Search results for: hospital site suitability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5012

Search results for: hospital site suitability

932 The Application of the Biopsychosocial-Spiritual Model to the Quality of Life of People Living with Sickle Cell Disease

Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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931 Experience of Inpatient Life in Korean Complex Regional Pain Syndrome: A Phenomenological Study

Authors: Se-Hwa Park, En-Kyung Han, Jae-Young Lim, Hye-Jung Ahn

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Purpose: The objective of this study is to provide basic data for understanding the substance of inpatient life with CRPS (Complex Regional Pain Syndrome) and developing efficient and effective nursing intervention. Methods: From September 2018 to November, we have interviewed 10 CRPS patients about inpatient experiences. To understand the implication of inpatient life experiences with CRPS and intrinsic structure, we have used the question: 'How about the inpatient experiences with CRPS'. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' inpatient life process was structured in six categories: (a) breakthrough pain experience (b) the limitation of pain treatment, (c) worsen factors of pain during inpatient period, (d) treat method for pain, (e) positive experience for inpatient period, (f) requirements for medical team, family and people in hospital room. Conclusion: Inpatient with CRPS have experienced the breakthrough pain. They had expected immediate treatment for breakthrough pain, but they experienced severe pain because immediate treatment was not implemented. Pain-worsening factors which patients with CRPS are as follows: personal factors from negative emotions such as insomnia, stress, sensitive character, pain part touch or vibration stimulus on the bed, physical factors from high threshold or rapid speed during fast transfer, conflict with other people, climate factors such as humidity or low temperature, noise, smell, lack of space because of many visitors. Patients actively manage the pain committing into another tasks or diversion. And also, patients passively manage the pain, just suppress, give-up. They think positively about rehabilitation treatment. And they require the understanding and sympathy for other people, and emotional support, immediate intervention for medical team. Based on the results of this study, we suppose the guideline of systematic breakthrough pain management for the relaxation of sudden pain, using notice of informing caution for touch or vibration. And we need to develop non-medicine pain management nursing intervention.

Keywords: breakthrough pain, CRPS, complex regional pain syndrome, inpatient life experiences, phenomenological method

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930 Hands on Tools to Improve Knowlege, Confidence and Skill of Clinical Disaster Providers

Authors: Lancer Scott

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Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

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929 Enhancing Skills of Mothers of Asthmatic Children in Techniques of Drug Administration

Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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928 Role of P53 Codon 72 Polymorphism and Mir-146a Rs2910164 Polymorphism in Cervical Cancer

Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand

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Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia (CIN) and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, HPV18, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism

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927 Synthesis of Fluorescent PET-Type “Turn-Off” Triazolyl Coumarin Based Chemosensors for the Sensitive and Selective Sensing of Fe⁺³ Ions in Aqueous Solutions

Authors: Aidan Battison, Neliswa Mama

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Environmental pollution by ionic species has been identified as one of the biggest challenges to the sustainable development of communities. The widespread use of organic and inorganic chemical products and the release of toxic chemical species from industrial waste have resulted in a need for advanced monitoring technologies for environment protection, remediation and restoration. Some of the disadvantages of conventional sensing methods include expensive instrumentation, well-controlled experimental conditions, time-consuming procedures and sometimes complicated sample preparation. On the contrary, the development of fluorescent chemosensors for biological and environmental detection of metal ions has attracted a great deal of attention due to their simplicity, high selectivity, eidetic recognition, rapid response and real-life monitoring. Coumarin derivatives S1 and S2 (Scheme 1) containing 1,2,3-triazole moieties at position -3- have been designed and synthesized from azide and alkyne derivatives by CuAAC “click” reactions for the detection of metal ions. These compounds displayed a strong preference for Fe3+ ions with complexation resulting in fluorescent quenching through photo-induced electron transfer (PET) by the “sphere of action” static quenching model. The tested metal ions included Cd2+, Pb2+, Ag+, Na+, Ca2+, Cr3+, Fe3+, Al3+, Cd2+, Ba2+, Cu2+, Co2+, Hg2+, Zn2+ and Ni2+. The detection limits of S1 and S2 were determined to be 4.1 and 5.1 uM, respectively. Compound S1 displayed the greatest selectivity towards Fe3+ in the presence of competing for metal cations. S1 could also be used for the detection of Fe3+ in a mixture of CH3CN/H¬2¬O. Binding stoichiometry between S1 and Fe3+ was determined by using both Jobs-plot and Benesi-Hildebrand analysis. The binding was shown to occur in a 1:1 ratio between the sensor and a metal cation. Reversibility studies between S1 and Fe3+ were conducted by using EDTA. The binding site of Fe3+ to S1 was determined by using 13 C NMR and Molecular Modelling studies. Complexation was suggested to occur between the lone-pair of electrons from the coumarin-carbonyl and the triazole-carbon double bond.

Keywords: chemosensor, "click" chemistry, coumarin, fluorescence, static quenching, triazole

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926 Data Management System for Environmental Remediation

Authors: Elizaveta Petelina, Anton Sizo

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Environmental remediation projects deal with a wide spectrum of data, including data collected during site assessment, execution of remediation activities, and environmental monitoring. Therefore, an appropriate data management is required as a key factor for well-grounded decision making. The Environmental Data Management System (EDMS) was developed to address all necessary data management aspects, including efficient data handling and data interoperability, access to historical and current data, spatial and temporal analysis, 2D and 3D data visualization, mapping, and data sharing. The system focuses on support of well-grounded decision making in relation to required mitigation measures and assessment of remediation success. The EDMS is a combination of enterprise and desktop level data management and Geographic Information System (GIS) tools assembled to assist to environmental remediation, project planning, and evaluation, and environmental monitoring of mine sites. EDMS consists of seven main components: a Geodatabase that contains spatial database to store and query spatially distributed data; a GIS and Web GIS component that combines desktop and server-based GIS solutions; a Field Data Collection component that contains tools for field work; a Quality Assurance (QA)/Quality Control (QC) component that combines operational procedures for QA and measures for QC; Data Import and Export component that includes tools and templates to support project data flow; a Lab Data component that provides connection between EDMS and laboratory information management systems; and a Reporting component that includes server-based services for real-time report generation. The EDMS has been successfully implemented for the Project CLEANS (Clean-up of Abandoned Northern Mines). Project CLEANS is a multi-year, multimillion-dollar project aimed at assessing and reclaiming 37 uranium mine sites in northern Saskatchewan, Canada. The EDMS has effectively facilitated integrated decision-making for CLEANS project managers and transparency amongst stakeholders.

Keywords: data management, environmental remediation, geographic information system, GIS, decision making

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925 Extending ACOSOG Z0011 to Encompass Mastectomy Patients: A Retrospective Review

Authors: Ruqayya Naheed Khan, Awais Amjad Malik, Awais Naeem, Amina Khan, Asad Parvaiz

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Introduction: Axillary nodal status in breast cancer patients is a paramount prognosticator, next to primary tumor size and grade. It has been well established that patients with negative sentinel lymph node biopsy can safely avoid axillary lymph node dissection. A positive sentinel lymph node has traditionally required subsequent axillary dissection. According to ACOSOG Z11 trial, patients who underwent axillary dissection with 3 or more positive sentinel nodes or opted for observation in case of negative sentinel lymph node, did not find any difference in Overall Survival (OS) and Disease Free Survival (DFS). The Z11 trial included patients who underwent breast conserving surgery and excluded patients with mastectomies. The purpose of this study is to determine whether Z0011 can be applied to mastectomy patients as well in 1-3 positive sentinel lymph nodes and avoid unnecessary ALND. Methods: A retrospective review was conducted at Shaukat Khanam Memorial Cancer Hospital Pakistan from Jan 2015 to Dec 2017 including patients who were treated for invasive breast cancer and required upfront mastectomy. They were clinically node negative, so sentinel lymph node biopsy was performed. Patients underwent ALND with positive sentinel lymph node. A total of 156 breast cancer patients with mastectomies were reviewed. Results: 95% of the patients were female while 3% were male. Average age was 44 years. There was no difference in race, comorbidities, histology, T stage, N stage, and overall stage, use of adjuvant chemotherapy and radiation therapy. 64 patients underwent ALND for positive lymph node while 92 patients were spared of axillary dissection due to negative sentinel lymph node biopsy. Out of 64 patients, 38 patients (59%) had only 1 lymph node positive which was the sentinel node. 18 patients (28%) had 2 lymph nodes positive including the sentinel node while only 8 patients (13%) had 3 or more positive nodes. Conclusion: Keeping in mind the complications related to ALND, above results clearly show that ALND could have been avoided in 87% of patients in the setting of adjuvant radiation, possibly avoiding the morbidity associated with axillary lymphadenectomy although a prospective randomized trial needs to confirm these results.

Keywords: mastectomy, sentinel lymph node biopsy, axillary lymph node dissection, breast cancer

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924 Transformation to M-Learning at the Nursing Institute in the Armed Force Hospital Alhada, in Saudi Arabia Based on Activity Theory

Authors: Rahimah Abdulrahman, A. Eardle, Wilfred Alan, Abdel Hamid Soliman

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With the rapid development in technology, and advances in learning technologies, m-learning has begun to occupy a great part of our lives. The pace of the life getting together with the need for learning started mobile learning (m-learning) concept. In 2008, Saudi Arabia requested a national plan for the adoption of information technology (IT) across the country. Part of the recommendations of this plan concerns the implementation of mobile learning (m-learning) as well as their prospective applications to higher education within the Kingdom of Saudi Arabia. The overall aim of the research is to explore the main issues that impact the deployment of m-learning in nursing institutes in Saudi Arabia, at the Armed Force Hospitals (AFH), Alhada. This is in order to be able to develop a generic model to enable and assist the educational policy makers and implementers of m-learning, to comprehend and treat those issues effectively. Specifically, the research will explore the concept of m-learning; identify and analyse the main organisational; technological and cultural issue, that relate to the adoption of m-learning; develop a model of m-learning; investigate the perception of the students of the Nursing Institutes to the use of m-learning technologies for their nursing diploma programmes based on their experiences; conduct a validation of the m-learning model with the use of the nursing Institute of the AFH, Alhada in Saudi Arabia, and evaluate the research project as a learning experience and as a contribution to the body of knowledge. Activity Theory (AT) will be adopted for the study due to the fact that it provides a conceptual framework that engenders an understanding of the structure, development and the context of computer-supported activities. The study will be adopt a set of data collection methods which engage nursing students in a quantitative survey, while nurse teachers are engaged through in depth qualitative studies to get first-hand information about the organisational, technological and cultural issues that impact on the deployment of m-learning. The original contribution will be a model for developing m-learning material for classroom-based learning in the nursing institute that can have a general application.

Keywords: activity theory (at), mobile learning (m-learning), nursing institute, Saudi Arabia (sa)

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923 The Effect of Empathy Training Given to Midwives on Mothers’ Satisfaction with Midwives and Their Birth Perception

Authors: Songul Aktas, Turkan Pasinlioglu, Kiymet Yesilcicek Calik

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Introduction: Emphatic approach during labor increases both quality of care and birth satisfaction of mothers. Besides; maternal satisfaction statements and expressions about midwives who assist labor contribute to a positive birth perception and wish to give vaginal delivery again. Aim: The study aimed at investigating the effect of empathy training given to midwives on mothers’ satisfaction with midwives and their birth perception. Material/Method: This experimental study was undertaken between February 2013 and January 2014 at a public hospital in Trabzon Province. The population of the study was composed of mothers who gave vaginal delivery and the sample was composed of 222 mothers determined with power analyzes. Ethical approval and written informed consents were obtained. Mothers who were assisted by midwives during 1st, 2nd and 3rd phases of delivery and first two postpartum hours were included. Empathy training given to midwives included didactic narration, creative drama, psychodrama techniques and lasted 32 hours. The data were collected before the empathy training (BET), right after empathy training (RAET) and 8 weeks later after birth (8WLAB). Mothers were homogenous in terms of socio-demographic, obstetric characteristics. Data were collected with a questionnaire and were analyzed with Chi-square tests. Findings: Rate of mother’s satisfaction with midwives was 36.5% in BET, 81.1% in RAET and 75.7% in 8WLAB. Key mother’s satisfaction with midwives were as follows: 27.6% of mothers told that midwives were “smiling-kind” in BET, 39.6% of them in RAET and 33.7% of them in 8WLAB; 31% of mothers told that midwives were “understanding” in BET, 38.2% of them in RAET and 33.7% of them in 8WLAB; 15.7% of mothers told that midwives were “reassuring” in BET, 44.9% of them in RAET and 39.3% of them in 8WLAB;19.5% of mothers told that midwives were “encouraging and motivating” in BET, 39.8% of them in RAET and 19.8% of mothers told that midwives were “informative” in BET, 45.6% of them in RAET and 35.1% of them in 8WLAB (p<0.05). Key mother’s dissatisfaction with midwives were as follows: 55.3% of mothers told that midwives were “poorly-informed” in BET, 17% of them in RAET and 27.7% of them in 8WLAB; 56.9% of mothers told that midwives were “poorly-listening” in BET, 17.6% of them in RAET and 25.5% of them in 8WLAB; 53.2% of mothers told that midwives were “judgmental-embarrassing” in BET, 17% of them in RAET and 29.8% of them in 8WLAB; 56.2% of mothers told that midwives had “fierce facial expressions” in BET, 15.6% of them in RAET and 28.1% of them in 8WLAB. Rates of mothers’ perception that labor was “easy” were 8.1% in BET, 21.6% in RAET and 13.5% in 8WLAB and rates of mothers’ perception that labor was “very difficult and tiring” were 41.9% in BET, 5.4% in RAET and 13.5% in 8WLAB (p<0.05). Conclusion: The effect of empathy training given to midwives upon statements that described mothers’ satisfaction with midwives and their birth perception was positive. Note: This study was financially funded by TUBİTAK project with number 113S672.

Keywords: empathy training, labor perception, mother’s satisfaction with midwife, vaginal delivery

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922 Synthesis and Two-Photon Polymerization of a Cytocompatibility Tyramine Functionalized Hyaluronic Acid Hydrogel That Mimics the Chemical, Mechanical, and Structural Characteristics of Spinal Cord Tissue

Authors: James Britton, Vijaya Krishna, Manus Biggs, Abhay Pandit

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Regeneration of the spinal cord after injury remains a great challenge due to the complexity of this organ. Inflammation and gliosis at the injury site hinder the outgrowth of axons and hence prevent synaptic reconnection and reinnervation. Hyaluronic acid (HA) is the main component of the spinal cord extracellular matrix and plays a vital role in cell proliferation and axonal guidance. In this study, we have synthesized and characterized a photo-cross-linkable HA-tyramine (tyr) hydrogel from a chemical, mechanical, electrical, biological and structural perspective. From our experimentation, we have found that HA-tyr can be synthesized with controllable degrees of tyramine substitution using click chemistry. The complex modulus (G*) of HA-tyr can be tuned to mimic the mechanical properties of the native spinal cord via optimization of the photo-initiator concentration and UV exposure. We have examined the degree of tyramine-tyramine covalent bonding (polymerization) as a function of UV exposure and photo-initiator use via Photo and Nuclear magnetic resonance spectroscopy. Both swelling and enzymatic degradation assays were conducted to examine the resilience of our 3D printed hydrogel constructs in-vitro. Using a femtosecond 780nm laser, the two-photon polymerization of HA-tyr hydrogel in the presence of riboflavin photoinitiator was optimized. A laser power of 50mW and scan speed of 30,000 μm/s produced high-resolution spatial patterning within the hydrogel with sustained mechanical integrity. Using dorsal root ganglion explants, the cytocompatibility of photo-crosslinked HA-tyr was assessed. Using potentiometry, the electrical conductivity of photo-crosslinked HA-tyr was assessed and compared to that of native spinal cord tissue as a function of frequency. In conclusion, we have developed a biocompatible hydrogel that can be used for photolithographic 3D printing to fabricate tissue engineered constructs for neural tissue regeneration applications.

Keywords: 3D printing, hyaluronic acid, photolithography, spinal cord injury

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921 Identification of Rare Mutations in Genes Involved in Monogenic Forms of Obesity and Diabetes in Obese Guadeloupean Children through Next-Generation Sequencing

Authors: Lydia Foucan, Laurent Larifla, Emmanuelle Durand, Christine Rambhojan, Veronique Dhennin, Jean-Marc Lacorte, Philippe Froguel, Amelie Bonnefond

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In the population of Guadeloupe Island (472,124 inhabitants and 80% of subjects of African descent), overweight and obesity were estimated at 23% and 9% respectively among children. High prevalence of diabetes has been reported (~10%) in the adult population. Nevertheless, no study has investigated the contribution of gene mutations to childhood obesity in this population. We aimed to investigate rare genetic mutations in genes involved in monogenic obesity or diabetes in obese Afro-Caribbean children from Guadeloupe Island using next-generation sequencing. The present investigation included unrelated obese children, from a previous study on overweight conducted in Guadeloupe Island in 2013. We sequenced coding regions of 59 genes involved in monogenic obesity or diabetes. A total of 25 obese schoolchildren (with Z-score of body mass index [BMI]: 2.0 to 2.8) were screened for rare mutations (non-synonymous, splice-site, or insertion/deletion) in 59 genes. Mean age of the study population was 12.4 ± 1.1 years. Seventeen children (68%) had insulin-resistance (HOMA-IR > 3.16). A family history of obesity (mother or father) was observed in eight children and three of the accompanying parent presented with type 2 diabetes. None of the children had gonadotrophic abnormality or mental retardation. We detected five rare heterozygous mutations, in four genes involved in monogenic obesity, in five different obese children: MC4R p.Ile301Thr and SIM1 p.Val326Thrfs*43 mutations which were pathogenic; SIM1 p.Ser343Pro and SH2B1 p.Pro90His mutations which were likely pathogenic; and NTRK2 p.Leu140Phe that was of uncertain significance. In parallel, we identified seven carriers of mutation in ABCC8 or KCNJ11 (involved in monogenic diabetes), which were of uncertain significance (KCNJ11 p.Val13Met, KCNJ11 p.Val151Met, ABCC8 p.Lys1521Asn and ABCC8 p.Ala625Val). Rare pathogenic or likely pathogenic mutations, linked to severe obesity were detected in more than 15% of this Afro-Caribbean population at high risk of obesity and type 2 diabetes.

Keywords: childhood obesity, MC4R, monogenic obesity, SIM1

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920 Regulation of Differentiating Intramuscular Stromal Vascular Cells Isolated from Hanwoo Beef Cattle by Retinoic Acid and Calcium

Authors: Seong Gu Hwang, Young Kyoon Oh, Joseph F. dela Cruz

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Marbling, or intramuscular fat, has been consistently identified as one of the top beef quality problems. Intramuscular adipocytes distribute throughout the perimysial connective tissue of skeletal muscle and are the major site for the deposition of intramuscular fat, which is essential for the eating quality of meat. The stromal vascular fraction of the skeletal muscle contains progenitor cells that can be enhanced to differentiate to adipocytes and increase intramuscular fat. Primary cultures of bovine intramuscular stromal vascular cells were used in this study to elucidate the effects of extracellular calcium and retinoic acid concentration on adipocyte differentiation. Cell viability assay revealed that even at different concentrations of calcium and retinoic acid, there was no significant difference on cell viability. Monitoring of the adipocyte differentiation showed that bovine intramuscular stromal vascular cells cultured in a low concentration of extracellular calcium and retinoic acid had a better degree of fat accumulation. The mRNA and protein expressions of PPARγ, C/EBPα, SREBP-1c and aP2 were analyzed and showed a significant upregulation upon the reduction in the level of extracellular calcium and retinoic acid. The upregulation of these adipogenic related genes means that the decreasing concentration of calcium and retinoic acid is able to stimulate the adipogenic differentiation of bovine intramuscular stromal vascular cells. To further elucidate the effect of calcium, the expression level of calreticulin was measured. Calreticulin which is known to be an inhibitor of PPARγ was down regulated by the decreased level of calcium and retinoic acid in the culture media. The same tendency was observed on retinoic acid receptors RARα and CRABP-II. These receptors are recognized as adipogenic inhibitors, and the downregulation of their expression allowed a better level of differentiation in bovine intramuscular stromal vascular cells. In conclusion, data show that decreasing the level of extracellular calcium and retinoic acid can significantly promote adipogenesis in intramuscular stromal vascular cells of Hanwoo beef cattle. These findings may provide new insights in enhancing intramuscular adipogenesis and marbling in beef cattle.

Keywords: calcium, calreticulin, hanwoo beef, retinoic acid

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919 Periplasmic Expression of Anti-RoxP Antibody Fragments in Escherichia Coli.

Authors: Caspar S. Carson, Gabriel W. Prather, Nicholas E. Wong, Jeffery R. Anton, William H. McCoy

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Cutibacterium acnes is a commensal bacterium found on human skin that has been linked to acne. C. acnes can also be an opportunistic pathogen when it infiltrates the body during surgery. This pathogen can cause dangerous infections of medical implants, such as shoulder replacements, leading to life-threatening blood infections. Compounding this issue, C. acnes resistance to many antibiotics has become an increasing problem worldwide, creating a need for special forms of treatment. C. acnes expresses the protein RoxP, and it requires this protein to colonize human skin. Though this protein is required for C. acnes skin colonization, its function is not yet understood. Inhibition of RoxP function might be an effective treatment for C. acnes infections. To develop such reagents, the McCoy Laboratory generated four unique anti-RoxP antibodies. Preliminary studies in the McCoy Lab have established that each antibody binds a distinct site on RoxP. To assess the potential of these antibodies as therapeutics, it is necessary to specifically characterize these antibody epitopes and evaluate them in assays that assess their ability to inhibit RoxP-dependent C. acnes growth. To provide material for these studies, an antibody expression construct, Fv-clasp(v2), was adapted to encode anti-RoxP antibody sequences. The author hypothesizes that this expression strategy can produce sufficient amounts of >95% pure antibody fragments for further characterization of these antibodies. Four anti-RoxP Fv-clasp(v2) expression constructs (pET vector-based) were transformed into E. coli BL21-Gold(DE3) cells and a small-scale expression and purification trial was performed for each construct to evaluate anti-RoxP Fv-clasp(v2) yield and purity. Successful expression and purification of these antibody constructs will allow for their use in structural studies, such as protein crystallography and cryogenic electron microscopy. Such studies would help to define the antibody binding sites on RoxP, which could then be leveraged in the development of certain methods to treat C. acnes infection through RoxP inhibition.

Keywords: structural biology, protein expression, infectious disease, antibody, therapeutics, E. coli

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918 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

Procedia PDF Downloads 47
917 Comparison of High Speed Railway Bride Foundation Design

Authors: Hussein Yousif Aziz

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This paper discussed the design and analysis of bridge foundation subjected to load of train with three codes, namely AASHTO code, British Standard BS Code 8004 (1986), and Chinese code (TB10002.5-2005).The study focused on the design and analysis of bridge’s foundation manually with the three codes and found which code is better for design and controls the problem of high settlement due to the applied loads. The results showed the Chinese codes are costly that the number of reinforcement bars in the pile cap and piles is more than those with AASHTO code and BS code with the same dimensions. Settlement of the bridge was calculated depending on the data collected from the project site. The vertical ultimate bearing capacity of single pile for three codes is also discussed. Other analyses by using the two-dimensional Plaxis program and other programs like SAP2000 14, PROKON many parameters are calculated. The maximum values of the vertical displacement are close to the calculated ones. The results indicate that the AASHTO code is economics and safer in the bearing capacity of single pile. The purpose of this project is to study out the pier on the basis of the design of the pile foundation. There is a 32m simply supported beam of box section on top of the structure. The pier of bridge is round-type. The main component of the design is to calculate pile foundation and the settlement. According to the related data, we choose 1.0m in diameter bored pile of 48m. The pile is laid out in the rectangular pile cap. The dimension of the cap is 12m 9 m. Because of the interaction factors of pile groups, the load-bearing capacity of simple pile must be checked, the punching resistance of pile cap, the shearing strength of pile cap, and the part in bending of pile cap, all of them are very important to the structure stability. Also, checking soft sub-bearing capacity is necessary under the pile foundation. This project provides a deeper analysis and comparison about pile foundation design schemes. Firstly, here are brief instructions of the construction situation about the Bridge. With the actual construction geological features and the upper load on the Bridge, this paper analyzes the bearing capacity and settlement of single pile. In the paper the Equivalent Pier Method is used to calculate and analyze settlements of the piles.

Keywords: pile foundation, settlement, bearing capacity, civil engineering

Procedia PDF Downloads 411
916 The Spatial Pattern of Economic Rents of an Airport Development Area: Lessons Learned from the Suvarnabhumi International Airport, Thailand

Authors: C. Bejrananda, Y. Lee, T. Khamkaew

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With the rise of the importance of air transportation in the 21st century, the role of economics in airport planning and decision-making has become more important to the urban structure and land value around it. Therefore, this research aims to examine the relationship between an airport and its impacts on the distribution of urban land uses and land values by applying the Alonso’s bid rent model. The New Bangkok International Airport (Suvarnabhumi International Airport) was taken as a case study. The analysis was made over three different time periods of airport development (after the airport site was proposed, during airport construction, and after the opening of the airport). The statistical results confirm that Alonso’s model can be used to explain the impacts of the new airport only for the northeast quadrant of the airport, while proximity to the airport showed the inverse relationship with the land value of all six types of land use activities through three periods of time. It indicates that the land value for commercial land use is the most sensitive to the location of the airport or has the strongest requirement for accessibility to the airport compared to the residential and manufacturing land use. Also, the bid-rent gradients of the six types of land use activities have declined dramatically through the three time periods because of the Asian Financial Crisis in 1997. Therefore, the lesson learned from this research concerns about the reliability of the data used. The major concern involves the use of different areal units for assessing land value for different time periods between zone block (1995) and grid block (2002, 2009). As a result, this affect the investigation of the overall trends of land value assessment, which are not readily apparent. In addition, the next concern is the availability of the historical data. With the lack of collecting historical data for land value assessment by the government, some of data of land values and aerial photos are not available to cover the entire study area. Finally, the different formats of using aerial photos between hard-copy (1995) and digital photo (2002, 2009) made difficult for measuring distances. Therefore, these problems also affect the accuracy of the results of the statistical analyses.

Keywords: airport development area, economic rents, spatial pattern, suvarnabhumi international airport

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915 Professionals’ Learning from Casework in Child Protection: The View from Within

Authors: Jude Harrison

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Child protection is a complex and sensitive practice. The core responsibility is the care and protection of children and young people who have been subject to or who are at risk from abuse and neglect. The work involves investigating allegations of harm, preparing for and making representations to the legal system, and case planning and management across a continuum of complicated care interventions. Professionals’ learning for child protection practice is evident in a range of literature investigating multiple learning processes such as university preparation, student placements, professional supervision, training, and other post-qualifying professional development experiences at work. There is, however, very limited research into how caseworkers learn in and through their daily practice. Little is known, therefore, about how learning at work unfolds for caseworkers, the dimensions in which it can be understood or the ways in which it can be best facilitated and supported. Compounding this, much of the current child protection learning literature reflects an orthodox conception of learning as mentalistic and individualised, in which knowledge is typically understood as abstract theory or as technical skill or competency. This presentation outlines key findings from a PhD research study that explored learning at work for statutory child protection caseworkers from an alternative interpretation of learning using a practice theory approach. Practice theory offers an interpretation of learning as performative and grounded in situated experience. The findings of the study show that casework practice is both a mode and site of learning. The study was ethnographic in design based and followed 17 child protection caseworkers via in-depth interviews, observations and participant reflective journaling. Inductive and abductive analysis was used to organise and interpret the data and expand analysis, leading to themes. Key findings show learning to be a sociomaterial property of doing; the social ontological character of learning; and teleoaffectivity as a feature of learning. The findings contribute to theoretical and practical understandings of learning and practice in child protection, child welfare and the professional learning literature more broadly. The findings have potential to contribute to policy directions at state, territory and national levels to enhance child protection practice and systems.

Keywords: adiult learning, workplace learning, child welfare, sociomaterial, practice theory

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914 Association of Post-Traumatic Stress Disorder with Work Performance amongst Emergency Medical Service Personnel, Karachi, Pakistan

Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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913 Heat Stress Adaptive Urban Design Intervention for Planned Residential Areas of Khulna City: Case Study of Sonadanga

Authors: Tanjil Sowgat, Shamim Kobir

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World is now experiencing the consequences of climate change such as increased heat stress due to high temperature rise. In the context of changing climate, this study intends to find out the planning interventions necessary to adapt to the current heat stress in the planned residential areas of Khulna city. To carry out the study Sonadanga residential area (phase I) of Khulna city has been taken as the study site. This residential neighbourhood covering an area of 30 acres has 206 residential plots. The study area comprises twelve access roads, one park, one playfield, one water body and two street furniture’s. This study conducts visual analysis covering green, open space, water body, footpath, drainage and street trees and furniture and questionnaire survey deals with socio-economic, housing tenancy, experience of heat stress and urban design interventions. It finds that the current state that accelerates the heat stress condition such as lack of street trees and inadequate shading, maximum uses are not within ten minutes walking distance, no footpath for the pedestrians and lack of well-maintained street furniture. It proposes that to adapt to the heat stress pedestrian facilities, buffer sidewalk with landscaping, street trees and open spaces, soft scape, natural and man-made water bodies, green roofing could be effective urban design interventions. There are evidences of limited number of heat stress adaptive planned residential area. Since current sub-division planning practice focuses on rigid land use allocation, it partly addresses the climatic concerns through creating open space and street trees. To better respond to adapt to the heat stress, urban design considerations in the context of sub-division practice would bring more benefits.

Keywords: climate change, urban design, adaptation, heat stress, water-logging

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912 Seismic Isolation of Existing Masonry Buildings: Recent Case Studies in Italy

Authors: Stefano Barone

Abstract:

Seismic retrofit of buildings through base isolation represents a consolidated protection strategy against earthquakes. It consists in decoupling the ground motion from that of the structure and introducing anti-seismic devices at the base of the building, characterized by high horizontal flexibility and medium/high dissipative capacity. This allows to protect structural elements and to limit damages to non-structural ones. For these reasons, full functionality is guaranteed after an earthquake event. Base isolation is applied extensively to both new and existing buildings. For the latter, it usually does not require any interruption of the structure use and occupants evacuation, a special advantage for strategic buildings such as schools, hospitals, and military buildings. This paper describes the application of seismic isolation to three existing masonry buildings in Italy: Villa “La Maddalena” in Macerata (Marche region), “Giacomo Matteotti” and “Plinio Il Giovane” school buildings in Perugia (Umbria region). The seismic hazard of the sites is characterized by a Peak Ground Acceleration (PGA) of 0.213g-0.287g for the Life Safety Limit State and between 0.271g-0.359g for the Collapse Limit State. All the buildings are isolated with a combination of free sliders type TETRON® CD with confined elastomeric disk and anti-seismic rubber isolators type ISOSISM® HDRB to reduce the eccentricity between the center of mass and stiffness, thus limiting torsional effects during a seismic event. The isolation systems are designed to lengthen the original period of vibration (i.e., without isolators) by at least three times and to guarantee medium/high levels of energy dissipation capacity (equivalent viscous damping between 12.5% and 16%). This allows the structures to resist 100% of the seismic design action. This article shows the performances of the supplied anti-seismic devices with particular attention to the experimental dynamic response. Finally, a special focus is given to the main site activities required to isolate a masonry building.

Keywords: retrofit, masonry buildings, seismic isolation, energy dissipation, anti-seismic devices

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911 Exploring the Dynamic Identities of Multilingual Adolescents in Contexts of L3+ Learning in Four European Sites

Authors: Harper Staples

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A necessary outcome of today’s contemporary globalised reality, current views of multilingualism hold that it no longer represents the exception, but rather the rule. As such, the simultaneous acquisition of multiple languages represents a common experience for many of today's students and therefore represents a key area of inquiry in the domain of foreign language learner identity. Second and multilingual language acquisition processes parallel each other in many ways; however, there are differences to be found in the ways in which a student may learn a third language. A multilingual repertoire will have to negotiate complex change as language competencies dynamically evolve; moreover, this process will vary according to the contextual factors attributed to a unique learner. A developing multilingual identity must, therefore, contend with an array of potential challenges specific to the individual in question. Despite an overarching recognition in the literature that pluri-language acquisition represents a unique field of inquiry within applied linguistic research, there is a paucity of empirical work which examines the ways in which individuals construct a sense of their own identity as multilingual speakers in such contexts of learning. This study explores this phenomenon via a mixed-methods, comparative case study approach at four school sites based in Finland, France, Wales, and England. It takes a strongly individual-in-context view, conceptualising each adolescent participant in dynamic terms in order to undertake a holistic exploration of the myriad factors that might impact upon, and indeed be impacted by, a learner's developing multilingual identity. Emerging themes of note thus far suggest that, beyond the expected divergences in the experience of multilinguality at the individual level, there are contradictions in the way in which adolescent students in each site 'claim' their plurilingualism. This can be argued to be linked to both meso and macro-level factors, including the foreign language curriculum and, more broadly, societal attitudes towards multilingualism. These diverse emergent identifications have implications not only for attainment in the foreign language but also for student well-being more generally.

Keywords: foreign language learning, student identity, multilingualism, educational psychology

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910 Literature Review of Rare Synchronous Tumours

Authors: Diwei Lin, Amanda Tan, Rajinder Singh-Rai

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We present the first reported case of a concomitant Leydig cell tumor (LCT) and paratesticular leiomyoma in an adult male with a known history of bilateral cryptorchidism. An 80-year-old male presented with a 2-month history of a left testicular lump associated with mild discomfort and a gradual increase in size on a background of bilateral cryptorchidism requiring multiple orchidopexy procedures as a child. Ultrasound confirmed a lesion suspicious for malignancy and he proceeded to a left radical orchidectomy. Histopathological assessment of the left testis revealed a concomitant testicular LCT with malignant features and paratesticular leiomyoma. Leydig cell tumors (LCTs) are the most common pure testicular sex cord-stromal tumors, accounting for up to 3% of all testicular tumors. They can occur at almost any age, but are noted to have a bi-modal distribution, with a peak incidence at 6 to 10 and at 20 to 50 years of age. LCT’s are often hormonally active and can lead to feminizing or virilizing syndromes. LCT’s are usually regarded as benign but can rarely exhibit malignant traits. Paratesticular tumours are uncommon and their reported prevalence varies between 3% and 16%. They occur in a complex anatomical area which includes the contents of the spermatic cord, testicular tunics, epididymis and vestigial remnants. Up to 90% of paratesticular tumours are believed to originate from the spermatic cord, though it is often difficult to definitively ascertain the exact site of origin. Although any type of soft-tissue neoplasm can be found in the paratesticular region, the most common benign tumors reported are lipomas of the spermatic cord, adenomatoid tumours of the epididymis and leiomyomas of the testis. Genetic studies have identified potential mutations that could potentially cause LCTs, but there are no known associations between concomitant LCTs and paratesticular tumors. The presence of cryptorchidism in adults with both LCTs and paratesticular neoplasms individually has been previously reported and it appears intuitive that cryptorchidism is likely to be associated with the concomitant presentation in this case report. This report represents the first documented case in the literature of a unilateral concomitant LCT and paratesticular leiomyoma on a background of bilateral cryptorchidism.

Keywords: testicular cancer, leydig cell tumour, leiomyoma, paratesticular neoplasms

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909 Derivation of Bathymetry from High-Resolution Satellite Images: Comparison of Empirical Methods through Geographical Error Analysis

Authors: Anusha P. Wijesundara, Dulap I. Rathnayake, Nihal D. Perera

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Bathymetric information is fundamental importance to coastal and marine planning and management, nautical navigation, and scientific studies of marine environments. Satellite-derived bathymetry data provide detailed information in areas where conventional sounding data is lacking and conventional surveys are inaccessible. The two empirical approaches of log-linear bathymetric inversion model and non-linear bathymetric inversion model are applied for deriving bathymetry from high-resolution multispectral satellite imagery. This study compares these two approaches by means of geographical error analysis for the site Kankesanturai using WorldView-2 satellite imagery. Based on the Levenberg-Marquardt method calibrated the parameters of non-linear inversion model and the multiple-linear regression model was applied to calibrate the log-linear inversion model. In order to calibrate both models, Single Beam Echo Sounding (SBES) data in this study area were used as reference points. Residuals were calculated as the difference between the derived depth values and the validation echo sounder bathymetry data and the geographical distribution of model residuals was mapped. The spatial autocorrelation was calculated by comparing the performance of the bathymetric models and the results showing the geographic errors for both models. A spatial error model was constructed from the initial bathymetry estimates and the estimates of autocorrelation. This spatial error model is used to generate more reliable estimates of bathymetry by quantifying autocorrelation of model error and incorporating this into an improved regression model. Log-linear model (R²=0.846) performs better than the non- linear model (R²=0.692). Finally, the spatial error models improved bathymetric estimates derived from linear and non-linear models up to R²=0.854 and R²=0.704 respectively. The Root Mean Square Error (RMSE) was calculated for all reference points in various depth ranges. The magnitude of the prediction error increases with depth for both the log-linear and the non-linear inversion models. Overall RMSE for log-linear and the non-linear inversion models were ±1.532 m and ±2.089 m, respectively.

Keywords: log-linear model, multi spectral, residuals, spatial error model

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908 Validation of the Arabic Version of the Positive and Negative Syndrome Scale (PANSS)

Authors: Arij Yehya, Suhaila Ghuloum, Abdlmoneim Abdulhakam, Azza Al-Mujalli, Mark Opler, Samer Hammoudeh, Yahya Hani, Sundus Mari, Reem Elsherbiny, Ziyad Mahfoud, Hassen Al-Amin

Abstract:

Introduction: The Positive and Negative Syndrome Scale (PANSS) is a valid instrument developed by Kay and colleagues6 to assess symptoms of patients with schizophrenia. It consists of 30 items that factor the symptoms into three subscales: positive, negative and general psychopathology. This scale has been translated and validated in several languages. Objective: This study aims to determine the validity and psychometric properties of the Arabic version of the PANSS. Methods: A standardized translation and cultural adaptation method was adopted. Patients diagnosed with schizophrenia (n=98), according to psychiatrist’s diagnosis based on DSM-IV criteria, were recruited from the Psychiatry Department at Rumailah Hospital, Qatar. A first rater confirmed the diagnosis using the Arabic version of Mini International Neuropsychiatric Interview (MINI 6). A second and independent rater-administered the Arabic version of PANSS. Also, a control group (n=101), with no history of psychiatric disorder was recruited from the family and friends of the patients and from primary health care centers in Qatar. Results: There were more males than females in our sample of patients with schizophrenia (68.9% and 31.6%, respectively). On the other hand, in the control group the number of females outweighed that of males (58.4% and 41.6% respectively). The scale had a good internal consistency with Cronbach’s alpha 0.91. There was a significant difference between the scores on the three subscales of the PANSS. Patients with schizophrenia scored significantly higher (p<.0001) than the control subjects on subscales for positive symptoms 20.01(SD=7.21) and 7.30(SD=1.38), negative symptoms 18.89(SD=8.88) and 7.37(SD=2.38) and general psychopathology 34.41 (SD=11.56) and 16.93 (SD=3.93), respectively. Factor analysis and ROC curve were carried out to further test the psychometrics of the scale. Conclusions: The Arabic version of PANSS is a reliable and valid tool to assess both positive and negative symptoms of patients with schizophrenia in a balanced manner. In addition to providing the Arab population with a standardized tool to monitor symptoms of schizophrenia, this version provides a gateway to compare the prevalence of positive and negative symptoms in the Arab world which can be compared to others done elsewhere.

Keywords: Arabic version, assessment, diagnosis, schizophrenia, validation

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907 The Influence of Wildlife Watching Experience on Tourists’ Connection to Wildlife Conservation Caring and Awareness

Authors: Fiffy Hanisdah Saikim, Bruce Prideaux

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One of the aims of wildlife tourism is to educate visitors about the threats facing wildlife, in general, and the actions needed to protect the environment and maintain biodiversity. Annually, millions of tourists visit natural areas and zoos primarily to view flagship species such as rhinos and elephants. Venues rely on the inherent charisma of these species to increase visitation and anchor conservation efforts. Expected visitor outcomes from the use of flagships include raised levels of awareness and pro-conservation behaviors. However, the role of flagships in wildlife tourism has been criticized for not delivering conservation benefits for species of interest or biodiversity and producing negative site impacts. Furthermore, little is known about how the connection to a species influences conservation behaviors. This paper addresses this gap in knowledge by extending previous work exploring wildlife tourism to include the emotional connection formed with wildlife species and pro-conservation behaviors for individual species and biodiversity. This paper represents a substantial contribution to the field because (a) it incorporates the role of the experience in understanding how tourists connect with a species and how this connection influences pro-conservation behaviors; and (b) is the first attempt to operationalize Conservation Caring as a measure of tourists’ connection with a species. Existing studies have investigated how specific elements, such as interpretation or species’ morphology may influence programmatic goals or awareness. However, awareness is a poor measure of an emotional connection with an animal. Furthermore, there has not been work done to address the holistic nature of the wildlife viewing experience, and its subsequent influence on behaviors. Results based on the structural equation modelling, support the validity of Conservation Caring as a factor; the ability of wildlife tourism to influence Conservation Caring; and that this connection is a strong predictor of conservation awareness behaviors. These findings suggest wildlife tourism can deliver conservation outcomes. The studies in this paper also provide a valuable framework for structuring wildlife tourism experiences to align with flagship related conservation outcomes, and exploring a wider assemblage of species as potential flagships.

Keywords: wildlife tourism, conservation caring, conservation awareness, structural equation modelling

Procedia PDF Downloads 279
906 Structural and Functional Comparison of Untagged and Tagged EmrE Protein

Authors: S. Junaid S. Qazi, Denice C. Bay, Raymond Chew, Raymond J. Turner

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EmrE, a member of the small multidrug resistance protein family in bacteria is considered to be the archetypical member of its family. It confers host resistance to a wide variety of quaternary cation compounds (QCCs) driven by proton motive force. Generally, purification yield is a challenge in all membrane proteins because of the difficulties in their expression, isolation and solubilization. EmrE is extremely hydrophobic which make the purification yield challenging. We have purified EmrE protein using two different approaches: organic solvent membrane extraction and hexahistidine (his6) tagged Ni-affinity chromatographic methods. We have characterized changes present between ligand affinity of untagged and his6-tagged EmrE proteins in similar membrane mimetic environments using biophysical experimental techniques. Purified proteins were solubilized in a buffer containing n-dodecyl-β-D-maltopyranoside (DDM) and the conformations in the proteins were explored in the presence of four QCCs, methyl viologen (MV), ethidium bromide (EB), cetylpyridinium chloride (CTP) and tetraphenyl phosphonium (TPP). SDS-Tricine PAGE and dynamic light scattering (DLS) analysis revealed that the addition of QCCs did not induce higher multimeric forms of either proteins at all QCC:EmrE molar ratios examined under the solubilization conditions applied. QCC binding curves obtained from the Trp fluorescence quenching spectra, gave the values of dissociation constant (Kd) and maximum specific one-site binding (Bmax). Lower Bmax values to QCCs for his6-tagged EmrE shows that the binding sites remained unoccupied. This lower saturation suggests that the his6-tagged versions provide a conformation that prevents saturated binding. Our data demonstrate that tagging an integral membrane protein can significantly influence the protein.

Keywords: small multidrug resistance (SMR) protein, EmrE, integral membrane protein folding, quaternary ammonium compounds (QAC), quaternary cation compounds (QCC), nickel affinity chromatography, hexahistidine (His6) tag

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905 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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904 Post-Islamic Utopias, Contentious Memory and the Revolutionary Mobilization in Iran

Authors: Saeed Saffar-Heidari

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This article aims to study the recent Iranian national uprising of “Women, Life, Freedom” as a site of memory which renders the political possibility of imagining the post-Islamic futures in Iran. “Women, Life, Freedom” movement in Iran has been arguably the most pervasive social movement since the Islamic Revolution (1979) as it has posed serious issues and conflicts for the present Islamic state in Iran. The core argument of this article, however, is oriented toward the critical role of collective memory as a means of political transition and revolutionary mobilization. “Women, Life, Freedom” movement, among other things, has revitalized the popular binary opposition of pre-1979 and post-1979 Iran through which the Ancien Régime or the pre-1979 era is likely to be interpreted, read, and remembered in terms of present post-1979 cultural and political demands. As remembering involves everyday participation in shaping and reshaping the past through new codes, criteria, and values, it is argued that the presentist refashioning and remembering of the pre-1979 monarchical era has been one of the major facilitatory forces for the on-going revolutionary mobilization in Iran. The construction of the pre-1979 memory and the return of the dynastic specter has played a significant role in revolutionary mobilization as it has provided the protesters with the possible perspectives of post-Islamic regime in Iran. Additionally, the question of compulsory “Hijab” (veiling) as the prime mover of "Women, Life, Freedom” movement in Iran has strongly contributed to the everyday comparative discourse of pre/post 1979 memory. According to this presentist remembering of pre-1979, the Pahlavi dynasty would be conceived as a symbol of modernization, westernization, secularization, and non-compulsory Hijab. While the memory of the pre-revolutionary Iran is genuinely an imaginative as well as a constructed entity that finally culminates in the public condemnation of the very Islamic revolution (1979), it serves the enrichment of the Iranian political imagination as it paves the ways for the revolutionary mobilization and then the overthrowing of the Islamic regime in Iran. This article makes a case for the ways that the public narrative and discourse around the Islamic regime (especially the Islamic Hijab) led to the refashioning of the memory of pre-1979 era and inspired he revolutionary mobilization in Iran.

Keywords: post-islamic, utopias, memory, revolutionary, mobilization, Iran

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903 Effect of Pulmonary Rehabilitation towards Length of Stay and IL-6 Level on Community-Acquired Pneumonia Patients

Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

Abstract:

Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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