Search results for: medical resonance (MR) images

Authors: Seyed Ahmad Hosseini, Makan Cheraghpour, Saeed Shirali, Roya Rafie, Matin Ghanavati, Arezoo Amjadi, Meysam Alipour

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Background: There is a mutual relationship between sleep duration and obesity. We studied the relationship between sleep duration with obesity and dietary Intake. Methods: This cross-sectional study was conducted on 444 male students in Ahvaz Jundishapur University of Medical Science. Dietary intake was analyzed by food frequency questionnaire (FFQ). Anthropometric indices were analyzed. Participants were being asked about their sleep duration and they were categorized into three groups according to their responses (less than six hours, between six and eight hours, and more than eight hours). Results: Macronutrient, micronutrient, and antioxidant intake did not show significant difference between three groups. Moreover, we did not observe any significant difference between anthropometric indices (weight, body mass index, waist circumference, and percentage body fat). Conclusions: Our study results show no significant relationship between sleep duration, nutrition pattern, and obesity. Further study is recommended.

Keywords: sleep duration, obesity, dietary intake, cross-sectional

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Authors: Vitaliy Petrov, Natalia Shusharina, Vitaliy Kasymov, Maksim Patrushev, Evgeny Bogdanov

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The leading worldwide death reasons are ischemic heart disease and other cardiovascular illnesses. Generally, the common symptom is high blood pressure. Long-time blood pressure control is very important for the prophylaxis, correct diagnosis and timely therapy. Non-invasive methods which are based on Korotkoff sounds are impossible to apply often and for a long time. Implantable devices can combine longtime monitoring with high accuracy of measurements. The main purpose of this work is to create a real-time monitoring system for decreasing the death rate from cardiovascular diseases. These days implantable electronic devices began to play an important role in medicine. Usually implantable devices consist of a transmitter, powering which could be wireless with a special made battery and measurement circuit. Common problems in making implantable devices are short lifetime of the battery, big size and biocompatibility. In these work, blood pressure measure will be the focus because it’s one of the main symptoms of cardiovascular diseases. Our device will consist of three parts: the implantable pressure sensor, external transmitter and automated workstation in a hospital. The Implantable part of pressure sensors could be based on piezoresistive or capacitive technologies. Both sensors have some advantages and some limitations. The Developed circuit is based on a small capacitive sensor which is made of the technology of microelectromechanical systems (MEMS). The Capacitive sensor can provide high sensitivity, low power consumption and minimum hysteresis compared to the piezoresistive sensor. For this device, it was selected the oscillator-based circuit where frequency depends from the capacitance of sensor hence from capacitance one can calculate pressure. The external device (transmitter) used for wireless charging and signal transmission. Some implant devices for these applications are passive, the external device sends radio wave signal on internal LC circuit device. The external device gets reflected the signal from the implant and from a change of frequency is possible to calculate changing of capacitance and then blood pressure. However, this method has some disadvantages, such as the patient position dependence and static using. Developed implantable device doesn’t have these disadvantages and sends blood pressure data to the external part in real-time. The external device continuously sends information about blood pressure to hospital cloud service for analysis by a physician. Doctor’s automated workstation at the hospital also acts as a dashboard, which displays actual medical data of patients (which require attention) and stores it in cloud service. Usually, critical heart conditions occur few hours before heart attack but the device is able to send an alarm signal to the hospital for an early action of medical service. The system was tested with wireless charging and data transmission. These results can be used for ASIC design for MEMS pressure sensor.

Keywords: MEMS sensor, RF power, wireless data, oscillator-based circuit

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Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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Authors: Jui-Chen Huang

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Nowadays, the population is aging, the number of people who need to be taken care of is increased, but the manpower and funding are insufficient. Therefore, this study aims to explore the attitudes and willingness of arthritis patients to adopt telecare and to take a large medical institution in the central area of Taiwan as a sample hospital. A structured questionnaire (using the Likert five-point scale) was used to collect chronic patients over 20 years old as sample data, and a total of 500 valid questionnaires were effectively collected. The SPSS 18.0 statistical software was used for reliability analysis and independent sample t-test to explore the differences in attitudes and willingness to use telecare for arthritis patients and non-arthritic patients. The Cronbach's alpha value of this study questionnaire was above 0.94, showing good reliability. Arthritis patients and non-arthritic patients had statistically significant differences in attitudes toward telecare, while the willingness to use did not reach statistically significant differences. In addition, the average attitude and intention of arthritis patients for telecare are 3.38 and 3.41, respectively, indicating that arthritis patients have a certain degree of attitude and willingness to adopt telecare, which is worthy of follow-up research and practical industry push.

Keywords: telecare, arthritis patients, attitudes, intention

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Authors: Mohammad J. J. Taha, Mohammad T. Abuawwad, Warda A. Alrubasy, Shams Khalid Sameer, Taleb Alsafi, Yaqeen Al-Bustanji, Luai Abu-Ismail, Abdulqadir J. Nashwan

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Viral pandemics often take the world by storm, urging the medical community to prioritize the most evident systemic manifestations, often causing ocular manifestations to go unnoticed. This literature review aims to highlight the ocular complications of monkeypox, SARS-CoV-2, MERS, ebola, H1N1, and zika viruses as the most recent viral pandemics. Since the emergence of the newly resurfacing monkeypox and the novel SARS-CoV-2, research aiming to uncover the effects of these pandemics began right away. Moreover, it also discusses the ocular complications of the vaccines and treatments that were used in the scope of the viral pandemics. To add, this work discussed the role of the eye as an important route of viral transmission, and thereafter, the American Academy of Ophthalmology (AAO) recommendations to reduce the incidence of viral transmission were mentioned. Finally, this paper aims to outline a platform for researchers who are interested in further investigating eye-related viral manifestations.

Keywords: ophthalmology, monkeypox, ebola, zika, MERS, H1N1, influenza, COVID-19

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Authors: Yassir Mohammed

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The study examines the impact of skilled parental migration on left-behind children. It uses the SCOPUS database to evaluate the existing literature from 1972 to 2022 and synthesizes data using the PRISMA framework and bibliometric method of analysis. 49 articles out of 202 papers were involved in the synthesis. International migration, outcome migration, consequence, parental migration, high-skill and left-behind children, and left-behind preschool were all searched. The research found that mental health issues, self-isolation, and physical harm have negative impacts, while sending children to good schools, having good academic records, and better medical care have positive impacts. The study also found that gender gaps increase in some countries while decreasing in others. Further research is needed on child maltreatment, academic performance, subjective well-being, societal effects, behavioral difficulties, and quality of life. The study only included peer-reviewed English publications in the final analysis.

Keywords: parental migration, impact of migration, systematic review, left-behind children

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Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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Authors: Madala Venkateswara Rao

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The major blood supply to the long bones occurs through the nutrient arteries, which enters through the nutrient foramina. This is the study of nutrient Foramina in the shaft of upper limb long bones taken from the department of Anatomy at Narayana medical college nellore. Nutrient foramina play an important role in nutrition and growth of the bones. Most of the nutrient arteries follow the rule, 'to the elbow I go, from the knee I flee' but they are very variable in position. Their number, location, direction & its importance in the growing end of long bones were studied in the long bones of upper limb. The present study has variations in the position & direction of long bones especially in the radius & ulna, as most of the nutrient foramina are found in anterior surface of upper 1/3rd and middle 1/3rd of these bones. The study of nutrient foramina is not only of academic interest but also in medico-legal practice in relation to their position. Careful observation has also been made on the position of nutrient foramina in relation to upper end of long bones. This study also gives importance of length long bones to know the height of an individual. With the knowledge of variations in the nutrient foramen, placement of internal fixation devices can be appropriately done.

Keywords: nutrient artery, nutrient foramina, shaft of long bones, upper limb bones

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Authors: Ashiraliyev SHavkat

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Relevance of the topic: Diabetes mellitus in overweight people development and absence of treatment measures. Objective: to give patients the correct instructions on proper nutrition, to organize a network of preventive and therapeutic measures. Materials and methods: Multidisciplinary Tashkent Medical Academy. As a result of objective observations in patients who applied to the clinic, 28 11 overweight patients had to type 2 diabetes. Diabetesmellituswasdiagnosed. Results: 11.5 mmol / L on an empty stomach in the morning. EDT yes. Pathogenesis: fat content in the diet of patients with diabetes mellitus. Carbohydrate foods make up 60%. Eating disorders and physical inactivity As a result, the accumulation of glucose in the form of fat increases, and this is constantly in the blood, which led to an increase in the number of fatty acids. Clinic: Frequent fasting in 11 patients (hypothalamus). Associated with glucose deficiency), drinking 8-9 liters of water per day of blood in 7 people Systolic pressure 150 diastolic pressures 100. Sensation of ants in 3 people and poor eyesight in 5 people. Conclusion: Explain to patients that nutritional guidelines should be followed. Assign active movement in accordance with the energy entering the body.

Keywords: mellitus, diabetes, pathogenesis, clinic

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Authors: Farnaz Dehkhoda

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This study was conducted to compare the effectiveness of active and receptive music-therapy on anxiety in cancer patients undergoing chemotherapy or radiotherapy. 184 young adult patients, who were diagnosed with early stage cancer and were undergoing treatment, were divided into three groups. Two groups received music therapy as a parallel treatment and the third group was control group. In active music-therapy, a music specialist helped the patients to play guitar and sing. In the receptive music-therapy, patients preferred pre-recorded music played by MP3 player. The level of anxiety was measured by the Beck Anxiety Inventory as pre-test and post-test. ANCOVA revealed that both types of music-therapy reduced anxiety level of patients and the active music-therapy intervention found to be more effective. The results suggest that music-therapy can be applied as an intervention method contemporary with cancer medical treatment, for improving quality of life in cancer patients by reducing their anxiety.

Keywords: Anxiety, Cancer, Chemotherapy, Music-therapy

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Authors: B. Thanasansomboon, S. Choemprayong, N. Parinyanitikul, U. Tanlamai

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Being diagnosed with metastatic breast cancer, the patients as well as their caretakers are affected physically and mentally. Although the medical systems in Thailand have been attempting to improve the quality and effectiveness of the treatment of the disease in terms of physical illness, the success of the treatment also depends on the quality of mental health. Metastatic breast cancer patients have found that social support is a key factor that helps them through this difficult time. It is recognized that social support in different dimensions, including emotional support, social network support, informational support, instrumental support and appraisal support, are contributing factors that positively affect the quality of life of patients in general, and it is undeniable that social support in various forms is important in promoting the quality of life of metastatic breast patients. However, previous studies have not been dedicated to investigating their quality of life concerning affective, cognitive, and behavioral outcomes. Therefore, this study aims to develop integrated social support through social networks to improve the quality of life of metastatic breast cancer patients in Thailand.

Keywords: social support, metastatic breath cancer, quality of life, social network

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Authors: Bandana Koirala, Shivalal Sharma

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Introduction: Gingival enlargements are quite common and may be either inflammatory, non-inflammatory or a combination of both. Idiopathic gingival enlargement is a rare condition with a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. It is of undetermined etiology. Case Description: This case report addresses the diagnosis and treatment of a case of idiopathic gingival enlargement in a 9-year-old male patient. The patient presented with a generalized diffuse gingival enlargement involving the entire maxillary and the mandibular arch with extension on occlusal, buccal, lingual, and palatal surfaces with just parts of occlusal surfaces of few upper and lower molars visible resulting in open mouth, difficulty in mastication and speech. Biopsy report confirmed the diagnosis of fibromatosis gingivae. Gingivectomy was carried out in all four quadrants by using external bevel incision. Conclusion: Though total esthetics could not be restored due to unusual bony enlargement, the general appearance improved satisfactorily. Treatment after complete excision however, improved the masticatory competence to a great extent.

Keywords: idiopathic gingival fibromatosis, gingival enlargement, gingivectomy, medical and health sciences

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Authors: Amirmohammad Dahouri

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Each year, more than 795,000 individuals in the United States grieve a stroke, and by 2030, it is predictable that 4% of the U.S. people will have had a stroke. Ischemic stroke, accounting for about 80% of all strokes, is one of the main causes of disability. The goal of stroke rehabilitation is to help patients return to physical and mental functions and relearn the required aids to living everyday life. This flagging has an adverse effect on patients’ quality of life and affects their daily living activities. In recent years, the rehabilitation of ischemic stroke attractions more attention in the world. A review of the rudimentary perceptions of stroke rehabilitation that are price stressing to all specialists who delicacy patients with stroke. Ideas are made for patients on how to functionally manage daily activities after they have qualified for a stroke. It is vital for home healthcare clinicians to understand the process from acute events to medical equilibrium and rehabilitation to adaptation. Different sources such as Pub Med Google Scholar and science direct have been used and various contemporary articles in this era have been analyzed. The care plan must also foundation actual actions to protect against recurrent stroke, as stroke patients are generally at significant risk for further ischemic or hemorrhagic attacks. Here, we review evidence of rehabilitation in treating post-stroke impairment.

Keywords: rehabilitation, stroke, ischemic, hemorrhagic, brain

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Authors: Najib K. Dankadai, Ahmad 'Athif Mohd Faudzi, Khairuddin Osman, Muhammad Rusydi Muhammad Razif, IIi Najaa Aimi Mohd Nordin

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Researches in soft actuators are now growing rapidly because of their adequacy to be applied in sectors like medical, agriculture, biological and welfare. This paper presents system identification (SI) and control of the force generated by a two chambers pneumatic soft actuator (PSA). A force mathematical model for the actuator was identified experimentally using data acquisition card and MATLAB SI toolbox. Two control techniques; a predictive functional control (PFC) and conventional proportional integral and derivative (PID) schemes are proposed and compared based on the identified model for the soft actuator flexible mechanism. Results of this study showed that both of the proposed controllers ensure accurate tracking when the closed loop system was tested with the step, sinusoidal and multi step reference input through MATLAB simulation although the PFC provides a better response than the PID.

Keywords: predictive functional control (PFC), proportional integral and derivative (PID), soft actuator, system identification

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Authors: Stephanie Al Otaiba, Kyle Roberts

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Background and Significance Globally far too many students read below grade level; thus improving literacy outcomes is vital. Research suggests that non-cognitive factors, including Social and Emotional Learning (SEL) are linked to success in literacy outcomes. Converging evidence exists that early interventions are more effective than later remediation; therefore teachers need strategies to support early literacy while developing students’ SEL and their vocabulary, or language, for learning. This presentation describe findings from a US federally-funded project that trained teachers to provide an evidence-based read-aloud program for young children, using commercially available books with multicultural characters and themes to help their students “GROW”. The five GROW SEL themes include: “I can name my feelings”, “I can learn from my mistakes”, “I can persist”, “I can be kind to myself and others”, and “I can work toward and achieve goals”. Examples of GROW vocabulary (from over 100 words taught across the 5 units) include: emotions, improve, resilient, cooperate, accomplish, responsible, compassion, adapt, achieve, analyze. Methodology This study used a mixed methods research design, with qualitative methods to describe data from teacher feedback surveys (regarding satisfaction, feasibility), observations of fidelity of implementation, and with quantitative methods to assess the effect sizes for student vocabulary growth. GROW Intervention and Teacher Training Procedures Researchers trained classroom teachers to implement GROW. Each thematic unit included four books, vocabulary cards with images of the vocabulary words, and scripted lessons. Teacher training included online and in-person training; researchers incorporated virtual reality videos of instructors with child avatars to model lessons. Classroom teachers provided 2-3 20 min lessons per week ranging from short-term (8 weeks) to longer-term trials for up to 16 weeks. Setting and Participants The setting for the study included two large urban charter schools in the South. Data was collected across two years; during the first year, participants included 7 kindergarten teachers and 108 and the second year involved an additional set of 5 kindergarten and first grade teachers and 65 students. Initial Findings The initial qualitative findings indicate teachers reported the lessons to be feasible to implement and they reported that students enjoyed the books. Teachers found the vocabulary words to be challenging and important. They were able to implement lessons with fidelity. Quantitative analyses of growth for each taught word suggest that students’ growth on taught words ranged from large (ES = .75) to small (<.20). Researchers will contrast the effects for more and less successful books within the GROW units. Discussion and Conclusion It is feasible for teachers of young students to effectively teach SEL vocabulary and themes during shared book reading. Teachers and students enjoyed the books and students demonstrated growth on taught vocabulary. Researchers will discuss implications of the study and about the GROW program for researchers in learning sciences, will describe some limitations about research designs that are inherent in school-based research partnerships, and will provide some suggested directions for future research and practice.

Keywords: early literacy, learning science, language and vocabulary, social and emotional learning, multi-cultural

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Authors: Jia Xin Low, Keng Wah Choo

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This paper presents an automatic normal and abnormal heart sound classification model developed based on deep learning algorithm. MITHSDB heart sounds datasets obtained from the 2016 PhysioNet/Computing in Cardiology Challenge database were used in this research with the assumption that the electrocardiograms (ECG) were recorded simultaneously with the heart sounds (phonocardiogram, PCG). The PCG time series are segmented per heart beat, and each sub-segment is converted to form a square intensity matrix, and classified using convolutional neural network (CNN) models. This approach removes the need to provide classification features for the supervised machine learning algorithm. Instead, the features are determined automatically through training, from the time series provided. The result proves that the prediction model is able to provide reasonable and comparable classification accuracy despite simple implementation. This approach can be used for real-time classification of heart sounds in Internet of Medical Things (IoMT), e.g. remote monitoring applications of PCG signal.

Keywords: convolutional neural network, discrete wavelet transform, deep learning, heart sound classification

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Authors: Qudsiya Baig

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Empathy yields an unparalleled therapeutic value within patient physician interactions. Medical research is inundated with evidence to support that a physician’s ability to empathise with patients leads to a greater willingness to report symptoms, an improvement in diagnostic accuracy and safety, and a better adherence and satisfaction with treatment plans. Furthermore, the Institute of Medicine states that empathy leads to a more patient-centred care, which is one of the six main goals of a 21st century health system. However, there is a paradox between the theoretical significance of empathy and its presence, or lack thereof, in clinical practice. Recent studies have reported that empathy declines amongst students and physicians over time. The three most impactful contributors to this decline are: (1) disagreements over the definitions of empathy making it difficult to implement it into practice (2) poor consideration or regulation of empathy leading to burnout and thus, abandonment altogether, and (3) the lack of diversity in the curriculum and the influence of medical culture, which prioritises science over patient experience, limiting some physicians from using ‘too much’ empathy in the fear of losing clinical objectivity. These issues were investigated by conducting a fully inductive thematic narrative analysis of patient narratives in the UK to evaluate the behaviours and attitudes that patients associate with empathy. The principal enquiries underpinning this study included uncovering the factors that affected experience of empathy within provider-patient interactions and to analyse their effects on patient care. This research contributes uniquely to this discourse by examining the phenomenon of empathy directly from patients’ experiences, which were systematically extracted from a repository of online patient narratives of care titled ‘CareOpinion UK’. Narrative analysis was specifically chosen as the methodology to examine narratives from a phenomenological lens to focus on the particularity and context of each story. By enquiring beyond the superficial who-whatwhere, the study of narratives prescribed meaning to illness by highlighting the everyday reality of patients who face the exigent life circumstances created by suffering, disability, and the threat of life. The following six themes were found to be the most impactful in influencing the experience of empathy: dismissive behaviours, judgmental attitudes, undermining patients’ pain or concerns, holistic care and failures and successes of communication or language. For each theme there were overarching themes relating to either a failure to understand the patient’s perspective or a success in taking a person-centred approach. An in-depth analysis revealed that a lack of empathy was greatly associated with an emotive-cognitive imbalance, which disengaged physicians with their patients’ emotions. This study hereby concludes that competent providers require a combination of knowledge, skills, and more importantly empathic attitudes to help create a context for effective care. The crucial elements of that context involve (a) identifying empathy clues within interactions to engage with patients’ situations, (b) attributing a perspective to the patient through perspective-taking and (c) adapting behaviour and communication according to patient’s individual needs. Empathy underpins that context, as does an appreciation of narrative, and the two are interrelated.

Keywords: empathy, narratives, person-centred, perspective, perspective-taking

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Authors: Bahaa Eldin Kornah

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The organism profile for peri-prosthetic joint infection caused by hematogenous seeding or direct inoculations is changing. The organisms that cause prosthetic joint infections range from normal skin colonizers to highly virulent pathogens. The pathogens continue to evolve. While Staphylococcus aureus continues to be the leading organism, gram-negative bacilli account for approximately 7% of cases and that incidence is increasing. Methicillin-resistant S. aureus(MRSA) accounts for approximately 10% of all infections occurring in the community setting and 20% of those in the health care setting. The list of organisms causing PJI has expanded in recent years. It is important to have an understanding of which organisms may be causing a periprosthetic joint infection based on where the patient contracted it and their recent medical history. Also, recent technology has expanded rapidly and new methods to detect the pathogen and why we failed in detecting it. There are a number of explanations for the latter finding, perhaps the most important reason being the liberal use of antibiotics that interferes with the isolation of the infective organism.

Keywords: infection, periprosthetic, hip, organism profile, joint infection, joint infection

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Authors: Georgeta Voicu, Cristina Daniela Ghitulica, Andreia Cucuruz, Cristina Busuioc

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In the field of tissue engineering, the compositional and microstructural features of the employed materials play an important role, with implications on the mechanical and biological behaviour of the medical devices. In this context, the development of apatite - natural biopolymer composites represents a choice of many scientific groups. Thus, hydroxyapatite powders were synthesized by a wet method, namely co-precipitation, starting from high purity reagents (CaO, MgO, and H3PO4). Moreover, the substitution of calcium with magnesium have been approached, in the 5 - 10 wt.% range. Afterward, the phosphate powders were integrated in two types of composites with chitosan, different from morphological point of view. First, 3D porous scaffolds were obtained by a freeze-drying procedure. Second, uniform, compact films were achieved by film casting. The influence of chitosan molecular weight (low, medium and high), as well as apatite powder to polymer ratio (1:1 and 1:2) on the morphological properties, were analysed in detail. In conclusion, the reported biocomposites, prepared by a straightforward route are suitable for bone substitution or repairing applications.

Keywords: bone reconstruction, chitosan, composite scaffolds, hydroxyapatite

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Authors: LouAnne Boyd

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From the perspective of self-advocates, the biggest unaddressed problem is not the symptoms of an autism spectrum diagnosis but the social stigma that accompanies autism. This societal perspective is in contrast to the focus on the majority of interventions. Autism interventions, and consequently, most innovative technologies for autism, aim to improve deficits that occur within the person. For example, the most common Human-Computer Interaction research projects in assistive technology for autism target social skills from a normative perspective. The premise of the autism technologies is that difficulties occur inside the body, hence, the medical model focuses on ways to improve the ailment within the person. However, other technological approaches to support people with autism do exist. In the realm of Human Computer Interaction, there are other modes of research that provide critique of the medical model. For example, critical design, whose intended audience is industry or other HCI researchers, provides products that are the opposite of interventionist work to bring attention to the misalignment between the lived experience and the societal perception of autism. For example, parodies of interventionist work exist to provoke change, such as a recent project called Facesavr, a face covering that helps allistic adults be more independent in their emotional processing. Additionally, from a critical disability studies’ perspective, assistive technologies perpetuate harmful normalizing behaviors. However, these critical approaches can feel far from the frontline in terms of taking direct action to positively impact end users. From a critical yet more pragmatic perspective, projects such as Counterventions lists ways to reduce the likelihood of perpetuating ableism in interventionist’s work by reflectively analyzing a series of evolving assistive technology projects through a societal lens, thus leveraging the momentum of the evolving ecology of technologies for autism. Therefore, all current paradigms fall short of addressing the largest need—the negative impact of social stigma. The current work introduces a new paradigm for technologies for autism, borrowing from a paradigm introduced two decades ago around changing the narrative related to eating disorders. It is the shift from reprimanding poor habits to celebrating positive aspects of eating. This work repurposes Celebratory Technology for Neurodiversity and intended to reduce social stigma by targeting for the public at large. This presentation will review how requirements were derived from current research on autism social stigma as well as design sessions with autistic adults. Congruence between these two sources revealed three key design implications for technology: provide awareness of the autistic experience; generate acceptance of the neurodivergence; cultivate an appreciation for talents and accomplishments of neurodivergent people. The current pilot work in Celebratory Technology offers a new paradigm for supporting autism by shifting the burden of change from the person with autism to address changing society’s biases at large. Shifting the focus of research outside of the autistic body creates a new space for a design that extends beyond the bodies of a few and calls on all to embrace humanity as a whole.

Keywords: neurodiversity, social stigma, accessibility, inclusion, celebratory technology

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Authors: Reihaneh Rafiemanzelat

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due to towards the rapid urbanization, cities throughout the world faced to rapid growth through gray infrastructure. Therefore designing cities based on green and blue infrastructure can offer the best solution to support healthy urban environment. This conformation with a wide range of ecosystem service has a positive impact on the regulation of air temperature, noise reduction, air quality, and also create a pleasant environment for humans activities. Research mainly focuses on the concept and principles of green and blue infrastructure in the city of Esfahan at the center of Iran in order to create a livable and healthy environment. Design principles for green and blue infrastructure are classified into two different but interconnect evaluations. Healthy green infrastructure assessing based on; volume, shape, location, dispersion, and maintenance. For blue infrastructure there are three aspects of water and ecosystem which are; the contribution of water on medical health, the contribution of water on mental health, and creating possibilities to exercise.

Keywords: healthy cities, livability, urban landscape, green and blue infrastructure

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Authors: Samir Sarfraj Terdalkar

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India needs to step into affordable higher education with more focus on skill development and employability. The general scenario of higher education in India revolves around two major branches of higher education ie., Engineering and Medical Sciences. These two branches still cannot be considered as affordable. Hence, skill development of each and every student beginning from the school education should emphasize on learning skills with special focus on physics and mathematics. In India, the Central Government initiated a survey based process of all higher Educational Institutes/ Universities and colleges in India. This survey/ process was – All India Survey On Higher Education (AISHE). The focus of this process was understand and Though the increase is significant, it is necessary to propagate skill and vocational education which would add to the employability factor. Similarly, there has been a significant increase in number of higher education institutes, there is need to rethink on the type of education/ curriculum offered by these institutions. In this regard, vocational education has helped to build skill sets to certain extent. There is need to bring in this vocational educational in main stream education which could be complementary for undergraduate / post graduate education. The paper focuses on different policies to bring in vocational/ skill education.

Keywords: higher education, skill, vocational, India

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Authors: Dechrit Maneetham

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The aim of this paper was to design a void and head controlled electric power wheelchair (EPW). A novel activate the control system for quadriplegics with voice, head and neck mobility. Head movement has been used as a control interface for people with motor impairments in a range of applications. Acquiring measurements from the module is simplified through a synchronous a motor. Axis measures the two directions namely x and y. At the same time, patients can control the motorized wheelchair using voice signals (forward, backward, turn left, turn right, and stop) given by it self. The model of a dc motor is considered as a speed control by selection of a PID parameters using genetic algorithm. An experimental set-up constructed, which consists of micro controller as controller, a DC motor driven EPW and feedback elements. This paper is tuning methods of parameter for a pulse width modulation (PWM) control system. A speed controller has been designed successfully for closed loop of the dc motor so that the motor runs very closed to the reference speed and angle. Intelligent wheelchair can be used to ensure the person’s voice and head are attending the direction of travel asserted by a conventional, direction and speed control.

Keywords: wheelchair, quadriplegia, rehabilitation , medical devices, speed control

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Authors: Chu Shi Wei

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Supported employment in Malaysia is in the early stages of development. The development of supported employment in Malaysia is an important step towards the inclusion of individuals with disabilities who have previously lacked the necessary support for employment in the open labour market as they were confined to sheltered workshops. There is a paradigm shift from sheltered to supported employment as the sheltered workshop is based on the medical model of disability, which focuses on the disability of the individual and segregated training institutions. The paradigm shift revolves around the social model of disability, which emphasizes the abilities of the individual and the removal of the barriers in the environment by the provision of support. This study explores the development of supported employment by utilizing a mixed methods approach which consists of collecting quantitative data through a survey and interviewing participants to collect qualitative data. Job coaches from six employment sectors participated in the survey and interview. The findings of the study indicate that the role of job coaches is integral to the development of supported employment. The role of job coaches includes job matching, on-the-job training, and developing natural supports to foster greater diversity and inclusion in the workplace.

Keywords: supported employment, disabilities, diversity, development

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Authors: Maria Kjellgren, Sara Lilliehorn, Urban Markström

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Critical components that influence the role and performance of school social workers in Swedish elementary schools will be described and analysed, such as formal regulations, professional self-understanding, and the SSWs’ role in the interplay between professional domains involved in elementary school. The data collection was conducted through four semi-structured focus group interviews with a total of 22 SSWs in four different regions in Sweden. The result reveals three main challenges for the School Social Worker (SSW): (1) To navigate in a pedagogic and medical arena within a multidisciplinary team, (2) To manage ambiguity without any formal regulations and unclear settings and leadership and finally, (3) To negotiate tasks at different levels, with a health promotional and preventive focus, where the SSW ends up, mainly in remedial work with individual children. The results also disclosed that SSWs hold a vague professional self-understanding position with a little formal mandate to perform their work.

Keywords: school social worker, multidisciplinary team, counselling, professional self-understanding, formal regulations

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Authors: Shatarupa Thakurta Roy

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Along the limelight of mainstream academic practices in Indian art, exist a significant lot of habitual art practices that are mutually susceptible in their contemporary forms. Narrative folk paintings of regional India has successfully dispersed to its audience social messages through pulsating pictures and orations. The paper consists of images from narrative scroll paintings on ‘Ramayana’ theme from various neighboring states as well as districts in India, describing their subtle differences in style of execution, method, and use of material. Despite sharing commonness in the choice of subject matter, habitual and ceremonial Indian folk art in its formative phase thrived within isolated locations to yield in remarkable variety in the art styles. The differences in style took place district wise, cast wise and even gender wise. An open flow is only evident in the contemporary expressions as a result of substantial changes in social structures, mode of communicative devices, cross-cultural exposures and multimedia interactivities. To decipher the complex nature of popular cultural taste of contemporary India it is important to categorically identify its root in vernacular symbolism. The realization of modernity through European primitivism was rather elevated as a perplexed identity in Indian cultural margin in the light of nationalist and postcolonial ideology. To trace the guiding factor that has still managed to obtain ‘Indianness’ in today’s Indian art, researchers need evidences from the past that are yet to be listed in most instances. They are commonly created on ephemeral foundations. The artworks are also found in endangered state and hence, not counted much friendly for frequent handling. The museums are in dearth of proper technological guidelines to preserve them. Even though restoration activities are emerging in the country, the existing withered and damaged artworks are in threat to perish. An immediacy of digital achieving is therefore envisioned as an alternative to save this cultural legacy. The method of this study is, two folded. It primarily justifies the richness of the evidences by conducting categorical aesthetic analysis. The study is supported by comments on the stylistic variants, thematic aspects, and iconographic identities alongside its anthropological and anthropomorphic significance. Further, it explores the possible ways of cultural preservation to ensure cultural sustainability that includes technological intervention in the form of digital transformation as an altered paradigm for better accessibility to the available recourses. The study duly emphasizes on visual description in order to culturally interpret and judge the rare visual evidences following Feldman’s four-stepped method of formal analysis combined with thematic explanation. A habitual design that emerges and thrives within complex social circumstances may experience change placing its principle philosophy at risk by shuffling and altering with time. A tradition that respires in the modern setup struggles to maintain timeless values that operate its creative flow. Thus, the paper hypothesizes the survival and further growth of this practice within the dynamics of time and concludes in realization of the urgency to transform the implicitness of its knowledge into explicit records.

Keywords: aesthetic, identity, implicitness, paradigm

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Authors: Chui Ling Teng, R. Matsa

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We report a case with combined overdose of Lercanidipine (non-dihydropyridine calcium channel blocker), Quetiapine (Atypical antipsychotic), Ramipril and Duloxetine. A 66-year old male presented to the Emergency Department 12-hours after the ingestion of 1.2g Lercanidipine, 3g Quetiapine, 280mg of Ramipril and 420mg of Duloxetine. He describes lethargic, drowsiness and was unable to pass any urine since overdosed. He was found to be bradycardic, hypotensive and anuric. He had refractory hypotension and anuric despite fluid resuscitation, glucagon therapy and intravenous naloxone. His care was escalated to Intensive care, requiring noradrenaline, adrenaline, vasopressin, and hyperinsulinaemic euglycaemia therapy. He achieved haemodynamic stability and kidney function improved gradually with the support received. The total length of therapy lasted for 30 horus in which individual therapy was weaned down based on the requirement. He was then transferred to medical ward for further psychiatric assessment. This is a the first repored case of mixed overdose with lercanidipine, Quetiapine, Rampmipril and Duloxetine.

Keywords: calcium channel blocker, hyperinsulinaemic Euglycaemia therapy, lercanidipine, overdose

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Authors: Dmitriy Chernov, Maria Karavassilis, Suhyoun Youn, Amna Izhar, Devasenan Devendra

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Introduction and Background: A well-structured and comprehensive departmental induction improves patient safety and job satisfaction amongst doctors. The aims of our Project were as follows: 1. Assess the perceived preparedness of junior doctors starting their rotation in Acute Medicine at Watford General Hospital. 2. Develop a supplemental Induction Guide and Pocket reference in the form of an iOS mobile application. 3. To collect feedback after implementing the mobile application following a trial period of 8 weeks with a small cohort of junior doctors. Materials and Methods: A questionnaire was distributed to all new junior trainees starting in the department of Acute Medicine to assess their experience of current induction. A mobile Induction application was developed and trialled over a period of 8 weeks, distributed in addition to the existing didactic induction session. After the trial period, the same questionnaire was distributed to assess improvement in induction experience. Analytics data were collected with users’ consent to gauge user engagement and identify areas of improvement of the application. A feedback survey about the app was also distributed. Results: A total of 32 doctors used the application during the 8-week trial period. The application was accessed 7259 times in total, with the average user spending a cumulative of 37 minutes 22 seconds on the app. The most used section was Clinical Guidelines, accessed 1490 times. The App Feedback survey revealed positive reviews: 100% of participants (n=15/15) responded that the app improved their overall induction experience compared to other placements; 93% (n=14/15) responded that the app improved overall efficiency in completing daily ward jobs compared to previous rotations; and 93% (n=14/15) responded that the app improved patient safety overall. In the Pre-App and Post-App Induction Surveys, participants reported: a 48% improvement in awareness of practical aspects of the job; a 26% improvement of awareness on locating pathways and clinical guidelines; a 40% reduction of feelings of overwhelmingness. Conclusions and recommendations: This study demonstrates the importance of technology in Medical Education and Clinical Induction. The mobile application average engagement time equates to over 20 cumulative hours of on-the-job training delivered to each user, within an 8-week period. The most used and referred to section was clinical guidelines. This shows that there is high demand for an accessible pocket guide for this type of material. This simple mobile application resulted in a significant improvement in feedback about induction in our Department of Acute Medicine, and will likely impact workplace satisfaction. Limitations of the application include: post-app surveys had a small number of participants; the app is currently only available for iPhone users; some useful sections are nested deep within the app, lacks deep search functionality across all sections; lacks real time user feedback; and requires regular review and updates. Future steps for the app include: developing a web app, with an admin dashboard to simplify uploading and editing content; a comprehensive search functionality; and a user feedback and peer ratings system.

Keywords: mobile app, doctor induction, medical education, acute medicine

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Authors: Yuhanis Yusof, Zuriani Mustaffa, Siti Sakira Kamaruddin

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Data mining is a fundamental technique in identifying patterns from large data sets. The extracted facts and patterns contribute in various domains such as marketing, forecasting, and medical. Prior to that, data are consolidated so that the resulting mining process may be more efficient. This study investigates the effect of different data normalization techniques, which are Min-max, Z-score, and decimal scaling, on Swarm-based forecasting models. Recent swarm intelligence algorithms employed includes the Grey Wolf Optimizer (GWO) and Artificial Bee Colony (ABC). Forecasting models are later developed to predict the daily spot price of crude oil and gasoline. Results showed that GWO works better with Z-score normalization technique while ABC produces better accuracy with the Min-Max. Nevertheless, the GWO is more superior that ABC as its model generates the highest accuracy for both crude oil and gasoline price. Such a result indicates that GWO is a promising competitor in the family of swarm intelligence algorithms.

Keywords: artificial bee colony, data normalization, forecasting, Grey Wolf optimizer

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Authors: N. Khomarloo, F. Mousazadegan, M. Latifi, N. Hemmatinejad

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Recently, the utilization of reusable surgical gowns in order to decrease costs, environmental protection and enhance surgeon’s comfort is considered. One of the concerns in applying this kind of medical protective clothing is reduction of their resistance to bacterial penetration especially in wet state, after repeated laundering and sterilizing process. The purpose of this study is to investigate the effect of the laundering and sterilizing process on the reusable surgical gown’s resistance against bacterial wet penetration. To this end, penetration of Staphylococcus aureus bacteria in wet state after 70 washing and sterilizing cycles was evaluated on the two single-layer and three-layer reusable gowns. The outcomes reveal that up to 20 laundering and sterilizing cycles, protective property of samples improves due to fabric shrinkage, after that because of the fabric’s construction opening, the bacterial penetration increase. However, the three-layer gown presents higher protective performance comparing to the single-layer one.

Keywords: laundry, porosity, reusable surgical gown, sterilization, wet bacterial penetration

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