Search results for: resource-limited care environments
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5507

Search results for: resource-limited care environments

1247 The Effects of Critical Incident Stress Debriefing and Other Related Interventions on the Psychological Recovery of Earthquake Survivors

Authors: Joyce Fernandez

Abstract:

This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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1246 Base Deficit Profiling in Patients with Isolated Blunt Traumatic Brain Injury – Correlation with Severity and Outcomes

Authors: Shahan Waheed, Muhammad Waqas, Asher Feroz

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Objectives: To determine the utility of base deficit in traumatic brain injury in assessing the severity and to correlate with the conventional computed tomography scales in grading the severity of head injury. Methodology: Observational cross-sectional study conducted in a tertiary care facility from 1st January 2010 to 31st December 2012. All patients with isolated traumatic brain injury presenting within 24 hours of the injury to the emergency department were included in the study. Initial Glasgow Coma Scale and base deficit values were taken at presentation, the patients were followed during their hospital stay and CT scan brain findings were recorded and graded as per the Rotterdam scale, the findings were cross-checked by a radiologist, Glasgow Outcome Scale was taken on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Continuous variables with normal and non-normal distributions are reported as mean ± SD. Categorical variables are presented as frequencies and percentages. Relationship of the base deficit with GCS, GOS, CT scan brain and length of stay was calculated using Spearman`s correlation. Results: 154 patients were enrolled in the study. Mean age of the patients were 30 years and 137 were males. The severity of brain injuries as per the GCS was 34 moderate and 109 severe respectively. 34 percent of the total has an unfavorable outcome with a mean of 18±14. The correlation was significant at the 0.01 level with GCS on presentation and the base deficit 0.004. The correlation was not significant between the Rotterdam CT scan brain findings, length of stay and the base deficit. Conclusion: The base deficit was found to be a good predictor of severity of brain injury. There was no association of the severity of injuries on the CT scan brain as per the Rotterdam scale and the base deficit. Further studies with large sample size are needed to further evaluate the associations.

Keywords: base deficit, traumatic brain injury, Rotterdam, GCS

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1245 The Role of the Indigenous Radio Today and Its Impact on the Audience: The Case of Dambana FM in Sri Lanka

Authors: Dammika Bandara Herath

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A group of people who inherits a long history of existence within a particular country may be known as early inhabitants or indigenous peoples. In other words, they have not migrated to the particular territory from another part of the world and at the same time, they have inhabited the territory in issue prior to the time of a major invasion/migration. According to the UN, there are a number of unique attributes of the indigenous peoples: Self-identification as indigenous people,Historical continuity with pre-colonial and/or pre-settler societies, Distinct social, economic or political systems, Distinct language, culture and beliefs, Form non-dominant groups of society, Resolve to maintain and reproduce their ancestral environments and systems as distinctive peoples and communities. Indigenous peoples constitute 5% of the world’s population. They are also known as tribal people, first people, native people, and indigenous people. Various indigenous communities can be found in about 90 countries in the world. Asia is home to approximately 70 % of these indigenous communities who have their own unique socio-cultural identities. Most indigenous communities remain isolated from the mainstream social, cultural, and economic institutions of their homeland. Yet, they inherited their own unique rights and responsible peculiar to their own group. These include: Protecting the socio-cultural heritage of the group, Protecting the unique identity of their community from socio-cultural changes in the mainstream communities,Protecting their land, Diffusing their cultural heritage to the future generation, Co-existing peacefully with other community .However, indigenous peoples encounter a lot of challenges as a result of socio-cultural change and legal restrictions in the world today. To assist the communities to face these challenges, the mass –media can play a significant role and the radio media has a purpose-built mechanism for this mission, known as the indigenous radio. In Sri Lanka, Dambana FM is such a radio channel based on the indigenous radio model. The target audience of this channel is the vedda / indigenous community of Sri Lanka. This study intends to the current role of the indigenous radio based on Dambana FM, of which the target audience is the indigenous community of Dambana. For the purpose of this study, interviews were conducted among fifty randomly selected respondents from the indigenous community of Dambana. As far as the findings of this study are concerned, problems in the quality of the programmed broadcasted and problems of transmission are the key issues faced by the indigenous radio in Sri Lanka. Based on the findings, the researcher seeks to develop a model to enhance the impact of the indigenous radio on its listeners in Sri Lanka.

Keywords: indigenous, communities, radio, vedda, culture

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1244 Use of the Occupational Repetitive Action Method in Different Productive Sectors: A Literature Review 2007-2018

Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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1243 Informational Habits and Ideology as Predictors for Political Efficacy: A Survey Study of the Brazilian Political Context

Authors: Pedro Cardoso Alves, Ana Lucia Galinkin, José Carlos Ribeiro

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Political participation, can be a somewhat tricky subject to define, not in small part due to the constant changes in the concept fruit of the effort to include new forms of participatory behavior that go beyond traditional institutional channels. With the advent of the internet and mobile technologies, defining political participation has become an even more complicated endeavor, given de amplitude of politicized behaviors that are expressed throughout these mediums, be it in the very organization of social movements, in the propagation of politicized texts, videos and images, or in the micropolitical behaviors that are expressed in daily interaction. In fact, the very frontiers that delimit physical and digital spaces have become ever more diluted due to technological advancements, leading to a hybrid existence that is simultaneously physical and digital, not limited, as it once was, to the temporal limitations of classic communications. Moving away from those institutionalized actions of traditional political behavior, an idea of constant and fluid participation, which occurs in our daily lives through conversations, posts, tweets and other digital forms of expression, is discussed. This discussion focuses on the factors that precede more direct forms of political participation, interpreting the relation between informational habits, ideology, and political efficacy. Though some of the informational habits can be considered political participation, by some authors, a distinction is made to establish a logical flow of behaviors leading to participation, that is, one must gather and process information before acting on it. To reach this objective, a quantitative survey is currently being applied in Brazilian social media, evaluating feelings of political efficacy, social and economic issue-based ideological stances and informational habits pertaining to collection, fact-checking, and diversity of sources and ideological positions present in the participant’s political information network. The measure being used for informational habits relies strongly on a mix of information literacy and political sophistication concepts, bringing a more up-to-date understanding of information and knowledge production and processing in contemporary hybrid (physical-digital) environments. Though data is still being collected, preliminary analysis point towards a strong correlation between information habits and political efficacy, while ideology shows a weaker influence over efficacy. Moreover, social ideology and economic ideology seem to have a strong correlation in the sample, such intermingling between social and economic ideals is generally considered a red flag for political polarization.

Keywords: political efficacy, ideology, information literacy, cyberpolitics

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1242 The Effect of a New Reimbursement Policy for Discharge Planning Service

Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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1241 Children and Communities Benefit from Mother-Tongue Based Multi-Lingual Education

Authors: Binay Pattanayak

Abstract:

Multilingual state, Jharkhand is home to more than 19 tribal and regional languages. These are used by more than 33 communities in the state. The state has declared 12 of these languages as official languages of the state. However, schools in the state do not recognize any of these community languages even in early grades! Children, who speak in their mother tongues at home, local market and playground, find it very difficult to understand their teacher and textbooks in school. They fail to acquire basic literacy and numeracy skills in early grades. Out of frustration due to lack of comprehension, the majority of children leave school. Jharkhand sees the highest dropout in early grades in India. To address this, the state under the guidance of the author designed a mother tongue based pre-school education programme named Bhasha Puliya and bilingual picture dictionaries in 9 tribal and regional mother tongues of children. This contributed significantly to children’s school readiness in the school. Followed by this, the state designed a mother-tongue based multilingual education programme (MTB-MLE) for multilingual context. The author guided textbook development in 5 tribal (Santhali, Mundari, Ho, Kurukh and Kharia) and two regional (Odia and Bangla) languages. Teachers and community members were trained for MTB-MLE in around 1,000 schools of the concerned language pockets. Community resource groups were constituted along with their academic calendars in each school to promote story-telling, singing, painting, dancing, riddles, etc. with community support. This, on the one hand, created rich learning environments for children. On the other hand, the communities have discovered a great potential in the process of developing a wide variety of learning materials for children in own mother-tongue using their local stories, songs, riddles, paintings, idioms, skits, etc. as a process of their literary, cultural and technical enrichment. The majority of children are acquiring strong early grade reading skills (basic literacy and numeracy) in grades I-II thereby getting well prepared for higher studies. In a phased manner they are learning Hindi and English after 4-5 years of MTB-MLE using the foundational language learning skills. Community members have started designing new books, audio-visual learning materials in their mother-tongues seeing a great potential for their cultural and technological rejuvenation.

Keywords: community resource groups, MTB-MLE, multilingual, socio-linguistic survey, learning

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1240 Extraskeletal Ewing Sarcoma- Experience in a Tertiary Cancer Care Centre of India

Authors: Himanshu Rohela

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BACKGROUND: Ewing sarcoma can arise in either bone or soft tissue. Extraskeletal Ewing sarcoma (EES) is an uncommon primary tumor of the soft tissues, accounting for 20 30% of all reported cases of ES. AIM: Was to investigate demographic distribution, survival analysis and factors affecting the survival and recurrence in patients of EES. METHODS: Retrospective study of 19 biopsy-proven EES was performed. Overall survival (OS) using log-rank test and factors affecting OS and local recurrence (LR) were evaluated for the entire cohort. RESULTS: Patients with EES had a mean age of 19.5 and it was more commonly seen in males (63%). Axial location (58%) and solitary presentation (84%) were more common. The average size was 11 cm, 3 of 19 were metastatic at presentation, with the lung beings the most common site for metastasis. 17 received NACT, 16 with VAC-IE regimen and 1 underwent a second line with GEM/DOCE regimen. Unplanned surgery was done in 2 of 19. 3 patients received definitive RT and 13 underwent surgical-wide local excision. 2 of 13 showed good response to NACT. 10 patients required readmission out of which 6 patients had chemotherapy-related complications, 2 had surgical site complications and one patient developed secondary AML post-completion of treatment. A total of 4 patients had a recurrence. One had local recurrence alone, one had distant recurrence alone and 2 patients had a distant and local recurrence both. Tumor size >10 cm, axial location, and previous unplanned surgery was associated with higher LR rate. The mean overall survival was 32 months (2.66 years), with higher rates seen in non-metastatic and non-recurrent settings. CONCLUSIONS: Early and accurate diagnosis is the key to the management of EES, with promising results seen via NACT and RO resection regimens. But further studies with larger study groups are needed to standardize the treatment protocol and evaluate its efficacy.

Keywords: Ewings, sarcoma, extraskeletal, chemotherapy

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1239 Psychophysiological Adaptive Automation Based on Fuzzy Controller

Authors: Liliana Villavicencio, Yohn Garcia, Pallavi Singh, Luis Fernando Cruz, Wilfrido Moreno

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Psychophysiological adaptive automation is a concept that combines human physiological data and computer algorithms to create personalized interfaces and experiences for users. This approach aims to enhance human learning by adapting to individual needs and preferences and optimizing the interaction between humans and machines. According to neurosciences, the working memory demand during the student learning process is modified when the student is learning a new subject or topic, managing and/or fulfilling a specific task goal. A sudden increase in working memory demand modifies the level of students’ attention, engagement, and cognitive load. The proposed psychophysiological adaptive automation system will adapt the task requirements to optimize cognitive load, the process output variable, by monitoring the student's brain activity. Cognitive load changes according to the student’s previous knowledge, the type of task, the difficulty level of the task, and the overall psychophysiological state of the student. Scaling the measured cognitive load as low, medium, or high; the system will assign a task difficulty level to the next task according to the ratio between the previous-task difficulty level and student stress. For instance, if a student becomes stressed or overwhelmed during a particular task, the system detects this through signal measurements such as brain waves, heart rate variability, or any other psychophysiological variables analyzed to adjust the task difficulty level. The control of engagement and stress are considered internal variables for the hypermedia system which selects between three different types of instructional material. This work assesses the feasibility of a fuzzy controller to track a student's physiological responses and adjust the learning content and pace accordingly. Using an industrial automation approach, the proposed fuzzy logic controller is based on linguistic rules that complement the instrumentation of the system to monitor and control the delivery of instructional material to the students. From the test results, it can be proved that the implemented fuzzy controller can satisfactorily regulate the delivery of academic content based on the working memory demand without compromising students’ health. This work has a potential application in the instructional design of virtual reality environments for training and education.

Keywords: fuzzy logic controller, hypermedia control system, personalized education, psychophysiological adaptive automation

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1238 Role of Endotherapy vs Surgery in the Management of Traumatic Pancreatic Injury: A Tertiary Center Experience

Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

Abstract:

Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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1237 Improving Early Detection, Diagnosis And Intervention For Children With Autism Spectrum Disorder: A Cross-sectional Survey In China

Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

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Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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1236 Hand Motion Tracking as a Human Computer Interation for People with Cerebral Palsy

Authors: Ana Teixeira, Joao Orvalho

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This paper describes experiments using Scratch games, to check the feasibility of employing cerebral palsy users gestures as an alternative of interaction with a computer carried out by students of Master Human Computer Interaction (HCI) of IPC Coimbra. The main focus of this work is to study the usability of a Web Camera as a motion tracking device to achieve a virtual human-computer interaction used by individuals with CP. An approach for Human-computer Interaction (HCI) is present, where individuals with cerebral palsy react and interact with a scratch game through the use of a webcam as an external interaction device. Motion tracking interaction is an emerging technology that is becoming more useful, effective and affordable. However, it raises new questions from the HCI viewpoint, for example, which environments are most suitable for interaction by users with disabilities. In our case, we put emphasis on the accessibility and usability aspects of such interaction devices to meet the special needs of people with disabilities, and specifically people with CP. Despite the fact that our work has just started, preliminary results show that, in general, computer vision interaction systems are very useful; in some cases, these systems are the only way by which some people can interact with a computer. The purpose of the experiments was to verify two hypothesis: 1) people with cerebral palsy can interact with a computer using their natural gestures, 2) scratch games can be a research tool in experiments with disabled young people. A game in Scratch with three levels is created to be played through the use of a webcam. This device permits the detection of certain key points of the user’s body, which allows to assume the head, arms and specially the hands as the most important aspects of recognition. Tests with 5 individuals of different age and gender were made throughout 3 days through periods of 30 minutes with each participant. For a more extensive and reliable statistical analysis, the number of both participants and repetitions in further investigations should be increased. However, already at this stage of research, it is possible to draw some conclusions. First, and the most important, is that simple scratch games on the computer can be a research tool that allows investigating the interaction with computer performed by young persons with CP using intentional gestures. Measurements performed with the assistance of games are attractive for young disabled users. The second important conclusion is that they are able to play scratch games using their gestures. Therefore, the proposed interaction method is promising for them as a human-computer interface. In the future, we plan to include the development of multimodal interfaces that combine various computer vision devices with other input devices improvements in the existing systems to accommodate more the special needs of individuals, in addition, to perform experiments on a larger number of participants.

Keywords: motion tracking, cerebral palsy, rehabilitation, HCI

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1235 Examining Neo-colonialism and Power in Global Surgical Missions: An Historical, Practical and Ethical Analysis

Authors: Alex Knighton, Roba Khundkar, Michael Dunn

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Neo-colonialism is defined as the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies, and concerns have been raised about its presence in surgical missions. Surgical missions aim to rectify the huge disparity in surgical access worldwide, but their ethics must be carefully considered. This is especially in light of colonial history which affects international relations and global health today, to ensure that colonial attitudes are not influencing efforts to promote equity. This review examines the history of colonial global health, demonstrating that global health initiatives have consistently been used to benefit those providing them, and then asks whether elements of colonialism are still pervasive in surgical missions today. Data was collected from the literature using specified search terms and snowball searching, as well as from international expert web-based conferences on global surgery ethics. A thematic analysis was then conducted on this data, resulting in the identification of six themes which are identifiable in both past and present global health initiatives. These six themes are power, lack of understanding or respect, feelings of superiority, exploitation, enabling of dependency, and acceptance of poorer standards of care. An ethical analysis follows, concluding that the concerns of power and neo-colonialism in global surgery would be addressed by adopting a framework of procedural justice that promotes a refined governance process in which stakeholders are able to propose and reject decisions that affect them. The paper argues that adopting this model would address concerns of the power disparity in the field directly, as well as promoting an ethical framework to enable the other concerns of power disparity and neo-colonialism identified in the present analysis to be addressed.

Keywords: medical ethics, global surgery, global health, neocolonialism, surgical missions

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1234 Systematic Review and Meta-Analysis of Mid-Term Survival, and Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair

Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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1233 Injury Patterns and Outcomes in Alcohol Intoxicated Trauma Patients Admitted at Level I Apex Trauma Centre of a Developing Nation

Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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1232 Knowledge, Perception and Practice of Deworming among Mothers of Under-Five Children in Rural Communities of Lafia Local Government Area, North Central Nigeria

Authors: Bahago I. N., Oyewole O. E.

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Nigeria has the second highest prevalence of intestinal worms globally, which has not declined since the 1970s, especially in rural communities. Identifying the gaps in self-care practice will pave a way for a suitable intervention. This study investigated the knowledge, perception, and practice of deworming among mothers of under-five children in rural communities of Lafia Local Government Area, Nasarawa State. This study was descriptive cross-sectional and involved 419 mothers selected by systematic sampling technique. Information was obtained using a valid interviewer-questionnaire. Knowledge, perception, and practice was measured using a 10-point scale for each variable, respectively. Scores of 0-4, >4-6, and >6 were categorised as poor, average/fair, and good, respectively, at p<0.05 level of significance. Respondents’ age was 30.3±9.2 years; 46.5% were into trading, 26.7% were unemployed, 9.3% were skilled labour, and 7.4% were farmers. On literacy, secondary school (25.5%) while 9.1% above secondary school. Many (51.1%) had 2-3 children, while 42.2% had 5 or more children. Most of the respondents (96.2%) had good knowledge of deworming, and 3.8% had fair knowledge. Using multivariate model, Mothers between the ages of 25-34 years were 20 times likely to be more knowledgeable, given they have access to health information (O.R 2.39 -164.31). Most (62.3%) had good perception scores, 33.2% had fair scores, while 4.5% had poor perception scores. Majority (66.4%) had a good deworming practice of deworming, 66.4% had good, 28.4% had fair, and 5.3% had poor practice. The test of association between Parent's literacy level, religion, and age were significantly associated with the level of knowledge of deworming. Knowledge of deworming was above average; perception and practice was good. Women of ages 25-34 years could be trained as community volunteers to propagate the right information about deworming in rural communities, especially among young women of ages 13-19 years. Preferred channels to obtaining health information identified in the study should be explored.

Keywords: deworming, mothers of under-five, intestinal worms, rural communities

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1231 Diagnosing Depression during Pregnancy-Identifying Risk Factors of Prenatal Depression in Polish Women

Authors: Olga Plaza, Katarzyna Kosinska-Kaczynska, Stepan Feduniw, Dominika Pazdzior, Kinga Zebrowska, Katarzyna Kwiatkowska

Abstract:

Introduction: The main causes of depression among pregnant women remain unclear. However, it is clear that pregnancy carries a higher risk of depression occurrence. Left untreated, prenatal depression can be a cause of serious both maternal and neonatal complications. Aim of the study: The aim of the study was to define potential risk factors of prenatal depression and to assess the frequency of its occurrence among pregnant women. Material and Methods: A prospective cross-sectional study was performed among 346 women. The self- composed questionnaire consisting of 46 questions, was distributed via the Internet between November 2017 and March 2018. The questionnaire contained the Edinburgh Postnatal Depression Scale (EPDS), in which the results of 13 and more points (out of 30) suggested possible prenatal depression. Statistical analysis was performed with Chi2 Pearson. P value < 0.05 was considered significant. Results: 37.57% (n=130) of women had a score of 13 or more points. Women with depressive symptoms (DS) reported lack of support from the partner (46.9% vs. 16.2%; p < 0.001) as well as other family members (40.8% vs. 14.4%; p < 0.001), current pregnancy being unplanned (21.5% vs. 12.5%; p=0.014) and low socio-economic status (10% vs. 0.9%; p < 0.001). Both early and advanced maternal age seemed to play a role in occurrence of DS: in women aged 17-24 40.8% declared symptoms (vs 28.7%; p < 0.01), in mothers aged ≥37 6.2% did (vs 0.5%; p < 0.001). Smoking during pregnancy was also more frequent among patients with DS (31.5% vs. 18.1%; p=0.004). Previous diagnosis of depression or other mood disorders significantly increased a chance of DS occurrence (respectively- 17.7% vs. 4.6%; p < 0.001 and 49.2% vs. 25%; p<0.001). Parental diagnosis of mood disorders and other mental disorders was also more frequent in this group of patients (respectively- 24.6% vs. 15.7%; p= 0.026 and 26.4% vs. 9.7%; p < 0.001). Only 23.8% of women with DS sought help from healthcare professionals, with 21.5% receiving pharmacological treatment. Conclusions: Pregnant women often report having DS. Evaluation of risk factors of DS and possible prenatal depression is essential in proper screening for depression among pregnant women.

Keywords: obstetrics, polish women, prenatal care, prenatal depression, risk factors

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1230 Evaluation of a Driver Training Intervention for People on the Autism Spectrum: A Multi-Site Randomized Control Trial

Authors: P. Vindin, R. Cordier, N. J. Wilson, H. Lee

Abstract:

Engagement in community-based activities such as education, employment, and social relationships can improve the quality of life for individuals with Autism Spectrum Disorder (ASD). Community mobility is vital to attaining independence for individuals with ASD. Learning to drive and gaining a driver’s license is a critical link to community mobility; however, for individuals with ASD acquiring safe driving skills can be a challenging process. Issues related to anxiety, executive function, and social communication may affect driving behaviours. Driving training and education aimed at addressing barriers faced by learner drivers with ASD can help them improve their driving performance. A multi-site randomized controlled trial (RCT) was conducted to evaluate the effectiveness of an autism-specific driving training intervention for improving the on-road driving performance of learner drivers with ASD. The intervention was delivered via a training manual and interactive website consisting of five modules covering varying driving environments starting with a focus on off-road preparations and progressing through basic to complex driving skill mastery. Seventy-two learner drivers with ASD aged 16 to 35 were randomized using a blinded group allocation procedure into either the intervention or control group. The intervention group received 10 driving lessons with the instructors trained in the use of an autism-specific driving training protocol, whereas the control group received 10 driving lessons as usual. Learner drivers completed a pre- and post-observation drive using a standardized driving route to measure driving performance using the Driving Performance Checklist (DPC). They also completed anxiety, executive function, and social responsiveness measures. The findings showed that there were significant improvements in driving performance for both the intervention (d = 1.02) and the control group (d = 1.15). However, the differences were not significant between groups (p = 0.614) or study sites (p = 0.842). None of the potential moderator variables (anxiety, cognition, social responsiveness, and driving instructor experience) influenced driving performance. This study is an important step toward improving community mobility for individuals with ASD showing that an autism-specific driving training intervention can improve the driving performance of leaner drivers with ASD. It also highlighted the complexity of conducting a multi-site design even when sites were matched according to geography and traffic conditions. Driving instructors also need more and clearer information on how to communicate with learner drivers with restricted verbal expression.

Keywords: autism spectrum disorder, community mobility, driving training, transportation

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1229 A Battle of Identity(ies): Deconstructing Spaces of Belonging in Saleem Haddad’s Guapa and Hasan Namir’s God in Pink

Authors: Nour Aladdin

Abstract:

This paper explores the interconnectedness of belonging, space, and identity in Anglo Arab literature, particularly Saleem Haddad’s Guapa and Hasan Namir’sGod in Pink. This paper suggest that Rasa and Ramy, the queer Arab characters respectively, do not belong in either the Middle East or the West. Using Amin Maalouf’s analysis of the Arab identity, specifically his argument that an individual identifies strongly with the aspect of their identity that is under attack, this paper argues that all of Rasa and Ramy’s spaces are politically charged - a term that denotes that all values and beliefs instilled in Arabs and their spaces are heavily influenced by Arab politics, culture, and, often times religion. Therefore, the politically charged environments Rasa and Ramy inhabit will always be against one part of their identity, which is why they cannot identify as queer and Arab simultaneously. For Rasa, the unnamed Middle Eastern country, his home environment, as well as the so-called safe space nightclub, condemn his queerness, leading him to connect more to his sexual orientation. However, Rasa associates himself with his Arab roots when he migrates to America, a different form of politically charged space that minoritizes his ethnicity. Similarly, Ramy’s spaces are naturally religiopolitical after Islam heightened in Iraq during the Iraq War; as a result, Ramy’s home environment, Sheikh Ammar’s house, the mosque, and the nightclub are influenced by the religiopolitics and bombard his ability to identify as not only a queer Arab but a queer Arab Muslim. Ultimately, because Rasa and Ramy are constantly in movement, their identity attributes are also in movement. This paper is divided into three sections. The first section focuses on Guapa and the Arab Spring’s politics, mainly its influence on queer Arabs in and around the Middle East. Drawing from a number of queer and Arab gender theories, I analyze all of Rasa’s spaces as politically charged that prevent him from the means to be queer and Arab. The second section examines God in Pink in close connection to the 2003 invasion of Iraq. Ramy’s spaces are religiopolitically charged, that prevent him to embrace all of his identity attributes – nationality, ethnicity, sexual orientation, and religious affiliation – concomitantly. The last section considers the rapid use of technology and social media in the Middle East as a means to provide deviant heterotopic spaces for queer Arabs. With the rise of subtle and covert queer heterotopias, there is a slow and steady shift of queer tolerance in the Arab world.

Keywords: belonging, identity, spaces, queer, arabness, middle east, orientalism

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1228 Qualitative Study of Organizational Variables Affecting Nurses’ Resilience in Pandemic Condition

Authors: Zahra Soltani Shal

Abstract:

Introduction: The COVID-19 pandemic marks an extraordinary global public health crisis unseen in the last century, with its rapid spread worldwide and associated mortality burden. Healthcare resilience during a pandemic is crucial not only for continuous and safe patients care but also for control of any outbreak. Aim: The present study was conducted to discover the organizational variables effective in increasing resilience and continuing the work of nurses in critical and stressful pandemic conditions. Method: The study population is nurses working in hospitals for patients with coronavirus. Sampling was done purposefully and information was collected from 15 nurses through In-depth semi-structured interviews. The interview was conducted to analyze the data using the framework analysis method consisting of five steps and is classified in the table. Results: According to the findings through semi-structural interviews, among organizational variables, organizational commitment (Affective commitment, continuous commitment, normative commitment) has played a prominent role in nurses' resilience. Discussion: despite the non-withdrawal of nurses and their resilience, due to the negative quality of their working life, the mentioned variable has affected their level of performance and ability and leads to fatigue and physical and mental exhaustion. Implications for practice: By equipping hospitals and improving the facilities of nurses, their organizational commitment can be increased and lead to their resilience in critical situations. Supervisors and senior officials at the hospitals should be responsible for nurses' health and safety. A clear and codified program in critical situations and comprehensive management is effective in improving the quality of the work-life of nurses. Creating an empathetic and interactive environment can help promote nurses' mental health.

Keywords: organizational commitment, quality of work life, nurses resilience, pandemic, coronavirus

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1227 Applying Resilience Engineering to improve Safety Management in a Construction Site: Design and Validation of a Questionnaire

Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

Abstract:

Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

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1226 Air Breakdown Voltage Prediction in Post-arcing Conditions for Compact Circuit Breakers

Authors: Jing Nan

Abstract:

The air breakdown voltage in compact circuit breakers is a critical factor in the design and reliability of electrical distribution systems. This voltage determines the threshold at which the air insulation between conductors will fail or 'break down,' leading to an arc. This phenomenon is highly sensitive to the conditions within the breaker, such as the temperature and the distance between electrodes. Typically, air breakdown voltage models have been reliable for predicting failure under standard operational temperatures. However, in conditions post-arcing, where temperatures can soar above 2000K, these models face challenges due to the complex physics of ionization and electron behaviour at such high-energy states. Building upon the foundational understanding that the breakdown mechanism is initiated by free electrons and propelled by electric fields, which lead to ionization and, potentially, to avalanche or streamer formation, we acknowledge the complexity introduced by high-temperature environments. Recognizing the limitations of existing experimental data, a notable research gap exists in the accurate prediction of breakdown voltage at elevated temperatures, typically observed post-arcing, where temperatures exceed 2000K.To bridge this knowledge gap, we present a method that integrates gap distance and high-temperature effects into air breakdown voltage assessment. The proposed model is grounded in the physics of ionization, accounting for the dynamic behaviour of free electrons which, under intense electric fields at elevated temperatures, lead to thermal ionization and potentially reach the threshold for streamer formation as Meek's criterion. Employing the Saha equation, our model calculates equilibrium electron densities, adapting to the atmospheric pressure and the hot temperature regions indicative of post-arc temperature conditions. Our model is rigorously validated against established experimental data, demonstrating substantial improvements in predicting air breakdown voltage in the high-temperature regime. This work significantly improves the predictive power for air breakdown voltage under conditions that closely mimic operational stressors in compact circuit breakers. Looking ahead, the proposed methods are poised for further exploration in alternative insulating media, like SF6, enhancing the model's utility for a broader range of insulation technologies and contributing to the future of high-temperature electrical insulation research.

Keywords: air breakdown voltage, high-temperature insulation, compact circuit breakers, electrical discharge, saha equation

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1225 National Scope Study on Resilience of Nursing Teams During the COVID-19 Pandemic: Brazilian Experience

Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Pedro Henrique Tertuliano Leoni, Carla Aparecida Arena Ventura, Ana Cristina de Oliveira e Silva, Renata Karina Reis

Abstract:

Context and significance: Resilience is a protective agent for the physical and mental well-being of nursing professionals. Team members are constantly subjected to high levels of work stress that can negatively impact care performance and users of health services. Stress levels have been exacerbated with the COVID-19 pandemic. Objective: The aim of this study was to analyze the resilience of nursing professionals in Brazil during the COVID-19 pandemic. Method: Cross-sectional study with a quantitative approach carried out with professionals from nursing teams from all regions of Brazil. Data collection took place in the first year of the pandemic between October and December 2020. Data were obtained through an online questionnaire posted on social networks. The information collected included the sociodemographic characterization of the nursing professionals and the Brief Resilient Coping Scale was applied. Student's t-test for independent samples and analysis of variance (ANOVA) were used to compare resilience scores with sociodemographic variables. Results: 8,792 nursing professionals participated in the study, 5,767 (65.6%) were nurses, 7,437 (84.6%) were female and 2,643 (30.1%) were from the Northeast region of Brazil, 5,124 (58.8% ) had low levels of resilience. The results showed a statistically significant difference between the resilience score and the variables: professional category (p<0.001); sex (p = 0.003); age range (p<0.001); region of Brazil (p<0.001); marital status (p=0.029) and providing assistance in a field hospital (p<0.001). Conclusion: Participants in this study had, in general, low levels of resilience. There is an urgent need for actions aimed at promoting the psychological health of nursing professionals inserted in pandemic contexts. Descriptors: Psychological Resilience; Nursing professionals; COVID-19; SARSCoV-2.

Keywords: psychological resilience, nursing professionals, COVID-19, SARS-CoV-2

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1224 The Judiciary as Pacemaker? Considering the Role of Courts in an Expansion of Protection for War Refugees and People Fleeing Natural Disasters

Authors: Charlotte Lülf

Abstract:

Migration flows, resulting from war, climate change or economic crisis cannot be tackled by single states but need to be addressed as a transnational and international responsibility. The traditional architecture surrounding the work of the UNHCR and the 1951 Convention, however, is not equipped to deal with these challenges. Widely excluded from legal protection are people not individually persecuted for the statutory criteria, people that flee from the indiscriminate effects of an armed conflict as well as people fleeing natural disasters. With the lack of explicit legal protection and the political reluctance of nation states worldwide to extend their commitment in new asylum laws, the judiciary must be put in focus: it plays a unique role in interpreting and potentially expanding the application of existing regulations. This paper as part of an ongoing Ph.D. Project deals with the current and partly contradicting approaches to the protection of war- and climate refugees. Changing jurisprudential practice of national and regional courts will be assessed, as will be their dialogue to interpret the international obligations of human rights law, migration laws, and asylum laws in an interacting world. In recent judgments refoulment to an armed conflict as well as countries without adequate disaster relief or health care was argued as violating fundamental human and asylum law rights and therefore prohibited – even for applicants without refugee status: The first step towards access to subsidiary protection could herewith be established. Can one observe similar developments in other parts of the world? This paper will evaluate the role of the judiciary to define, redefine and potentially expand protection for people seeking refuge from armed conflicts and natural disasters.

Keywords: human rights law, asylum-seekers, displacement, migration

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1223 Study of Incubation Centres and Its Role in Fostering Entrepreneurship in India with Special Reference to Centres Set up in IIMs/IITs

Authors: Kalpeshkumar L. Gupta, Shivali Rathore

Abstract:

India is home to over 30 crore rural poor, aware of the criticality of the situation that has made to come with an innovative business idea. Entrepreneurship in India is on the verge of explosive growth and which is actually need of an hour for employment generation, poverty elevation at grass root through developmental intervention. India economic progress has started from the development of its small and medium scale enterprises to ensure that the sectors continues to stay competitive and achieve sustained growth in the era of global economy many incubators centers has been established with the mission to give the encouragement to many innovative ideas. If we define an Incubator, it is simply an enclosed apparatus in which premature small babies are placed and which provides a controlled and protective environment for their care this gives them a chance to adjust to outside environment, and grow stronger before they face the outside world. In a similar way the startup entrepreneur’s business idea is incubated in the incubation centers. Entrepreneurship has been conventionally rated as risky career, to break the myth and to augment the supply of new entrepreneurs through education; research training the incubation centers has been established, their goal is to help create and grow young businesses by providing them with necessary support and financial and technical services. The startup companies spend on an average two years in a business incubator during which numerous benefits like funding, office space, equipment’s etc. is provided by the incubators to the startup business. Present paper will study the background, role, objectives of different incubators set up in Indian Institute of Management (IIMs) and Indian Institute of Technology (IITs) for our study.

Keywords: incubation centres, entrepreneurship, Indian Institute of Management, Indian Institute of Technology

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1222 Physical, Psychological, and Sexual Implications of Living with Rheumatoid Arthritis among Women in Re

Authors: Anwaar Anwar Tayel

Abstract:

Background: Rheumatic arthritis (RA) affect all aspects of patients' life, lead to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient's life. Aim of the study: Identify physical, psychological, and sexual implications of rheumatoid arthritis among women in reproductive age. In addition to investigating the correlations between physical functional disability, psychological problems, and sexual dysfunction.Settings: The study was conducted at Rheumatology Clinic at the Main University Hospital of Alexandria. Subjects: Purposive sample was chosen from women patients with rheumatoid arthritis to be subjects of this study (n=250). Tools: Four tools were used to collect data. Tool I: Socio-demographic questionnaire. Tool II: Stanford Health Assessment Questionnaire Disability Index (HAQ- DI). Tool III: Depression Anxiety Stress Scale (DASS). Tool IV: The Sexual Dysfunction Questionnaire (SDQ) Results: The majority of the studied women suffer from severe physical disability, extreme level of depression, anxiety, and about half of them had an extreme level of stress. Also, the majority of the studied women had a severe level of sexual dysfunction. Also, statistically significant correlations between women's physical disability index, psychological problems, and sexual dysfunction were detected. Conclusion: The findings from this study confirm that women patients with RA suffer from multiple negative implications on the physical, psychological and sexual functions. Recommendations: Provide ongoing support to the patients from the time of diagnosis throughout their care and management. To help them to manage their pain and disabilities, improve their sexual function, promote their mental health, and optimize psychosocial functioning

Keywords: pysical, spycholgical, sexual, implication, rheumatic arthritis

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1221 Queer Social Realism and Architecture in British Cinema: Tenement Housing, Unions and the Affective Body

Authors: Christopher Pullen

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This paper explores the significance of British cinema in the late 1950s and early 1960s as offering a renaissance of realist discourse, in the representation of everyday social issues. Offering a rejection of Hollywood cinema and the superficially of the middle classes, these ‘kitchen sink dramas’ often set within modest and sometimes squalid domestic and social environments, focused on the political struggle of the disenfranchised examining poverty, the oppressed and the outsider. While films like Look Back in Anger and Room at the Top looked primarily at male heterosexual subjectivity, films like A Taste of Honey and Victim focused on female and queer male narratives. Framing the urban landscape as a discursive architectural arena, representing basic living conditions and threatening social worlds, these iconic films established new storytelling processes for the outsider. This paper examines this historical context foregrounding the contemporary films Beautiful Thing (Hettie Macdonald, 1996), Weekend (Andrew Haigh, 2011) and Pride (Marcus Warchus, 2014), while employing the process of textual analysis in relation to theories of affect, defined by writers such as Lisa U. Marks and Sara Ahmed. Considering both romance narratives and public demonstrations of unity, where the queer ‘affective’ body is placed within architectural and social space, Beautiful Thing tells the story of gay male teenagers falling in love despite oppression from family and school, Weekend examines a one-night stand between young gay men and the unlikeliness of commitment, but the drive for sensitivity, and Pride foregrounds an historical relationship between queer youth activists and the miner’s union, who were on strike between 1984-5. These films frame the queer ‘affective’ body within politicized public space, evident in lower class men’s working clubs, tenement housing and brutal modernist tower blocks, focusing on architectural features such as windows, doorways and staircases, relating temporality, desire and change. Through such an examination a hidden history of gay male performativity is revealed, framing the potential of contemporary cinema to focus on the context of the outsider in encouraging social change.

Keywords: queer, affect, cinema, architecture, life chances

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1220 Predictors of Survival of Therapeutic Hypothermia Based on Analysis of a Consecutive American Inner City Population over 4 Years

Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

Abstract:

Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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1219 Dual Electrochemical Immunosensor for IL-13Rα2 and E-Cadherin Determination in Cell, Serum and Tissues from Cancer Patients

Authors: Amira ben Hassine, A. Valverde, V. Serafín, C. Muñoz-San Martín, M. Garranzo-Asensio, M. Gamella, R. Barderas, M. Pedrero, N. Raouafi, S. Campuzano, P. Yáñez-Sedeño, J. M. Pingarrón

Abstract:

This work describes the development of a dual electrochemical immunosensing platform for accurate determination of two target proteins, IL-13 Receptor α2 (IL-13Rα2) and E-cadherin (E-cad). The proposed methodology is based on the use of sandwich immunosensing approaches (involving horseradish peroxidase-labeled detector antibodies) implemented onto magnetic microbeads (MBs) and amperometric transduction at screen-printed dual carbon electrodes (SPdCEs). The magnetic bioconjugates were captured onto SPdCEs and the amperometric transduction was performed using the H2O2/hydroquinone (HQ) system. Under optimal experimental conditions, the developed bio platform demonstrates linear concentration ranges of 1.0–25 and 5.0-100 ng mL-1, detection limits of 0.28 and 1.04 ng mL-1 for E-cad and IL-13Rα2, respectively, and excellent selectivity against other non-target proteins. The developed immuno-platform also offers a good reproducibility among amperometric responses provided by nine different sensors constructed in the same manner (Relative Standard Deviation values of 3.1% for E-cad and 4.3% for IL-13Rα2). Moreover, obtained results confirm the practical applicability of this bio-platform for the accurate determination of the endogenous levels of both extracellular receptors in colon cancer cells (both intact and lysed) with different metastatic potential and serum and tissues from patients diagnosed with colorectal cancer at different grades. Interesting features in terms of, simplicity, speed, portability and sample amount required to provide quantitative results, make this immuno-platform more compatible than conventional methodologies with the clinical diagnosis and prognosis at the point of care.

Keywords: electrochemistry, mmunosensors, biosensors, E-cadherin, IL-13 receptor α2, cancer colorectal

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1218 Flood Mapping and Inoudation on Weira River Watershed (in the Case of Hadiya Zone, Shashogo Woreda)

Authors: Alilu Getahun Sulito

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Exceptional floods are now prevalent in many places in Ethiopia, resulting in a large number of human deaths and property destruction. Lake Boyo watershed, in particular, had also traditionally been vulnerable to flash floods throughout the Boyo watershed. The goal of this research is to create flood and inundation maps for the Boyo Catchment. The integration of Geographic information system(GIS) technology and the hydraulic model (HEC-RAS) were utilized as methods to attain the objective. The peak discharge was determined using Fuller empirical methodology for intervals of 5, 10, 15, and 25 years, and the results were 103.2 m3/s, 158 m3/s, 222 m3/s, and 252 m3/s, respectively. River geometry, boundary conditions, manning's n value of varying land cover, and peak discharge at various return periods were all entered into HEC-RAS, and then an unsteady flow study was performed. The results of the unsteady flow study demonstrate that the water surface elevation in the longitudinal profile rises as the different periods increase. The flood inundation charts clearly show that regions on the right and left sides of the river with the greatest flood coverage were 15.418 km2 and 5.29 km2, respectively, flooded by 10,20,30, and 50 years. High water depths typically occur along the main channel and progressively spread to the floodplains. The latest study also found that flood-prone areas were disproportionately affected on the river's right bank. As a result, combining GIS with hydraulic modelling to create a flood inundation map is a viable solution. The findings of this study can be used to care again for the right bank of a Boyo River catchment near the Boyo Lake kebeles, according to the conclusion. Furthermore, it is critical to promote an early warning system in the kebeles so that people can be evacuated before a flood calamity happens. Keywords: Flood, Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Keywords: Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Procedia PDF Downloads 39