Search results for: patient safety in home hemodialysis

Authors: Sivanandan Balakrishnan, Sara Moridpour, Richard Tay

Abstract:

Heavy vehicles make a significant contribution to many developed economies, including Australia, because they are a major means of transporting goods within these countries. With the increase in road freight, there will be an increase in the heavy vehicle traffic proportion, and consequently, an increase in the possibility of collisions involving heavy vehicles. Crashes involving heavy vehicles are a major road safety concern because of the higher likelihood of fatal and serious injury, especially to any small vehicle occupant involved. The primary objective of this research is to identify the factors influencing injury severity to occupants in vehicle collisions involving heavy vehicle at T- intersection using a binary logit model in Victoria, Australia. Our results show that the factors influencing injury severity include occupants' gender, age and restraint use. Also, vehicles' type, movement, point-of-impact and damage, time-of-day, day-of-week and season, higher percentage of trucks in traffic volume, hit pedestrians, number of occupants involved and type of collisions are associated with severe injury.

Keywords: binary logit model, heavy vehicle, injury severity, T-intersections

Procedia PDF Downloads 394

Authors: Amy Halseth, Kevin Shan, Kye Gilder, John Buse

Abstract:

The study assessed the effect of prolonged-release naltrexone 32 mg/bupropion 360 mg (NB) on cardiovascular (CV) events in overweight/obese participants at elevated CV risk. Participants must lose ≥ 2% body weight at 16 wks, without a sustained increase in blood pressure, to continue drug. The study was terminated early after second interim analysis with 50% of all CV events. Data on CV endpoints has been published. Current analyses focus on weight change. Intent-to-treat (ITT) population (placebo [PBO] N=4450, NB N=4455) was 54.5% female, 83.5% white, mean age 61 yrs, mean BMI 37.3 kg/m2; 85.2% had type 2 diabetes, 32.1% had CV disease, 17.4% had both. At 52 wks, ITT-LOCF analysis showed greater least squares mean percent change in weight (LSM%ΔBW) with NB (-3.1%; 95% CI -4.8, -1.4) vs PBO (-0.3%; 95% CI -1.9, 1.4). Both groups demonstrated greater weight loss while on-treatment (NB [-7.3%], PBO [-3.9%]). Odds ratios of 5% and 10% weight loss were 3.3 and 4.1 (ITT-LOCF), respectively, in NB over PBO. At 104 wks, on-treatment LSM%ΔBW was -6.3% with NB (n=1137) vs -3.5% with PBO (n=741). Major reasons for NB withdrawal were adverse events (AE, 29%) and patient decision (21%), with GI disorders being the most common. Weight loss with NB in this study, in an older population predominantly with diabetes and elevated CV risk, was somewhat lower than that observed in overweight/obese participants without diabetes and similar to participants with diabetes in Phase 3 studies.

Keywords: contrave, mysimba, obesity, pharmacotherapy, weight loss

Procedia PDF Downloads 319

Authors: Asaad Alhabsi, Alyaqdan Algafri

Abstract:

Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

Procedia PDF Downloads 77

Authors: Konstantinos G. Papaioannou, Panagiotis K. Serdaris

Abstract:

This study, examines the level of implementation of Human Resource Management (HRM) activities in law enforcement agencies in Greece. Recognizing that HRM is crucial for maximizing organizational performance, the study aims to evaluate its application within Greek law enforcement. A quantitative-descriptive survey was conducted, involving 996 executives from Greek Law Enforcement Agencies (477 from the Hellenic Police and 519 from the Hellenic Coast Guard), through random sampling. The survey, revealed significant concerns regarding the minimal implementation of HRM practices, in both agencies. The findings indicate that HRM practices, such as HR planning, recruitment, job position, selection, training and development, personnel management, compensation, labor relations and health and safety, are minimally applied. Neither the Hellenic Police nor the Hellenic Coast Guard appears to follow a comprehensive HRM plan. The study, contributes both theoretically and practically by highlighting the lack of HRM implementation in these agencies. The data suggest that by adopting strategic HRM practices, these organizations can enhance personnel performance and better fulfill their societal roles. Future research should extend to law enforcement agencies in other countries to draw more representative conclusion.

Keywords: coastguard, human resources management, law enforcement agencies, performance management, police

Procedia PDF Downloads 44

Authors: Muhammad Fiaz, Muhammad Saqlain, Abid Mahmood, S. M. Saqlan Naqvi, Rizwan Aziz Qazi, Ghazala Kaukab Raja

Abstract:

Background: Metabolic Syndrome is a clustering of multiple risk factors including central obesity, hypertension, dyslipidemia and hyperglycemia. These risk phenotypes of metabolic syndrome (MetS) prevalent world-wide, Therefore we aimed to identify the frequency of risk phenotypes among metabolic syndrome subjects in local adult Pakistani population. Methods: Screening of subjects visiting out-patient department of medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad was performed to assess the occurrence of risk phenotypes among MetS subjects in Pakistani population. The Metabolic Syndrome was defined based on International Diabetes Federation (IDF) criteria. Anthropometric and biochemical assay results were recorded. Data was analyzed using SPSS software (16.0). Results: Our results showed that dyslipidemia (31.50%) and hyperglycemia (30.50%) was most population specific risk phenotypes of MetS. The results showed the order of association of metabolic risk phenotypes to MetS as follows hyperglycemia>dyslipidemia>obesity >hypertension. Conclusion: The hyperglycemia and dyslipidemia were found be the major risk phenotypes among the MetS subjects and have greater chances of deceloping MetS among Pakistani Population.

Keywords: dyslipidemia, hypertention, metabolic syndrome, obesity

Procedia PDF Downloads 209

Authors: Nima Safaei, Arezoo Masoud, Babak Safaei

Abstract:

In recent years, there has been a growing emphasis on the role of urban planning in walking capability and the effects of individual and socioeconomic factors on the physical activity levels of city dwellers. Although considerable number of studies are conducted about walkability and for identifying the effective factors in walking mode choice in developed countries, to our best knowledge, literature lacks in the study of factors affecting choice of walking mode in developing countries. Due to the high importance of health aspects of human societies and in order to make insights and incentives for reducing traffic during rush hours, many researchers and policy makers in the field of transportation planning have devoted much attention to walkability studies; they have tried to improve the effective factors in the choice of walking mode in city neighborhoods. In this study, effective factors in walkability that have proven to have significant impact on the choice of walking mode, are studied at the same time in work trips. The data for the study is collected from the employees in their workplaces by well-instructed people using questionnaires; the statistical population of the study consists of 117 employed people who commute daily from work to home in Rasht city of Iran during the beginning of spring 2015. Results of the study which are found through the linear regression modeling, show that people who do not have freedom of choice for choosing their living locations and need to be present at their workplaces in certain hours have lower levels of walking. Additionally, unlike some of the previous studies which were conducted in developed countries, coincidental effects of Body Mass Index (BMI) and the income level of employees, do not have a significant effect on the walking level in work travels.

Keywords: BMI, linear regression, transportation, walking, work trips

Procedia PDF Downloads 196

Authors: Jessie Fazel, Kristen Smith

Abstract:

Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

Procedia PDF Downloads 32

Authors: Safoin Aktaou, Aya Al Masri, Kamel Guerchouche, Malorie Martin, Fouad Maaloul

Abstract:

Introduction: In the ‘Magnetic Resonance Imaging (MRI)’ department, all workers involved in preparing the patient, setting it up, tunnel cleaning, etc. are likely to be exposed to ‘ElectroMagnetic fields (EMF)’ emitted by the MRI device. Exposure to EMF can cause adverse radio-biological effects to workers. The purpose of this study is to propose an organizational process to manage and control EMF risks. Materials and methods: The study was conducted at seven MRI departments using machines with 1.5 and 3 Tesla magnetic fields. We assessed the exposure of each one by measuring the two electromagnetic fields (static and dynamic) at different distances from the MRI machine both inside and around the examination room. Measurement values were compared with British and American references (those of the UK's ‘Medicines and Healthcare Regulatory Agency (MHRA)’ and the ‘American Radiology Society (ACR)’). Results: Following the results of EMF measurements and their comparison with the recommendations of learned societies, a zoning system that adapts to needs of different MRI services across the country has been proposed. In effect, three risk areas have been identified within the MRI services. This has led to the development of a good practice guide related to the magnetic protection of MRI workers. Conclusion: The guide established by our study is a standard that allows MRI workers to protect themselves against the risk of electromagnetic fields.

Keywords: comparison with international references, measurement of electromagnetic fields, magnetic protection of workers, magnetic resonance imaging

Procedia PDF Downloads 164

Authors: Fahrur Rozi, Daniswara Krisna Prabatha, Latief Zulfikar Chusaini

Abstract:

Amidst the backdrop of Pertamina Plaju Refinery, which stands as the oldest and historically less technologically advanced among Pertamina's refineries, lies a unique challenge. Originally integrating facilities established by Shell in 1904 and Stanvac (originally Standard Oil) in 1926, the primary challenge at Plaju Refinery does not solely revolve around complexity; instead, it lies in ensuring reliability, considering its operational history of over a century. After centuries of existence, Plaju Refinery has never undergone a comprehensive major turnaround encompassing all its units. The usual practice involves partial turnarounds that are sequentially conducted across its primary, secondary, and tertiary units (utilities and offsite). However, a significant shift is on the horizon. In the Q-IV of 2023, the refinery embarks on its first-ever major turnaround since its establishment. This decision was driven by the alignment of maintenance timelines across various units. Plaju Refinery's major turnaround was scheduled for October-November 2023, spanning 45 calendar days, with the objective of enhancing the operational reliability of all refinery units. The extensive job list for this turnaround encompasses 1583 tasks across 18 units/areas, involving approximately 9000 contracted workers. In this context, the Strategy of Simultaneous Operations (SIMOPS) execution emerges as a pivotal tool to optimize time efficiency and ensure safety. A Hazard Effect Management Process (HEMP) has been employed to assess the risk ratings of each task within the turnaround. Out of the tasks assessed, 22 are deemed high-risk and necessitate mitigation. The SIMOPS approach serves as a preventive measure against potential incidents. It is noteworthy that every turnaround period at Pertamina Plaju Refinery involves SIMOPS-related tasks. In this context, enhancing the implementation strategy of "Simultaneous Operations (SIMOPS)" becomes imperative to minimize the occurrence of incidents. At least four improvements have been introduced in the enhancement process for the major turnaround at Refinery Plaju. The first improvement involves conducting systematic risk assessment and potential hazard mitigation studies for SIMOPS tasks before task execution, as opposed to the previous on-site approach. The second improvement includes the completion of SIMOPS Job Mitigation and Work Matrices Sheets, which was often neglected in the past. The third improvement emphasizes comprehensive awareness to workers/contractors regarding potential hazards and mitigation strategies for SIMOPS tasks before and during the major turnaround. The final improvement is the introduction of a daily program for inspecting and observing work in progress for SIMOPS tasks. Prior to these improvements, there was no established program for monitoring ongoing activities related to SIMOPS tasks during the turnaround. This study elucidates the steps taken to enhance SIMOPS within Pertamina, drawing from the experiences of Plaju Refinery as a guide. A real actual case study will be provided from our experience in the operational unit. In conclusion, these efforts are essential for the success of the first-ever major turnaround at Plaju Refinery, with the SIMOPS strategy serving as a central component. Based on these experiences, enhancements have been made to Pertamina's official Internal Guidelines for Executing SIMOPS Risk Mitigation, benefiting all Pertamina units.

Keywords: process safety management, turn around, oil refinery, risk assessment

Procedia PDF Downloads 74

Authors: Fatema-Tuz-Zohra Khanam, Ali Al-Naji, Asanka G. Perera, Kim Gibson, Javaan Chahl

Abstract:

Conventional contact-based vital signs monitoring sensors such as pulse oximeters or electrocardiogram (ECG) may cause discomfort, skin damage, and infections, particularly in neonates with fragile, sensitive skin. Therefore, remote monitoring of the vital sign is desired in both clinical and non-clinical settings to overcome these issues. Camera-based vital signs monitoring is a recent technology for these applications with many positive attributes. However, there are still limited camera-based studies on neonates in a clinical setting. In this study, the heart rate (HR) and respiratory rate (RR) of eight infants at the Neonatal Intensive Care Unit (NICU) in Flinders Medical Centre were remotely monitored using a digital camera applying color and motion-based computational methods. The region-of-interest (ROI) was efficiently selected by incorporating an image decomposition method. Furthermore, spatial averaging, spectral analysis, band-pass filtering, and peak detection were also used to extract both HR and RR. The experimental results were validated with the ground truth data obtained from an ECG monitor and showed a strong correlation using the Pearson correlation coefficient (PCC) 0.9794 and 0.9412 for HR and RR, respectively. The RMSE between camera-based data and ECG data for HR and RR were 2.84 beats/min and 2.91 breaths/min, respectively. A Bland Altman analysis of the data also showed a close correlation between both data sets with a mean bias of 0.60 beats/min and 1 breath/min, and the lower and upper limit of agreement -4.9 to + 6.1 beats/min and -4.4 to +6.4 breaths/min for both HR and RR, respectively. Therefore, video camera imaging may replace conventional contact-based monitoring in NICU and has potential applications in other contexts such as home health monitoring.

Keywords: neonates, NICU, digital camera, heart rate, respiratory rate, image decomposition

Procedia PDF Downloads 104

Authors: Sulihantoro, Muhamad Irga Fahreza

Abstract:

Age of onset of the crisis makes more advanced understanding of the values of Islam that has been etched in architectural design. The majority Muslim mosque architecture designing buildings when they designed the architecture of Islam has always stuck in a cultural symbol, the shape of the facade, carving calligraphy, and all things that are closely related to the culture of the Middle East. As well as the interpretation of symbols, by designing a dome in every mosque, calligraphy carvings inside the mosque, and the other elements in the building which is interpreted by middle eastern culture. So here we have a problem understanding the meaning of Islam with kaf fah (overall), which appears distorted understanding to distinguish between cultural values and theological in design. This paper will try to evaluate the design of a contemporary mosque in Indonesia, with a case study in Masjid Kauman Yogyakarta Indonesia. building characteristics focused on the function of the building, history, aesthetics, comfort, and safety. The results of this study should be found on the evaluation of the integrated design of contemporary mosques are based on a study of the Quran and Hadith.

Keywords: characteristics, Islamic concept, culture, Kauman Mosque

Procedia PDF Downloads 225

Authors: Ashmita Bhattacharya

Abstract:

This study aims to investigate whether the English immersion experience offered by Kolkata’s high-cost private English-medium schools lead to additive or subtractive language learning outcomes for students. In India, English has increasingly become associated with power, social status, and socio-economic mobility. As a result, a proliferation of English-medium schools has emerged across Kolkata and the wider Indian context. While in some contexts, English language learning can be an additive experience, in others, it can be subtractive where proficiency in English is developed at the expense of students’ native language proficiency development. Subtractive educational experiences can potentially have severe implications, including heritage language loss, detachment from cultural roots, and a diminished sense of national identity. Thus, with the use of semi-structured interviews, the language practices and lived experiences of 12 former students who attended high-cost private English-medium schools in Kolkata were thoroughly explored. The data collected was thematically coded and analysis was conducted using the Thematic Analysis approach. The findings indicate that the English immersion experience at Kolkata’s high-cost private English-medium schools provide a subtractive language learning experience to students. Additionally, this study suggests that robust home-based support for native languages might be crucial for mitigating the effects of subtractive English education. Furthermore, the study underscores the importance of integrating opportunities within schools that promote Indian languages and cultures as it can create a more positive, inclusive, and culturally responsive environment. Finally, although subject to further evaluation, the study recommends the implementation of bilingual and multilingual educational systems and provides suggestions for future research in this area.

Keywords: bilingual education, English immersion, language loss, multilingual education, subtractive language learning

Procedia PDF Downloads 29

Authors: Lea Lenhardt, Ivana Zeković, Tatjana Dramićanin, Miroslav D. Dramićanin

Abstract:

Rapid and sensitive analytical technologies for food analysis are needed to respond to the growing public interest in food quality and safety. In this context, fluorescence spectroscopy offers several inherent advantages for the characterization of food products: high sensitivity, low price, objective, relatively fast and non-destructive. The objective of this work was to investigate the potential of fluorescence spectroscopy coupled with multi-way technique for characterization of cereal flours. Fluorescence landscape also known as excitation-emission matrix (EEM) spectroscopy utilizes multiple-color illumination, with the full fluorescence spectrum recorded for each excitation wavelength. EEM was measured on various types of cereal flours (wheat, oat, barley, rye, corn, buckwheat and rice). Obtained spectra were analyzed using PARAllel FACtor analysis (PARAFAC) in order to decompose the spectra and identify underlying fluorescent components. Results of the analysis indicated the presence of four fluorophores in cereal flours. It has been observed that relative concentration of fluorophores varies between different groups of flours. Based on these findings we can conclude that application of PARAFAC analysis on fluorescence data is a good foundation for further qualitative analysis of cereal flours.

Keywords: cereals, fluors, fluorescence, PARAFAC

Procedia PDF Downloads 665

Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

Abstract:

Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

Procedia PDF Downloads 237

Authors: Ayuko Itsuki, Sachiyo Aburatani

Abstract:

In recent years, pollutions of the environment by toxic substances become a serious problem. While there are many methods of environmental clean-up, the methods by microorganisms are considered to be reasonable and safety for environment. Compost is known that it catabolize the meladorous substancess in its production process, however the mechanism of its catabolizing system is not known yet. In the catabolization process, organic matters turn into inorganic by the released enzymes from lots of microorganisms which live in compost. In other words, the cooperative of activated enzymes in the compost decomposes malodorous substances. Thus, clarifying the interaction among enzymes is important for revealing the catabolizing system of meladorous substance in compost. In this study, we utilized statistical method to infer the interaction among enzymes. We developed a method which combined partial correlation with cross correlation to estimate the relevance between enzymes especially from time series data of few variables. Because of using cross correlation, we can estimate not only the associative structure but also the reaction pathway. We applied the developed method to the enzyme measured data and estimated an interaction among the enzymes in decomposition mechanism of toluene.

Keywords: enzyme activities, comparative analysis, compost, toluene

Procedia PDF Downloads 273

Authors: A. M. Attalla, A. F. lbrahim, Laila Y. Mostaffa

Abstract:

This study was conducted during three seasons 2010, 2011 and 2012 on Zahhloul date palm cultivar grown in calcareous soil, Alexandria governorate, Egypt. The palms received recommended dose of mineral N only or plus different rates of organic N with or without bio fertilizer to study the effect of such treatments on date palm yield and fruit nitrate and nitrite content due to its negative influence on human, animal and environment. The obtained results clarified that all used treatments of organic and bio fertilizers were effective in improving date palm yield and decreased fruit content of NO2 and NO3 in comparison with 100 % mineral N. It was also noticed that combined treatments of 50 % mineral N + 50 % organic manure with bio fertilizer is the superior treatments for increasing the values of yield and decreasing its content of NO2 and NO3. Hence, it could be concluded that, minimizing the use of chemical nitrogen fertilizer to half of recommended dose through addition of 50 % mineral N + 50 % organic manure with bio fertilizer and also, the utilization of organic and bio fertilizers is considered as a promising alternative for chemical fertilizers to avoid pollution and reduce the costs of mineral fertilizers.

Keywords: organic and bio fertilizers, mineral fertilizer, nitrate, nitrite, zaghloul date palm cv

Procedia PDF Downloads 449

Authors: Divya Pathak, James Sloane

Abstract:

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

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

Procedia PDF Downloads 143

Authors: Maide Yesilyurt, Saide Faydalı

Abstract:

Patients experience pain at different intensities in postoperative. The diagnosis of the pain, the assessment and the success of the treatment and care make the measurement of this finding compulsory. The aim of the study is to determine the evaluation differences numeric pain scales. The descriptive study was conducted with 360 patients with in postoperative. The data were obtained from questionnaires related to six numeric pain scales most preferred in clinical use, and a face-to-face interview technique was used by the researcher. Regarding to numeric pain scale, questions include forth positive and one negative statement. In evaluating the data; chi-square and Pearson correlation tests were used. For the study, the patients’ informed consents, the institution and the ethics committee received permission. In this study, patients' ages are between 18-80, 95.8% of the patients were not informed about pain assessment. Patients evaluated the 5-item numeric scale as the easy, can be answered quickly, accurate, and appropriate for clinical use and the 101 items numeric scale as complex than other scales. Regarding to numeric pain scales with positive statements between age, marital status, educational status, previous surgery, having chronic disease and getting information about pain assessment significant difference has been detected. All numeric pain scales are correlated to each other. As a result, it was determined that as the items in the numerical scales decreased, the patients were able to perceive the scales better, and the items in the scales increased, the patients were in trouble to understand.

Keywords: numeric pain scales, nurse, pain assessment, patient

Procedia PDF Downloads 290

Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

Abstract:

This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

Procedia PDF Downloads 318

Authors: Dawid Jakimiuk, Krzysztof Mitura, Leszek Szpakowski, Sławomir Pilip, Daniel Celiński

Abstract:

The Emergency Medical Teams (EMS) of the Ambulance Service in Siedlce serve the population living in the Mazowieckie Voivodeship (the area of eastern Poland with approximately 550,000 inhabitants). They provide health services at the pre-hospital stage to all life-threatening patients. The analysis covered the interventions of emergency medical teams in cases of suicide attempts that occurred in the years 2015-2018. The study was retrospective. The data was obtained on the basis of digital medical records of completed call-outs. When defining the disease entity, the International Statistical Classification of Diseases and Health Problems ICD-10 prepared by WHO was used. The relationship between selected disease entities and the area of EMT intervention, the patient's sex and age, and the time of occurrence of the event were investigated. Non-urban area was defined as the area inhabited by a population below 10,000 residents. Statistical analysis was performed using Pearson's Chi ^ 2 test and presenting the percentage of cases in the study group. Of all the suicide attempts, drug abuse cases were the most frequent, including: X60 (Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics); X61 (Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonian and psychotropic drugs, not elsewhere classified); X62 (Intentional self-poisoning by and exposure to narcotics and psycholeptics [hallucinogens], not elsewhere classified); X63 (Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system); X64 (Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substance) oraz X70 (Intentional self-harm by hanging, strangulation and suffocation). In total, they accounted for 69.4% of all interventions to suicide attempts in the studied period. Statistical analysis shows significant differences (χ2 = 39.30239, p <0.0001, n = 561) between the area of EMT intervention and the type of suicide attempt. In non-urban areas, a higher percentage of X70 diagnoses was recorded (55.67%), while in urban areas, X60-X64 (72.53%). In non-urban areas, a higher proportion of patients attempting suicide was observed compared to patients living in urban areas. For X70 and X60 - X64 in total, the incidence rates in non-urban areas were 80.8% and 56%, respectively. Significant differences were found (χ2 = 119.3304, p <0.0001, n = 561) depending on the method of attempting suicide in relation to the patient's sex. The percentage of women diagnosed with X60-X64 versus X70 was 87.50%, which was the largest number of patients (n = 154) as compared to men. In the case of X70 in relation to X60-X64, the percentage of men was 62.08%, which was the largest number of patients (n = 239) as compared to women (n = 22). In the case of X70, the percentage of men compared to women was as high as 92%. Significant differences were observed (χ2 = 14.94848, p <0.01058) between the hour of EMT intervention and the type of suicide attempt. The highest percentage of X70 occurred between 04:01 - 08:00 (64.44%), while X60-X64 between 00:01 - 04:00 (70.45%). The largest number of cases of all tested suicide attempts was recorded between 16:01 - 20:00 for X70 (n = 62), X60 - X64 (n = 82), respectively. The highest percentage of patients undertaking all suicide attempts studied at work was observed in the age range of 18-30 (31.5%), while the lowest was in the age group over 60 years of age. (11%). There was no significant correlation between the day of the week or individual months of the year and the type of suicide attempt - respectively (χ2 = 6.281729, p <0.39238, n = 561) and (χ2 = 3.348913, p <0.9857, n = 561). There were also no significant differences in the incidence of suicide attempts for each year in the study period (χ2 = 3.348913, p <0.9857 n = 561). The obtained results suggest the necessity to undertake preventive measures in order to minimize the number of suicide attempts. Such activities should be directed especially at young patients living in non-urban areas.

Keywords: emergency med, emergency medical team, attempted suicide, pre-hospital

Procedia PDF Downloads 92

Authors: Adrian Sebastian, Chris Gillespie

Abstract:

We describe a case of diffuse rectal involvement with cap polyposis, manifesting with a protein-losing colopathy and occurring in the setting of advanced mechanical pelvic floor dysfunction. A 59-year-old male with a 5-year history of persistent excessive flatulence, defecatory difficulties, and diarrhea. He had extensive cap polyposis of the entire rectum endoscopically. His symptoms progressed to severe fecal incontinence with mucus leakage, pelvic pain, weight loss, and hypoalbuminemia. Clinical examination exhibited severe perineal descent, a large rectocele, poor anal squeeze, and a poor defecatory technique. After a trial of nonoperative therapies addressing his defecatory dysfunction, and Helicobacter pylori eradication, surgical resection was offered due to severe symptoms with ongoing incontinence and protein loss with no other reasonable options. A robotic abdominoperineal resection with a permanent colostomy was performed, followed by an uncomplicated recovery. Our observation of coexisting mechanical pelvic floor changes in this patient lends weight to the concept of a prolapse-related phenomenon in the pathophysiology of this rare condition.

Keywords: cap polyposis, pelvic dysfunction, fecal incontinence, case report

Procedia PDF Downloads 79

Authors: Jayanthi Rajendran

Abstract:

Experience is what makes a man perfect. Though we tend to learn many a different things in life through practice still we need to go an extra mile to gain experience which would be profitable only when it is integrated with regular practice. A clear phenomenal idea is that every teacher is a learner. The centralized idea of this paper would focus on the integrated practices carried out among the students of Jizan University which enhances learning through experiences. Integrated practices like student-directed activities, balanced curriculum, phonological based activities and use of consistent language would enlarge the vision and mission of students to earn experience through learning. Students who receive explicit instruction and guidance could practice the skills and strategies through student-directed activities such as peer tutoring and cooperative learning. The second effective practice is to use consistent language. Consistent language provides students a model for talking about the new concepts which also enables them to communicate without hindrances. Phonological awareness is an important early reading skill for all students. Students generally have phonemic awareness in their home language can often transfer that knowledge to a second language. And also a balanced curriculum requires instruction in all the elements of reading. Reading is the most effective skill when both basic and higher-order skills are included on a daily basis. Computer based reading and listening skills will empower students to understand a language in a better way. English language learners can benefit from sound reading instruction even before they are fully proficient in English as long as the instruction is comprehensible. Thus, if students have to be well equipped in learning they should foreground themselves in various integrated practices through multifarious experience for which teachers are moderators and trainers. This type of learning prepares the students for a constantly changing society which helps them to meet the competitive world around them for better employability fulfilling the vision and mission of the institution.

Keywords: consistent language, employability, phonological awareness, balanced curriculum

Procedia PDF Downloads 401

Authors: Hamid Ahmadi, Neda Azari-Dodaran

Abstract:

A total of 270 nonlinear steady-state finite element (FE) analyses were performed on 54 FE models of two-planar circular hollow section (CHS) KK-joints subjected to axial loading at five different temperatures (20 ºC, 200 ºC, 400 ºC, 550 ºC, and 700 ºC). The primary goal was to investigate the effects of temperature and geometrical characteristics on the ultimate strength, modes of failure, and initial stiffness of the KK-joints. Results indicated that on an average basis, the ultimate load of a two-planar tubular KK-joint at 200 ºC, 400 ºC, 550 ºC, and 700 ºC is 90%, 75%, 45%, and 16% of the joint’s ultimate load at ambient temperature, respectively. Outcomes of the parametric study showed that replacing the yield stress at ambient temperature with the corresponding value at elevated temperature to apply the EN 1993-1-8 equations for the calculation of the joint’s ultimate load at elevated temperatures may lead to highly unconservative results that might endanger the safety of the structure. Results of the parametric study were then used to develop a set of design formulas, through nonlinear regression analyses, to calculate the ultimate load of two-planar tubular KK-joints subjected to axial loading at elevated temperatures.

Keywords: ultimate load, two-planar tubular KK-joint, axial loading, elevated temperature, parametric equation

Procedia PDF Downloads 158

Authors: Javad Sadoghi Yazdi, Robb Eric S. Moss

Abstract:

This paper utilizes a probabilistic liquefaction triggering method for modeling post-liquefaction ground deformation. This cone penetration test CPT-based liquefaction triggering is employed to estimate the factor of safety against liquefaction (FSL) and compute the maximum cyclic shear strain (γmax). The study identifies a maximum PL value of 90% across various relative densities, which challenges the decrease from 90% to 70% as relative density decreases. It reveals that PL ranges from 5% to 50% for volumetric strain (εvol) less than 1%, while for εvol values between 1% and 3.2%, PL spans from 50% to 90%. The application of the CPT-based simplified liquefaction triggering procedures has been employed in previous researches to estimate liquefaction ground-failure indices, such as the Liquefaction Potential Index (LPI) and Liquefaction Severity Number (LSN). However, several studies have been conducted to highlight the variability in liquefaction probability calculations, suggesting a more accurate depiction of liquefaction likelihood. Consequently, the utilization of these simplified methods may not offer practical efficiency. This paper further investigates the efficacy of various established liquefaction vulnerability parameters, including LPI and LSN, in explaining the observed liquefaction-induced damage within residential zones of Christchurch, New Zealand using results from CPT database.

Keywords: cone penetration test (CPT), liquefaction, postliquefaction, ground failure

Procedia PDF Downloads 71

Authors: J. Punj, R. K. Pandey, V. Darlong, K. Thangavel

Abstract:

Background: Dural puncture epidural (DPE) technique has been introduced recently for labour analgesia however, no study has compared ropivacaine and levobupivacaine for the same. Methods: The primary aim of the study was to compare time to onset of the Numerical Pain Rating Score (NPRS) ≤ 1 in labour analgesia with both drugs. After obtaining ethics and patient consent, ASA I and ASA II parturient with single foetus in vertex presentation and cervical dilatation <5.0 cm were included. DPE was performed with 16/ 26 G combined spinal epidural (CSE) technique, and parturients randomized into two groups. In Group R ( Ropivacaine) 20 ml 0.125% ropivacaine+ fentanyl 2µg/ml was injected to a maximum of 20 ml in 20 minutes and in Group L (Levobupivacaine), 20 ml 0.125% levobupivacaine + fentanyl 2µg/ml was injected. Outcomes were assessed at 0.5,2,4,6,8,10,12,14,16,18,20 and 30 minutes, then every 90 minutes until delivery. Appropriate statistical analysis was done, and p value of <0.05 was considered statistically significant. Results: The median time to onset of NPRS ≤1 in both groups was comparable (group R= 16 minutes vs group L= 18 minutes (p = 0.076). Volume of drug for NPR ≤1 in both groups was also comparable (Group R 15.95± 2.03 ml vs Group L 16.35 ± 1.34 ml (p=0.47). Conclusion: DPE with 16 G epidural needle and 26 gauge spinal needle with both 0.125% ropivacaine and 0.125% levobupivacaine results in similar efficacy of labour analgesia.

Keywords: dural puncture epidural, labour analgesia, obstetric analgesia, hypotension

Procedia PDF Downloads 87

Authors: Mahani Razali, Nordin Mamat

Abstract:

The purpose of this research is to identify the teacher’s role and parent’s participation to develop children`s socio emotion through play activities. This research is based on three main objectives which are to identify children`s socio emotion during play activities, teacher’s role and parent’s participation to develop children`s socio emotion. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify socio emotional development element among pre-school children through play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired socio emotional development among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on five main socio emotional elements among the pre-school children: 1) Cooperation, 2) Confidence and Courage, 3) Ability to communicate, 4) patience, and 5) Tolerance. The findings of this study were presented in the form of case to case manner from the researches sample. Findings revealed that the children showed positive outcomes on the socio emotional development during their play. Both teachers and parents showed positive perceptions towards the acquired socio emotional development during their play activities. In conclusion, this research summarizes that teacher’s role and parent’s support can improve children`s socio emotional development through play activities. As a whole, this research highlighted the significance of play activities as to stimulate socio emotional development among the pre-school children.

Keywords: social emotional, children, play activities, stimulating

Procedia PDF Downloads 407

Authors: Eugene Ivanov, Eduardo del-Rio, Igor Kapchenko, Maija Nystrӧm, Juha Kotila

Abstract:

Series of low modulus beta Ti alloy billets and powders can be produced in commercial quantities using a combination of electron beam melting (EBM) and EIGA atomization processes. In the present study, TNZT alloy powder was produced and processed in the EOSINT M290 laser sintering system to produce parts for mechanical testing. Post heat treatments such as diffusion annealing to reduce internal stresses or hot isostatic pressing to remove closed pores were not applied. The density can visually be estimated to be > 99,9 %. According to EDS study Nb, Zr, and Ta are distributed homogeneously throughout the printed sample. There are no indications for any segregation or chemical inhomogeneity, i.e. variation of the element distribution. These points to the fact that under the applied experimental conditions the melt generated by the laser rapidly cools down in the SLM (Selective Laser Melting) process. The selective laser sintering yielded dense structures with relatively good surface quality. The mechanical properties, especially the elongation (24%) along with tensile strength ( > 500MPa) and modulus of elasticity (~60GPa), were found to be promising compared to titanium alloys in general.

Keywords: beta titanium alloys, additive manufacturing, powder, implants

Procedia PDF Downloads 227

Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

Abstract:

Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

Procedia PDF Downloads 566

Authors: A. Lubis, L. Setiawati, A. R. Setyoningrum, A. Suryawan, Irwanto

Abstract:

Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: asthma, chronic health problems, growth, development

Procedia PDF Downloads 229

Authors: Lucy H. Kaiser, Kate Boersen

Abstract:

Kura Kaupapa Māori (kura) and bilingual schools are primary schools in Aotearoa/New Zealand which operate fully or partially under Māori custom and have curricula developed to include Te Reo Māori and Tikanga Māori (Māori language and cultural practices). These schools were established to support Māori children and their families through reinforcing cultural identity by enabling Māori language and culture to flourish in the field of education. Māori kaupapa (values), Mātauranga Māori (Māori knowledge) and Te Reo are crucial considerations for the development of educational resources developed for kura, bilingual and mainstream schools. The inclusion of hazard risk in education has become an important issue in New Zealand due to the vulnerability of communities to a plethora of different hazards. Māori have an extensive knowledge of their local area and the history of hazards which is often not appropriately recognised within mainstream hazard education resources. Researchers from the Joint Centre for Disaster Research, Massey University and East Coast LAB (Life at the Boundary) in Napier were funded to collaboratively develop a toolkit of tsunami risk reduction activities with schools located in Hawke’s Bay’s tsunami evacuation zones. A Māori-led bicultural approach to developing and running the education activities was taken, focusing on creating culturally and locally relevant materials for students and schools as well as giving students a proactive role in making their communities better prepared for a tsunami event. The community-based participatory research is Māori-centred, framed by qualitative and Kaupapa Maori research methodologies and utilizes a range of data collection methods including interviews, focus groups and surveys. Māori participants, stakeholders and the researchers collaborated through the duration of the project to ensure the programme would align with the wider school curricula and kaupapa values. The education programme applied a tuakana/teina, Māori teaching and learning approach in which high school aged students (tuakana) developed tsunami preparedness activities to run with primary school students (teina). At the end of the education programme, high school students were asked to reflect on their participation, what they had learned and what they had enjoyed during the activities. This paper draws on lessons learned throughout this research project. As an exemplar, retaining a bicultural and bilingual perspective resulted in a more inclusive project as there was variability across the students’ levels of confidence using Te Reo and Māori knowledge and cultural frameworks. Providing a range of different learning and experiential activities including waiata (Māori songs), pūrākau (traditional stories) and games was important to ensure students had the opportunity to participate and contribute using a range of different approaches that were appropriate to their individual learning needs. Inclusion of teachers in facilitation also proved beneficial in assisting classroom behavioral management. Lessons were framed by the tikanga and kawa (protocols) of the school to maintain cultural safety for the researchers and the students. Finally, the tuakana/teina component of the education activities became the crux of the programme, demonstrating a path for Rangatahi to support their whānau and communities through facilitating disaster preparedness, risk reduction and resilience.

Keywords: school safety, indigenous, disaster preparedness, children, education, tsunami

Procedia PDF Downloads 122