Search results for: hip fracture rehabilitation

Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: Bhavatharani S., Boopathy V., Kavin S., Naveethkumar R.

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Context: Resistance training with blood flow restriction (BFR) has increased in clinical rehabilitation due to the substantial benefits observed in augmenting muscle mass and strength using low loads. However, there is a great variability of training pressures for clinical populations as well as methods to estimate it. The aim of this study was to estimate the percentage of maximal BFR that could result by applying different methodologies based on arbitrary or individual occlusion levels using a cuff width between 9 and 13 cm. Design: A secondary analysis was performed on the combined databases of 2 previous larger studies using BFR training. Methods: To estimate these percentages, the occlusion values needed to reach complete BFR (100% limb occlusion pressure [LOP]) were estimated by Doppler ultrasound. Seventy-five participants (age 24.32 [4.86] y; weight: 78.51 [14.74] kg; height: 1.77 [0.09] m) were enrolled in the laboratory study for measuring LOP in the thigh, arm, or calf. Results: When arbitrary values of restriction are applied, a supra-occlusive LOP between 120% and 190% LOP may result. Furthermore, the application of 130% resting brachial systolic blood pressure creates a similar occlusive stimulus as 100% LOP. Conclusions: Methods using 100 mm Hg and the resting brachial systolic blood pressure could represent the safest application prescriptions as they resulted in applied pressures between 60% and 80% LOP. One hundred thirty percent of the resting brachial systolic blood pressure could be used to indirectly estimate 100% LOP at cuff widths between 9 and 13 cm. Finally, methodologies that use standard values of 200 and, 300 mm Hg far exceed LOP and may carry additional risk during BFR exercise.

Keywords: lower limb rehabilitation, ESP32, pneumatics for medical, programmed rehabilitation

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Authors: Ashwini Bhosale, Yogesh Patil

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Urban areas are extremely complicated environmental settings, where health and well-being of an individual and population are governed by a large number of bio-physical, socio-economical, and inclusive aspects. Although poverty and slums are the prime issues under UN-HABITAT agenda of environmental sustainability, slums, the inevitable part of urban environment, have not accounted for inclusive city planning. Developing nations, where about 60 % of world slum population resides, are increasingly under pressure to uplift the urban poor, particularly slum dwellers. From a point of advantage, these new slum redevelopment projects have succeeded in providing legitimized and more permanent and stable shelter for the low income people, as well as individualized sanitation and water supply. However, they unfortunately follow the “one type fits all" approach and exhibit no response to the climatic design needs on Mumbai. The thesis focuses on the study of environmental perspectives in the context of Daylight, natural ventilation and social aspects in the design process of Slum-Rehabilitation schemes (SRS) – case of Mumbai. It attempts to investigate into Indian approaches about SRS and concludes upon strategies to be incorporated in SRS to improve the overall SRS environment. The main objectives of this work have been to identify and study the spatial configuration and possibilities of daylight and natural ventilation in Slum Rehabilitated buildings. The performance of the proposed method was evaluated by comparison with the daylight luminance simulated by lighting software, namely ECOTECT, and with measurements under real skies whereas for the ventilation study purpose, software named FLOW DESIGN was used.

Keywords: urban environment, slum-rehabilitation, daylight, natural-ventilation, architectural consequences

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Authors: Balazs Patczai, Katalin Gocze, Gabriella Kiss, Dorottya Szabo, Tibor Mintal

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Introduction: Running has become increasingly popular on a global scale in the past decades. Amateur athletes are taking their sport to a new level in an attempt to surpass their performance goals. The aim of our study was to assess the musculoskeletal condition of amateur runners and the prevalence of injuries with a special focus on stress fracture risk. Methods: The cross sectional analysis included ankle mobility, hamstring and lower back flexibility, the use of Renne’s test for iliotibial band syndrome, functional tests for trunk and rotary stability, and measurements of bone density. Data was collected at 2 major half-marathon events in Hungary. Results: Participants (n=134) mean age was 41.76±8.57 years (males: 40.67±8.83, females: 42.08±8.56). Measures of hamstring and lower back flexibility fell into the category of good for both genders (males: 7.13±6.83cm, females: 10.17±6.67cm). No side asymmetry nor gender differences were characteristic in the case of ankle mobility. Trunk stability was significantly better for males than in females (p=0.004). Markers of bone health were in the low normal range for females and were significantly better for males (T-score: p=0.003, T-ratio: p=0.014, Z-score: p=0.034, Z-ratio: p=0.011). 5.2% of females had a previous stress fracture and 24.1% experienced irregular menstrual cycles during the past year. As for the knowledge on the possible association of energy deficiency, menstrual disturbances and their effect on bone health, Only 8.6% of females have heard of the female athlete triad either during their studies or from a health professional. Discussion: The overall musculoskeletal state was satisfactory for both genders both physically and functionally. More attention and effort should be placed on primary and secondary prevention of amateur runners. Very few active women are well informed about the effects of low energy availability and menstrual dysfunction and the negative impact these have on bone health.

Keywords: bone health, flexibility, running, stress fracture

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Authors: Tarek Duzan

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Fractures are a fundamental property of most reservoirs. Despite their abundance, they remain difficult to detect and quantify. The most effective characterization of fractured reservoirs is accomplished by integrating geological, geophysical, and engineering data. Detection of fractures and defines their relative contribution is crucial in the early stages of exploration and later in the production of any field. Because fractures could completely change our thoughts, efforts, and planning to produce a specific field properly. From the structural point of view, all reservoirs are fractured to some point of extent. North Gialo field is thought to be a naturally fractured reservoir to some extent. Historically, natural fractured reservoirs are more complicated in terms of their exploration and production efforts, and most geologists tend to deny the presence of fractures as an effective variable. Our aim in this paper is to determine the degree of fracturing, and consequently, our evaluation and planning can be done properly and efficiently from day one. The challenging part in this field is that there is no enough data and straightforward well testing that can let us completely comfortable with the idea of fracturing; however, we cannot ignore the fractures completely. Logging images, available well testing, and limited core studies are our tools in this stage to evaluate, model, and predict possible fracture effects in this reservoir. The aims of this study are both fundamental and practical—to improve the prediction and diagnosis of natural-fracture attributes in N. Gialo hydrocarbon reservoirs and accurately simulate their influence on production. Moreover, the production of this field comes from 2-phase plan; a self depletion of oil and then gas injection period for pressure maintenance and increasing ultimate recovery factor. Therefore, well understanding of fracturing network is essential before proceeding with the targeted plan. New analytical methods will lead to more realistic characterization of fractured and faulted reservoir rocks. These methods will produce data that can enhance well test and seismic interpretations, and that can readily be used in reservoir simulators.

Keywords: natural fracture, sandstone reservoir, geological, geophysical, and engineering data

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Authors: Yeaji Seok, Myung Kyung Lee

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Background: Even if patients survive after a stroke, stroke patients may experience disability in mobility, sensation, cognition, and speech and language. Stroke patients require rehabilitation for functional recovery and daily life for a considerable time. During rehabilitation, the role of caregivers is important. However, the stroke patients’ quality of life may deteriorate due to family caregivers’ non-preparedness and increased role burden. Purpose: To investigate the prediction of caregivers' preparedness and role burden on stroke patients’ quality of life. Methods: The target population was stroke patients who were hospitalized for rehabilitation and their family care providers. A total of 153 patient-family caregiver dyads were recruited from June to August 2021. Data were collected from self-reported questionnaires and analyzed using descriptive statistics, t-tests, chi-squared test, one-way analysis of variance, Pearson’s correlation coefficients, and multiple regression with SPSS statistics 28 programs. Results: Family caregivers’ preparedness affected stroke patients’ mobility (β = .20, p < 0.05) and character (β = -.084, p < 0.05) and production activities (β = -.197, p < 0.05) in quality of life. The role burden of family caregivers affected language skills (β = .310, p<0.05), visual functions (β=-.357, p < 0.05), thinking skills (β = 0.443, p = 0.05), mood conditions (β = 0.565, p < 0.001), family roles (β = -0.361, p < 0.001), and social roles (β = -0.304, p < 0.001), while the caregivers’ burden of performing self-protection negatively affected patients’ social roles (β = .180, p=.048). In addition, caregivers’ role burden of personal life sacrifice affected patients’ mobility (β = .311, p < 0.05), self-care (β =.232, p < 0.05) and energy (β = .239, p < 0.05). Conclusion: This study indicated that family caregivers' preparedness and role burden affected stroke patients’ quality of life. The results of this study suggested that intervention to improve family caregivers’ preparedness and to reduce role burden should be required for quality of life in stroke patients.

Keywords: quality of life, preparedness, role burden, caregivers, stroke

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Authors: Sharmila Sakravarthy

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Prison administration in India, even though an important limb of the criminal justice system are worse off in terms of overcrowding, prolonged detention of under-trial prisoners, and a host of other problems. Considering the statistics of the prison population, over a thousand three hundred prisons across the country were overcrowded, even to the extent of more than six hundred percent. A total of eighteen thousand eight hundred and fifty-eight female prisoners were in India, out of which thirteen thousand hundred and sixty-five were under trials and five thousand and sixty-three convicts. A total of around one thousand seven hundred thirty-five children are residing in prisons along with their mothers. District prisons are more overcrowded than the other prisons, and their practices are at odd with human rights standards. This article examines a range of issues in prisons throughout India including pretrial detention, overcrowding, resources and governance, women and children in prison and rehabilitation. A substantial amount of space is devoted to the reforms that are occurring across the nation, and recommendations are made with regard to what further reforms are necessary.

Keywords: human rights, overcrowding, prisons, rehabilitation

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Authors: Zuoji Huang, Haiming Qian, Chunlin Wang, Jinyan Sun, Nan Xu

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In this paper, the strategy to extract double road edge lines from acquired road stripe image was explored. The workflow is as follows: the road stripes are acquired by probabilistic boosting tree algorithm and morphological algorithm immediately, and road centerlines are detected by thinning algorithm, so the initial road edge lines can be acquired along the road centerlines. Then we refine the results with big variation of local curvature of centerlines. Specifically, the energy function of edge line is constructed by gradient feature and spectral information, and Dijkstra algorithm is used to optimize the initial road edge lines. The Snake model is constructed to solve the fracture problem of intersection, and the discrete dynamic programming algorithm is used to solve the model. After that, we could get the final road network. Experiment results show that the strategy proposed in this paper can be used to extract the continuous and smooth road edge lines from high-resolution remote sensing images with an accuracy of 88% in our study area.

Keywords: road edge lines extraction, energy function, intersection fracture, Snake model

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Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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Authors: Divya Pathak, James Sloane

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Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

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Authors: Nabeel Abdulkadhim Athab

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The purpose of this research is to conduct a comparative study according analysis of programmed to some of physical and mechanical variables for joint wrist injury. As it can be through this research to distinguish between the amount of variation in the work of the joint after sample underwent rehabilitation program to improve the effectiveness of the joint and naturally restore its effectiveness. Supposed researcher that there is statistically significant differences between the results of the tests pre and post the members research sample, as a result of submission the sample to the program of rehabilitation, which led to the development of muscle activity that are working on wrist joint and this is what led to note the differences between the results of the tests pre and post. The researcher used the descriptive method. The research sample included (6) of injured players in the wrist joint, as the average age (21.68) and standard deviation (1.13) either length average (178cm) and standard deviation (2.08). And the sample as evidenced homogeneous among themselves. And where the data were collected, introduced in program for statistical processing to get to the most important conclusions and recommendations and that the most important: 1-The commitment of the sample program the qualifying process variables studied in the search for the heterogeneity of study activity and effectiveness of wrist joint for injured players. 2-The analysis programmed a high accuracy in the measurement of the research variables, and which led to the possibility of discrimination into account differences in motor ability camel and injured in the wrist joint. To search recommendations including: 1-The use of computer systems in the scientific research for the possibility of obtaining accurate research results. 2-Programming exercises rehabilitation according to an expert system for possible use by patients without reference to the person processor.

Keywords: analysis of joint wrist injury, physical and mechanical variables, wrist joint, wrist injury

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Authors: Tryastuti I. B. Manullang, Juang Sunanto

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This study aimed to find the perspectives of the Toba Batak education stakeholders towards the education of children with disabilities in Toba Samosir North Sumatra Indonesia. The education stakeholders consist of a head of the education department in Toba Samosir, head of the H foundation, two principals and three teachers from the Special Primary Schools. This study uses qualitative a descriptive approach and research data obtained through interviews. The results of this study demonstrate that the education stakeholders knowledge about disabilities needs improvement in accordance with the development of science. The cultural views towards disability and its implications, and the education services available for children with disabilities, in addition, to encountered its problem in Toba Samosir are known. The education concept considered appropriate is the special school and the CBR (Community Based Rehabilitation) strategy, also inclusive education because it represents the Toba Batak philosophy.

Keywords: community based rehabilitation, education concept, education stakeholders, inclusive education

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Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Wei-Chia Huang, Jane Wang

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Damage to nerves is considered one of the most irreversible injuries. The regeneration of nerves has always been an important topic in regenerative medicine. In general, damage to human tissue will naturally repair overtime. However, when the nerves are damaged, healed flesh wound cannot guarantee full restoration to its original function, as truncated nerves are often irreversible. Therefore, the development of treatment methods to successfully guide and accelerate the regeneration of nerves has been highly sought after. In order to induce nerve tissue growth, nerve conduits are commonly used to help reconnect broken nerve bundles to provide protection to the location of the fracture while guiding the growth of the nerve bundles. To prevent the protected tissue from becoming necrotic and to ensure the growth rate, the conduits used are often modified with microstructures or blended with neuron growth factors that may facilitate nerve regeneration. Electrical stimulation is another attempted treatment for medical rehabilitation. With appropriate range of voltages and stimulation frequencies, it has been demonstrated to promote cell proliferation and migration. Biodegradability are critical for medical devices like nerve conduits, while conductive polymers pose great potential toward the differentiation and growth of nerve cells. In this work, biodegradability and conductivity were combined into a novel biodegradable, photocurable, conductive polymer composite materials by embedding conductive nanoparticles in poly(glycerol sebacate) acrylate (PGSA) and 3D-printed into nerve conduits. Rat pheochromocytoma cells and rat neuronal Schwann cells were chosen for the in vitro tests of the conduits and had demonstrate selective growth upon culture in the conductive conduits with built-in microchannels and electrical stimulation.

Keywords: biodegradable polymer, 3d printing, neural regeneration, electrical stimulation

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Authors: Carlos Cuenca, Diego Sarzosa

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Ductile fracture occurs by the mechanism of void nucleation, void growth and coalescence. Potential sites for initiation are second phase particles or non-metallic inclusions. Modelling of ductile damage at the microscopic level is very difficult and complex task for engineers. Therefore, conservative predictions of ductile failure using simple models are necessary during the design and optimization of critical structures like pressure vessels and pipelines. Nowadays, it is well known that the initiation phase is strongly influenced by the stress triaxiality and plastic deformation at the microscopic level. Thus, a simple model used to study the ductile failure under multiaxial stress condition is the Stress Modified Critical Strain (SMCS) approach. Ductile rupture has been study for a structural steel under different stress triaxiality conditions using the SMCS method. Experimental tests are carried out to characterize the relation between stress triaxiality and equivalent plastic strain by notched round bars. After calibration of the plasticity and damage properties, predictions are made for low constraint bending specimens with and without side grooves. Stress/strain fields evolution are compared between the different geometries. Advantages and disadvantages of the SMCS methodology are discussed.

Keywords: damage, SMSC, SEB, steel, failure

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Authors: Henar Martín-Sanz García, Eleni Chatzi, Eugen Brühwiler

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Located on the shore of Geneva Lake, in Switzerland, the Chillon Viaducts are two parallel structures consisted of post-tensioned concrete box girders, with a total length of 2 kilometers and 100m spans. Built in 1969, the bridges currently accommodate a traffic load of 50.000 vehicles per day, thereby holding a key role both in terms of historic value as well as socio-economic significance. Although several improvements have been carried out in the past two decades, recent inspections demonstrate an Alkali-Aggregate reaction in the concrete deck and piers reducing the concrete strength. In order to prevent further expansion of this issue, a layer of 40 mm of Ultra High Performance Fiber Reinforced cement-based Composite (UHPFRC) (incorporating rebars) was casted over the slabs, acting as a waterproof membrane and providing significant increase in resistance of the bridge structure by composite UHPFRC – RC composite action in particular of the deck slab. After completing the rehabilitation works, a Structural Monitoring campaign was installed on the deck slab in one representative span, based on accelerometers, strain gauges, thermal and humidity sensors. This campaign seeks to reveal information on the behavior of UHPFRC-concrete composite systems, such as increase in stiffness, fatigue strength, durability and long-term performance. Consequently, the structural monitoring is expected to last for at least three years. A first insight of the analyzed results from the initial months of measurements is presented herein, along with future improvements or necessary changes on the deployment.

Keywords: composite materials, rehabilitation, structural health monitoring, UHPFRC

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Authors: Ali Heidari, Hany Saleem

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The tailwater requirements are important criteria in the design of the stilling basins as energy dissipation of the spillways. The adequate tailwater level that ensures the hydraulic jump inside the basin should be fulfilled by the river's natural water level and the apron depth downstream of the chute. The requirements of the hydraulic jump should mainly be checked for the design flood, however, the drawn jump condition should not be critical in the discharges lesser than the design flood. The tailwater requirement is not met in Almatti dam, built in 2005 in India, and the jump sweep out from the basin, resulting in significant scour in the apron and end sill of the basin. This paper discusses different hydraulic solutions as sustainable solutions for the rehabilitation program. The deep apron alternative is proposed for the fewer bays of the spillway as the most cost-effective, sustainable solution. The apron level of 15 gates out of 26 gates should decrease by 5.4 m compared to the existing design to ensure a safe hydraulic jump up to the discharge of 10,000 m3/s i.e. 30% of the updated PMF.

Keywords: dam, spillway, stilling basin, Almatti

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Authors: Yunfan Jiang

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In response to an identified gap in available treatment programmes for high-risk offenders with multiple criminogenic needs and guided by emerging literature in the field of correctional rehabilitation, Singapore Prison Service (SPS) developed the Integrated Criminogenic Programme (ICP) in 2012. This evidence-informed psychological programme was designed to address all seven dynamic criminogenic needs (from the Central 8) of high-risk offenders by applying concepts from rehabilitation and psychological theories such as Risk-Need-Responsivity, Good Lives Model, narrative identity, and motivational interviewing. This programme also encompasses a 6-month community maintenance component for the purpose of providing structured step-down support in the aftercare setting. These sessions provide participants the opportunity for knowledge reinforcement and application of skills attained in-care. A quantitative evaluation of the ICP showed that the intervention group had statistically significant improvements across time in most self-report measures of criminal attitudes, substance use attitudes, and psychosocial functioning. This was congruent with qualitative data from participants saying that the ICP had the most impact on their criminal thinking patterns and management of behaviours in high-risk situations. Results from the comparison group showed no difference in their criminal attitudes, even though they reported statistically significant improvements across time in their substance use attitudes and some self-report measures of psychosocial functioning. The programme’s efficacy was also apparent in the lower rates of recidivism and relapse within 12 months for the intervention group. The management of staff issues arising from the development and implementation of an innovative high-intensity psychological programme such as the ICP will also be discussed.

Keywords: evaluation, forensic psychology, intervention programme, offender rehabilitation

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Authors: Ram Narayan Khare, Aradhna Shrivastava, Adhyatma Khare

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This paper focuses on the damage that has been occurred in the Ancient structures due to various factors such as rainfall, climate, insects, lifespan and also most important lack of technologies in the era of its construction. The structure is of lime surkhi masonry and is made a century ago. It has crossed its durability but is of historical importance for the area, that is the reason why it needs utmost importance for its Rehabilitation. The paper deals with the damage that has been occurred in the structure and how to repair and renovate the same keeping in mind that the material deviation could not take place because it shows how in ancient era structures are made of. The building has used lime surkhi mortar along with wood apple as fibrous material for providing adhesiveness in masonry binding. The paper helps in sustainable retrofitting of the structure without changing the integrity of the structure. This helps in maintaining the originality of structure in present era and also help in providing information to the upcoming generation how ancient civil construction has been carried out that withstand even more than a century.

Keywords: Lime Surkhi masonry, rehabilitation, sustainable development, historical building

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Authors: B. Kenny

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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: Hasan Izhar Khan, Naiqiang Zhang, Hong Xu, Zhongliang Zhu, Dongfang Jiang

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Inconel 617, a nickel-based alloy designed for high-temperature applications, got an excellent amalgamation of strength and oxidation resistance at high temperatures. For a better understanding of its suitability to be used in superheater and reheater tubes in ultra-supercritical power plants, stress corrosion cracking (SCC) susceptibility must be evaluated. In the present study, the effect of medium environment on SCC behavior of Inconel 617, in the form of a round bar tensile specimen, was tested via slow strain rate tensile tests in steam and supercritical water (SCW) at 650 °C. The results showed that SCC susceptibility has a linear relationship with exposed pressure and increases monotonically with an increase in pressure. A severe SCC susceptibility was observed in SCW followed by that in a steam environment. Fracture and gage surface showed apparent characteristics of brittle fracture. Intergranular cracks initiated from the edge region and propagated into the matrix through cross section until ductile rupture. When dissolved oxygen contents were decreased in SCW environment, it showed no noticeable effect on mechanical properties but SCC susceptibility slightly decreased. The research revealed the influence of environment on SCC susceptibility of Inconel 617 in steam and SCW.

Keywords: Inconel 617, steam, supercritical water, stress corrosion cracking

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Authors: Rezvan Khavari

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The Zagros fold-thrust belt in SW Iran is a part of the Alpine-Himalayan system which consists of a variety of structures with different sizes or geometries. The study area is Chamshir Dam, which is located on the Zohreh River, 20 km southeast of Gachsaran City (southwest Iran). The satellite images are valuable means available to geologists for locating geological or geomorphological features expressing regional fault or fracture systems, therefore, the satellite images were used for structural analysis of the Chamshir dam area. As well, using the DEM and geological maps, 3D Models of the area have been constructed. Then, based on these models, all the acquired fracture traces data were integrated in Geographic Information System (GIS) environment by using Arc GIS software. Based on field investigation and DEM model, main structures in the area consist of Cham Shir syncline and two fault sets, the main thrust faults with NW-SE direction and small normal faults in NE-SW direction. There are three joint sets in the study area, both of them (J1 and J3) are the main large fractures around the Chamshir dam. These fractures indeed consist with the normal faults in NE-SW direction. The third joint set in NW-SE is normal to the others. In general, according to topography, geomorphology and structural geology evidences, Chamshir dam has a potential for sliding in some parts of Gachsaran formation.

Keywords: DEM, chamshir dam, zohreh river, satellite images

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Authors: Pinal Patel

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The study defines the problems and issues of women in Maoist groups, also referred as ‘Naxalites’, in Chhattisgarh, India. It analyses the causes and consequences of increasing number of women joining Maoists groups and measures taken by the central and state government to retreat them. The main aspect of the study is, how to counter the challenges to resolve the issues and restore normalcy in the life of women Maoists to resettle them in mainstream once they become physically inactive and wish to become part of the society. The rationale behind this study is that women Maoists once inactive, has no place either with Maoist camps/rebel groups or particularly in society. The problems faced by the women Maoists, in society as well as in Maoists camps, can be studied through social, economic, cultural, political and humanitarian aspects. The methodology of the study is dependent on primary sources of information which includes a research survey in majorly affected areas, statistical analysis. Secondary sources of information are helpful for understanding the background of the problem. Government’s strategy of rewarding with cash and providing resettlement and rehabilitation benefits including houses and jobs to ex-women Maoists and their families is a well formulated and feasible policy and effectively implemented by the concerned authorities. But, the survey results show that the policy has not been able to have impacts as it was intended. Because inactive and physically disabled women are still left deserted in deep forests to die and police or authorities are not able to reach them and bring them back. The difficult terrain and dense forest areas are major hurdles to reach to Maoists camps. Moreover, to make people aware of government’s surrendering and rehabilitation schemes and policies as communication networks are very poor due to the lack of development in the state.

Keywords: maoists, women, government, policy

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Authors: Jonida Hasanaj

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Abstract: Four years after the pandemic, numerous studies discuss the long-term effects of COVID-19 on patients, with chronic fatigue syndrome being a prominent concern. Understanding the mechanisms behind this syndrome is crucial for developing prevention, treatment, and rehabilitation strategies. The appropriateness of physiotherapeutic treatment in covid 19 and post-COVID-19 patients has remained uncertain due to inconsistent diagnostic criteria, highlighting the need for further research. This paper intends to offer guidelines and specific suggestions for hospital-based physical therapists managing COVID-19 hospitalized patients at ‘’Expert Physiotherapy’ and ’American Hospital’ in Albania using a national approach in accordance with worldwide initiatives. Several studies indicate that chronic tiredness syndrome and high intracranial pressure could result from failure of the post-Covid-19 lymphatic system. Enabling the patient to intensify their physical activity and enhance their ability to move, exercise, and even resume a regular life cycle is the aim of physiotherapy treatment.

Keywords: mobility, physiotherapy, post-covid 19, rehabilitation, results

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Authors: Deepthy Ann Joy, N. Sreedevi

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Hearing impairment (HI) at an early age, identified before the onset of language development can reduce the negative effect on speech and language development of children. Early rehabilitation is very important in the improvement of speech production in children with HI. Other than conventional hearing aids, Cochlear Implants are being used in the rehabilitation of children with HI. However, delay in acquisition of speech and language milestones persist in children with Cochlear Implant (CI). Delay in speech milestones are reflected through speech sound errors. These errors reflect the temporal and spectral characteristics of speech. Hence, acoustical analysis of the speech sounds will provide a better representation of speech production skills in children with CI. The present study aimed at investigating the acoustic characteristics of vowels in Malayalam speaking children with a cochlear implant. The participants of the study consisted of 20 Malayalam speaking children in the age range of four and seven years. The experimental group consisted of 10 children with CI, and the control group consisted of 10 typically developing children. Acoustic analysis was carried out for 5 short (/a/, /i/, /u/, /e/, /o/) and 5 long vowels (/a:/, /i:/, /u:/, /e:/, /o:/) in word-initial position. The responses were recorded and analyzed for acoustic parameters such as Vowel duration, Ratio of the duration of a short and long vowel, Formant frequencies (F₁ and F₂) and Formant Centralization Ratio (FCR) computed using the formula (F₂u+F₂a+F₁i+F₁u)/(F₂i+F₁a). Findings of the present study indicated that the values for vowel duration were higher in experimental group compared to the control group for all the vowels except for /u/. Ratio of duration of short and long vowel was also found to be higher in experimental group compared to control group except for /i/. Further F₁ for all vowels was found to be higher in experimental group with variability noticed in F₂ values. FCR was found be higher in experimental group, indicating vowel centralization. Further, the results of independent t-test revealed no significant difference across the parameters in both the groups. It was found that the spectral and temporal measures in children with CI moved towards normal range. The result emphasizes the significance of early rehabilitation in children with hearing impairment. The role of rehabilitation related aspects are also discussed in detail which can be clinically incorporated for the betterment of speech therapeutic services in children with CI.

Keywords: acoustics, cochlear implant, Malayalam, vowels

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Authors: G. Culache, M. P. Byfield, N. S. Ferguson, A. Tyas

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Steel joints in building structures represent a weak link in the case of accidental transient loading. This type of loading can occur due to blast effects or impact with moving vehicles and will result in large deformations in the material as well as large rotations. This paper addresses the lack of experimental investigations into the response of moment resisting connections subjected to such loading. The current design philosophy was used to create test specimens with flush and extended end plates. The specimens were tested in a specially designed testing rig capable of delivering the sustained loading even beyond the point of failure. Types of failure that the authors attempted to obtain were bolt fracture, flange crushing and end plate fracture. Experimental data is presented, described and analyzed. The tests show that the strength and ductility can be significantly improved by replacing ordinary mild-steel bolts with their stainless steel equivalents. This minor modification is demonstrated to significantly improve the robustness when subjected to loading that results in high deformations and rotation, where loading is maintained during failure. Conclusions are drawn about the wider implications of this research and recommendations made on the direction of future research in this field.

Keywords: steel moment connections, high strain rates, dynamic loading, experimental testing

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Authors: Natalie Hoyer

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Bridges in both roadway and railway systems depend on bearings to ensure extended service life and functionality. These bearings enable proper load distribution from the superstructure to the substructure while permitting controlled movement of the superstructure. The design of bridge bearings, according to Eurocode DIN EN 1337 and the relevant sections of DIN EN 1993, increasingly requires the use of thick plates, especially for long-span bridges. However, these plate thicknesses exceed the limits specified in the national appendix of DIN EN 1993-2. Furthermore, compliance with DIN EN 1993-1-10 regulations regarding material toughness and through-thickness properties necessitates further modifications. Consequently, these standards cannot be directly applied to the selection of bearing materials without supplementary guidance and design rules. In this context, a recommendation was developed in 2011 to regulate the selection of appropriate steel grades for bearing components. Prior to the initiation of the research project underlying this contribution, this recommendation had only been available as a technical bulletin. Since July 2023, it has been integrated into guideline 804 of the German railway. However, recent findings indicate that certain bridge-bearing components are exposed to high fatigue loads, which necessitate consideration in structural design, material selection, and calculations. Therefore, the German Centre for Rail Traffic Research called a research project with the objective of defining a proposal to expand the current standards in order to implement a sufficient choice of steel material for bridge bearings to avoid brittle fracture, even for thick plates and components subjected to specific fatigue loads. The results obtained from theoretical considerations, such as finite element simulations and analytical calculations, are validated through large-scale component tests. Additionally, experimental observations are used to calibrate the calculation models and modify the input parameters of the design concept. Within the large-scale component tests, a brittle failure is artificially induced in a bearing component. For this purpose, an artificially generated initial defect is introduced at the previously defined hotspot into the specimen using spark erosion. Then, a dynamic load is applied until the crack initiation process occurs to achieve realistic conditions in the form of a sharp notch similar to a fatigue crack. This initiation process continues until the crack length reaches a predetermined size. Afterward, the actual test begins, which requires cooling the specimen with liquid nitrogen until a temperature is reached where brittle fracture failure is expected. In the next step, the component is subjected to a quasi-static tensile test until failure occurs in the form of a brittle failure. The proposed paper will present the latest research findings, including the results of the conducted component tests and the derived definition of the initial crack size in bridge bearings.

Keywords: bridge bearings, brittle fracture, fatigue, initial crack size, large-scale tests

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Authors: Julia A. Ermakova

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This study aimed to investigate the efficacy of a physical rehabilitation program for postpartum women. The program was developed with the purpose of restoring physical performance in women during the postpartum period. The research employed a variety of methods, including an analysis of scientific literature, pedagogical testing and experimentation, mathematical processing of study results, and physical performance assessment using a range of tests. The program recommends refraining from abdominal exercises during the first 6-8 months following a cesarean section and avoiding exercises with weights. Instead, a feasible training regimen that gradually increases in intensity several times a week is recommended, along with moderate cardio exercises such as walking, bodyweight training, and a separate workout component that targets posture improvement. Stretching after strength training is also encouraged. The necessary equipment includes comfortable sports attire with a chest support top, mat, push-ups, resistance band, timer, and clock. The motivational aspect of the program is paramount, and the mentee's positive experience with the workout regimen includes feelings of lightness in the body, increased energy, and positive emotions. The gradual reduction of body size and weight loss due to an improved metabolism also serves as positive reinforcement. The mentee's progress can be measured through various means, including an external assessment of her form, body measurements, weight, BMI, and the presence or absence of slouching in everyday life. The findings of this study reveal that the program is effective in restoring physical performance in postpartum women. The mentee achieved weight loss and almost regained her pre-pregnancy shape while her self-esteem improved. Her waist, shoulder, and hip measurements decreased, and she displayed less slouching in her daily life. In conclusion, the developed physical rehabilitation program for postpartum women is an effective means of restoring physical performance. It is crucial to follow the recommended training regimen and equipment to avoid limitations and ensure safety during the postpartum period. The motivational component of the program is also fundamental in encouraging positive reinforcement and improving self-esteem.

Keywords: physical rehabilitation, postpartum, methodology, postpartum recovery, rehabilitation

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Authors: Min Yu, Olivier T. Picot, Theo Graves Saunders, Ivo Dlouhy, Amit Mahajan, Michael J. Reece

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Graphene was successfully introduced into a polymer-derived silicon oxycarbide (SiOC) matrix by phase transfer of graphene oxide (GO) from an aqueous (GO dispersed in water) to an organic phase (copolymer as SiOC precursor in diethyl ether). With GO concentrations increasing up to 2 vol%, graphene-containing flakes self-assembled into a lamellar structure in the matrix leading to composite with the anisotropic property. Spark plasma sintering (SPS) was applied to densify the composites with four different GO concentrations (0, 0.5, 1 and 2 vol%) up to ~2.3 g/cm3. The fracture toughness of SiOC-2 vol% GO composites was significantly increased by ~91% (from 0.70 to 1.34 MPa·m¹/²), at the expense of a decrease in the flexural strength (from 85MPa to 55MPa), compared to SiOC-0 vol% GO composites. Moreover, the electrical conductivity in the perpendicular direction (σ┴=3×10⁻¹ S/cm) in SiOC-2 vol% GO composite was two orders of magnitude higher than the parallel direction (σ║=4.7×10⁻³ S/cm) owing to the self-assembled lamellar structure of graphene in the SiOC matrix. The composites exhibited increased electrical conductivity (σ┴) from 8.4×10⁻³ to 3×10⁻¹ S/cm, with the increasing GO content from 0.5 to 2 vol%. The SiOC-2 vol% GO composites further showed the better electrochemical performance of oxygen reduction reaction (ORR) than pure graphene, exhibiting a similar onset potential (~0.75V vs. RHE) and more positive half-wave potential (~0.6V vs. RHE).

Keywords: composite, fracture toughness, flexural strength, electrical conductivity, electrochemical performance

Procedia PDF Downloads 161