camps and their environs to further explore the agency of such floating populations in establishing rooted networks that extended the time and place boundaries. The paper’s argument stems from the fact that the spatial configuration of urban systems is not only an outcome of a historical evolutionary process but is also a result of interactions between the actors. The research operationalizes Marka camp in Jordan as a case study. Marka Camp is one of the six "emergency" camps erected in 1968 to shelter 15,000 Palestine refugees and displaced persons who left the West Bank and Gaza Strip. Nowadays, camp shelters more than 50,000 refugees in the same area of land. The camp is located in Russeifa, a city in Zarqa Governorate in Jordan. Together with Amman and Zarqa, Russeifa is part of a larger metropolitan area that acts as a home to more than half of Jordan’s businesses. The paper aspires to further understand the post-conflict strategies which were historically applied in Jordan and can be employed to handle more recent geopolitical challenges such as the Syrian refugee crisis. Methodological framework: The paper traces the evolution of the refugee-camp regulating norms in Jordan, parallel with the horizontal and vertical evolution of the Marka camp and its surroundings. Consequently, the main methods employed are historical and mental tracing, Interviews, in addition to using available Aerial and archival photos of the Marka camp and its surrounding.

Keywords: forced migration, Palestine refugee camps, spatial agency, urban regulations

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832 Survival of Micro-Encapsulated Probiotic Lactic Acid Bacteria in Mutton Nuggets and Their Assessments in Simulated Gastro-Intestinal Conditions

Authors: Rehana Akhter, Sajad A. Rather, F. A. Masoodi, Adil Gani, S. M. Wani

Abstract:

During recent years probiotic food products receive market interest as health-promoting, functional foods, which are believed to contribute health benefits. In order to deliver the health benefits by probiotic bacteria, it has been recommended that they must be present at a minimum level of 106 CFU/g to 107 CFU/g at point of delivery or be eaten in sufficient amounts to yield a daily intake of 108 CFU. However a major challenge in relation to the application of probiotic cultures in food matrix is the maintenance of viability during processing which might lead to important losses in viability as probiotic cultures are very often thermally labile and sensitive to acidity, oxygen or other food constituents for example, salts. In this study Lactobacillus plantarum and Lactobacillus casei were encapsulated in calcium alginate beads with the objective of enhancing their survivability and preventing exposure to the adverse conditions of the gastrointestinal tract and where then inoculated in mutton nuggets. Micro encapsulated Lactobacillus plantarum and Lactobacillus casei were resistant to simulated gastric conditions (pH 2, 2h) and bile solution (3%, 2 h) resulting in significantly (p ≤ 0.05) improved survivability when compared with free cell counterparts. A high encapsulation yield was found due to the encapsulation procedure. After incubation at low pH-values, micro encapsulation yielded higher survival rates compared to non-encapsulated probiotic cells. The viable cell numbers of encapsulated Lactobacillus plantarum and Lactobacillus casei were 107-108 CFU/g higher compared to free cells after 90 min incubation at pH 2.5. The viable encapsulated cells were inoculated into mutton nuggets at the rate of 108 to 1010 CFU/g. The micro encapsulated Lactobacillus plantarum and Lactobacillus casei achieved higher survival counts (105-107 CFU/g) than the free cell counterparts (102-104 CFU/g). Thus micro encapsulation offers an effective means of delivery of viable probiotic bacterial cells to the colon and maintaining their survival during simulated gastric, intestinal juice and processing conditions during nugget preparation.

Keywords: survival, Lactobacillus plantarum, Lactobacillus casei, micro-encapsulation, nugget

Procedia PDF Downloads 279