Search results for: complementary and aLternative medicine
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5530

Search results for: complementary and aLternative medicine

5080 Variation in the Traditional Knowledge of Curcuma longa L. in North-Eastern Algeria

Authors: A. Bouzabata, A. Boukhari

Abstract:

Curcuma longa L. (Zingiberaceae), commonly known as turmeric, has a long history of traditional uses for culinary purposes as a spice and a food colorant. The present study aimed to document the ethnobotanical knowledge about Curcuma longa and to assess the variation in the herbalists’ experience in Northeastern Algeria. Data were collected by semi-structured questionnaires and direct interviews with 30 herbalists. Ethnobotanical indices, including the fidelity level (FL%), the relative frequency citation (RFC) and use value (UV) were determined by quantitative methods. Diversity in the knowledge was analyzed using univariate, non-parametric and multivariate statistical methods. Three main categories of uses were recorded for C. longa: for food, for medicine and for cosmetic purposes. As a medicine, turmeric was used for the treatment of gastrointestinal, dermatological and hepatic diseases. Medicinal and food uses were correlated with both forms of use (rhizome and powder). The age group did not influence the use. Multivariate analyses showed a significant variation in traditional knowledge, associated with the use value, origin, quality and efficacy of the drug. These findings suggested that the geographical origin of C. longa affected the use in Algeria.

Keywords: curcuma, indices, knowledge, variation

Procedia PDF Downloads 544
5079 An Analysis of Organoleptic Qualities of a Three-Course Menu from Moringa Leaves in Mubi, Adamawa State Nigeria

Authors: Rukaiya Suleiman Umar, Annah Kwadu Medugu

Abstract:

Moringa oleifera is mainly used as herbal medicine in most homes in Northern Nigeria. The plant is easy to grow and thrives very well regardless the type of soil. Use of moringa leaves in food production can yield attractive varieties on menu. This paper evaluates the acceptability of dishes produced with fresh moringa leaves with a view to promoting it in popular restaurants. A three course menu consisting of cream of moringa soup as the starter, mixed meat moringa sauce with semovita as the main dish and moringa roll as sweet was produced and served to a 60-member taste panel made of three groups of 20 each. Respondents were asked to rate the organoleptic qualities of the samples on a 10-point bipolar scale ranging from 1 (Dislike extremely) – 10 (Like extremely). Data collected were treated to one sample t-test and One Way ANOVA. Results show that the panelists extremely like the moringa products. It is recommended that Moringa oleifera should be incorporated into meals which is more readily acceptable than medicine.

Keywords: Moringa oleifera, food production, menu planning, healthy living

Procedia PDF Downloads 282
5078 Radio Frequency Heating of Iron-Filled Carbon Nanotubes for Cancer Treatment

Authors: L. Szymanski, S. Wiak, Z. Kolacinski, G. Raniszewski, L. Pietrzak, Z. Staniszewska

Abstract:

There exist more than one hundred different types of cancer, and therefore no particular treatment is offered to people struggling with this disease. The character of treatment proposed to a patient will depend on a variety of factors such as type of the cancer diagnosed, advancement of the disease, its location in the body, as well as personal preferences of a patient. None of the commonly known methods of cancer-fighting is recognised as a perfect cure, however great advances in this field have been made over last few decades. Once a patient is diagnosed with cancer, he is in need of medical care and professional treatment for upcoming months, and in most cases even for years. Among the principal modes of treatment offered by medical centres, one can find radiotherapy, chemotherapy, and surgery. All of them can be applied separately or in combination, and the relative contribution of each is usually determined by medical specialist in agreement with a patient. In addition to the conventional treatment option, every day more complementary and alternative therapies are integrated into mainstream care. There is one promising cancer modality - hyperthermia therapy which is based on exposing body tissues to high temperatures. This treatment is still being investigated and is not widely available in hospitals and oncological centres. There are two kinds of hyperthermia therapies with direct and indirect heating. The first is not commonly used due to low efficiency and invasiveness, while the second is deeply investigated and a variety of methods have been developed, including ultrasounds, infrared sauna, induction heating and magnetic hyperthermia. The aim of this work was to examine possibilities of heating magnetic nanoparticles under the influence of electromagnetic field for cancer treatment. For this purpose, multiwalled carbon nanotubes used as nanocarriers for iron particles were investigated for its heating properties. The samples were subjected to an alternating electromagnetic field with frequency range between 110-619 kHz. Moreover, samples with various concentrations of carbon nanotubes were examined. The lowest frequency of 110 kHz and sample containing 10 wt% of carbon nanotubes occurred to influence the most effective heating process. Description of hyperthermia therapy aiming at enhancing currently available cancer treatment was also presented in this paper. Most widely applied conventional cancer modalities such as radiation or chemotherapy were also described. Methods for overcoming the most common obstacles in conventional cancer modalities, such as invasiveness and lack of selectivity, has been presented in magnetic hyperthermia characteristics, which explained the increasing interest of the treatment.

Keywords: hyperthermia, carbon nanotubes, cancer colon cells, ligands

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5077 Anatomical and Pathological Evaluation of Anomaly Cases Presented to the Department of Pathology at the Kafkas University Faculty of Veterinary Medicine, between 2017 and 2019

Authors: Gülseren Kırbaş Doğan, Emin Karakurt, Mushap Kuru, Hilmi Nuhoğlu

Abstract:

Developmental anomalies can be caused by defects in bone tissue, cartilage tissue, or primitive mesenchymal tissue. Genetic-, environmental-, teratogenic-, faulty breeding selection–, or feeding-related anomalies can be observed either locally or systemically. This study aimed to evaluate in detail the various anomalies in six calves according to pathological and anatomical investigations. Six calves were delivered to the Department of Pathology at the Kafkas University Faculty of Veterinary Medicine between 2017 and 2019. These calves comprised one with anencephaly, one with the diencephalic syndrome, one with Schistosoma reflexum, two with anasarca, and one with nasal and calvarium openings. After necropsy, samples were taken from the organs, foreseen, and routine pathological examinations were performed. Following these procedures, the calves were brought to the anatomy laboratory and anatomically examined. As a result, various anomalies in 6 calves were evaluated according to pathological and anatomical investigations. These findings are believed to contribute to the literature.

Keywords: anatomy, anomaly, calf, pathology

Procedia PDF Downloads 182
5076 Indoor and Outdoor Forest Farming for Year-Round Food and Medicine Production, Carbon Sequestration, Soil-Building, and Climate Change Mitigation

Authors: Jerome Osentowski

Abstract:

The objective at Central Rocky Mountain Permaculture Institute has been to put in practice a sustainable way of life while growing food, medicine, and providing education. This has been done by applying methods of farming such as agroforestry, forest farming, and perennial polycultures. These methods have been found to be regenerative to the environment through carbon sequestration, soil-building, climate change mitigation, and the provision of food security. After 30 years of implementing carbon farming methods, the results are agro-diversity, self-sustaining systems, and a consistent provision of food and medicine. These results are exhibited through polyculture plantings in an outdoor forest garden spanning roughly an acre containing about 200 varieties of fruits, nuts, nitrogen-fixing trees, and medicinal herbs, and two indoor forest garden greenhouses (one Mediterranean and one Tropical) containing about 50 varieties of tropical fruits, beans, herbaceous plants and more. While the climate zone outside the greenhouse is 6, the tropical forest garden greenhouse retains an indoor climate zone of 11 with near-net-zero energy consumption through the use of a climate battery, allowing the greenhouse to serve as a year-round food producer. The effort to source food from the forest gardens is minimal compared to annual crop production. The findings at Central Rocky Mountain Permaculture Institute conclude that agroecological methods are not only beneficial but necessary in order to revive and regenerate the environment and food security.

Keywords: agroecology, agroforestry, carbon farming, carbon sequestration, climate battery, food security, forest farming, forest garden, greenhouse, near-net-zero, perennial polycultures

Procedia PDF Downloads 443
5075 Life Cycle Assessment Comparison between Methanol and Ethanol Feedstock for the Biodiesel from Soybean Oil

Authors: Pawit Tangviroon, Apichit Svang-Ariyaskul

Abstract:

As the limited availability of petroleum-based fuel has been a major concern, biodiesel is one of the most attractive alternative fuels because it is renewable and it also has advantages over the conventional petroleum-base diesel. At Present, productions of biodiesel generally perform by transesterification of vegetable oils with low molecular weight alcohol, mainly methanol, using chemical catalysts. Methanol is petrochemical product that makes biodiesel producing from methanol to be not pure renewable energy source. Therefore, ethanol as a product produced by fermentation processes. It appears as a potential feed stock that makes biodiesel to be pure renewable alternative fuel. The research is conducted based on two biodiesel production processes by reacting soybean oils with methanol and ethanol. Life cycle assessment was carried out in order to evaluate the environmental impacts and to identify the process alternative. Nine mid-point impact categories are investigated. The results indicate that better performance on Abiotic Depletion Potential (ADP) and Acidification Potential (AP) are observed in biodiesel production from methanol when compared with biodiesel production from ethanol due to less energy consumption during the production processes. Except for ADP and AP, using methanol as feed stock does not show any advantages over biodiesel from ethanol. The single score method is also included in this study in order to identify the best option between two processes of biodiesel production. The global normalization and weighting factor based on eco-taxes are used and it shows that producing biodiesel form ethanol has less environmental load compare to biodiesel from methanol.

Keywords: biodiesel, ethanol, life cycle assessment, methanol, soybean oil

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5074 Governance and Financial Constraints the Impact on Corporate Social Responsibility Implementation in Cooperatives

Authors: Wanlapha Phraibueng, Patrick Sentis, Geraldine Riviere-Giordano

Abstract:

Corporate Social Responsibility (CSR) initiatives have been widely discussed especially in investor-oriented firms. In contrast, cooperatives pay less attention to CSR because their activities have integrated the responsibility and the solidity of social, economic and environment. On the other hand, by adopting ownership theory and agency theory – cooperatives ignore CSR investment due to unclarified decision control in the governance and the limitation to acquire the capital financed. The unique governance and financial structures in cooperatives lead to the conflict among the stakeholders and long-term investment which have an impact on firm financial performance. As an illustration of cooperatives dilemmas, we address the question of Whether or not cooperatives in term of governance and financial structures are the constraints on implementing CSR policies. We find that the governance and financial structures in large cooperatives are the influence factors which predispose cooperatives to invest on CSR. In contrast, in the startup or small cooperatives, its governance and financial structures are the constraints on implementing CSR policies. We propose the alternative financial structure based on the trade-off between debt and equity which aims to relax the restrictions in cooperatives’ governance and allow cooperatives to acquire the capital financed either from its members or non-members. We suggest that engaging equity as a financial structure induces cooperatives to invest on CSR policies. Alternative financial structure eliminates not only cooperative ownership control problem but also the constraints in capital acquisition. By implementing CSR activities consistent with the alternative financial choice, cooperatives can increase firm’s value and reduce the conflict among their stakeholders.

Keywords: cooperatives, corporate social responsibility, financial, governance

Procedia PDF Downloads 139
5073 Design and Study of a Low Power High Speed Full Adder Using GDI Multiplexer

Authors: Biswarup Mukherjee, Aniruddha Ghosal

Abstract:

In this paper, we propose a new technique for implementing a low power full adder using a set of GDI multiplexers. Full adder circuits are used comprehensively in Application Specific Integrated Circuits (ASICs). Thus it is desirable to have low power operation for the sub components. The explored method of implementation achieves a low power design for the full adder. Simulated results using state-of-art Tanner tool indicates the superior performance of the proposed technique over conventional CMOS full adder. Detailed comparison of simulated results for the conventional and present method of implementation is presented.

Keywords: low power full adder, 2-T GDI MUX, ASIC (application specific integrated circuit), 12-T FA, CMOS (complementary metal oxide semiconductor)

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5072 Other End of the Leash: The Volunteer Handlers Perspective of Animal-Assisted Interventions

Authors: Julie A. Carberry, Victor Maddalena

Abstract:

Animal-Assisted Interventions (AAIs) have existed in various forms for centuries. In the past 30 years, there has been a dramatic increase in popularity. AAIs are now part of the lives of persons of all ages in many types of institutions. Anecdotal evidence of the benefits of AAIs have led to widespread adoption, yet there remains a lack of solid research base for support. The research question was, what are the lived experiences of AAI volunteer handlers are? An interpretive phenomenological methodology was used for this qualitative study. Data were collected from 1 - 2 hour-long semi-structured interviews and 1 observational field visit. All interviews were conducted, transcribed, and coded for themes by the principal investigator. Participants must have been an active St. John Ambulance Therapy Dog Program volunteer for a least one year. In total, 14 volunteer handlers, along with some of their dogs, were included. The St. John Ambulance is a not for profit organization that provides training and community services to Canadians. The Therapy Dog Program is 1 of the 4 nationally recognized core community service programs. The program incorporates dogs in the otherwise traditional therapeutic intervention of friendly visitation with clients. The lack of formal objectives and goals, and a trained therapist defines the program as an Animal-Assisted Activity (AAA), which is a type of AAI. Since the animals incorporated are dogs, the program is specifically a Canine-Assisted Activity (CAA), which is a type of Canine-Assisted Intervention (CAI). Six themes emerged from the analysis of the data: (a) a win-win-win situation for all parties involved – volunteer handlers, clients, and the dogs, (b) being on the other end of the leash: functions of the role of volunteer handler, (c) the importance of socialization: from spreading smiles to creating meaningful connections, (d) the role of the dog: initiating interaction and providing comfort, (e) an opportunity to feel good and destress, and (f) altruism versus personal rewards. Other insights were found regarding the program, clients, and staff. Possible implications from this research include increased organizational recruitment and retention of volunteer handlers and as well as increased support for CAAs and other CAIs that incorporate teams of volunteer handlers and their dogs. This support could, in turn, add overall support for the acceptance and broad implementation of AAIs as an alternative and or complementary non-pharmaceutical therapeutic intervention.

Keywords: animal-assisted activity, animal-assisted intervention, canine-assisted activity, canine-assisted intervention, perspective, qualitative, volunteer handler

Procedia PDF Downloads 139
5071 Experimental Studies on the Effect of Premixing Methods in Anaerobic Digestor with Corn Stover

Authors: M. Sagarika, M. Chandra Sekhar

Abstract:

Agricultural residues are producing in large quantities in India and account for abundant but underutilized source of renewable biomass in agriculture. In India, the amount of crop residues available is estimated to be approximately 686 million tons. Anaerobic digestion is a promising option to utilize the surplus agricultural residues and can produce biogas and digestate. Biogas is mainly methane (CH4), which can be utilized as an energy source in replacement for fossil fuels such as natural gas, oil, in other hand, digestate contains high amounts of nutrients, can be employed as fertilizer. Solid state anaerobic digestion (total solids ≥ 15%) is suitable for agricultural residues, as it reduces the problems like stratification and floating issues that occur in liquid anaerobic digestion (total solids < 15%). The major concern in solid-state anaerobic digestion is the low mass transfer of feedstock and inoculum that resulting in low performance. To resolve this low mass transfer issue, effective mixing of feedstock and inoculum is required. Mechanical mixing using stirrer at the time of digestion process can be done, but it is difficult to operate the stirring of feedstock with high solids percentage and high viscosity. Complete premixing of feedstock and inoculum is an alternative method, which is usual in lab scale studies but may not be affordable due to high energy demand in large-scale digesters. Developing partial premixing methods may reduce this problem. Current study is to improve the performance of solid-state anaerobic digestion of corn stover at feedstock to inoculum ratios 3 and 5, by applying partial premixing methods and to compare the complete premixing method with two partial premixing methods which are two alternative layers of feedstock and inoculum and three alternative layers of feedstock and inoculum where higher inoculum ratios in the top layers. From experimental studies it is observed that, partial premixing method with three alternative layers of feedstock and inoculum yielded good methane.

Keywords: anaerobic digestion, premixing methods, methane yield, corn stover, volatile solids

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5070 Integration of an Innovative Complementary Approach Inspired by Clinical Hypnosis into Oncology Care: Nurses’ Perception of Comfort Talk

Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

Abstract:

Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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5069 Influence of S.carnosus Bacteria as Biocollector for the Recovery Organic Matter in the Flotation Process

Authors: G. T. Ramos-Escobedo, E. T. Pecina-Treviño, L. F. Camacho-Ortegon, E. Orrantia-Borunda

Abstract:

The mineral bioflotation represents a viable alternative for the evaluation of new processes benefit alternative. The adsorption bacteria on minerals surfaces will depend mainly on the type of the microorganism as well as of the studied mineral surface. In the current study, adhesion of S. carnosus on coal was studied. Several methods were used as: DRX, Fourier Transform Infra Red (FTIR) adhesion isotherms and kinetic. The main goal is the recovery of organic matter by the microflotation process on coal particles with biological reagent (S. carnosus). Adhesion tests revealed that adhesion took place after 8 h at pH 9. The results suggest that the adhesion of bacteria to solid substrates can be considered an abiotic physicochemical process that is consequently governed by bacterial surface properties such as their specific surface area, hydrophobicity and surface functionalities. The greatest coal fine flotability was 75%, after 5 min of flotation.

Keywords: fine coal, bacteria, adhesion, recovery organic matter

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5068 Biodiesel Production from Canola Oil Using Trans-Esterification Process with Koh as a Catalyst

Authors: M. Nafis Alfarizi, Dinda A. Utami, Arif Hidayat

Abstract:

Biodiesel is one solution to overcome the use of petroleum fuels. Many alternative feedstocks that can be used among which canola oil. The purpose of this study was to determine the ability of canola oil and KOH for the trans-esterification reaction in biodiesel production. Canola oil has a very high purity that can be used as an alternative feedstock for biodiesel production and expected it will be produced biodiesel with excellent quality. In this case of study, we used trans-esterification process wherein the triglyceride is reacted with an alcohol with KOH as a catalyst, and it will produce biodiesel and glycerol as byproduct and we choose trans-esterification process because canola oil has a 0,445% FFA content. The variables studied in this research include the comparison of canola oil and methanol, temperature, time, and the percent of catalyst used. In this study the method of analysis we use GCMS and FTIR to know what the characteristic in canola oil. Development of canola oil seems to be the perfect solution to produce high-quality biodiesel. The reaction conditions resulted in 97.87% -w methyl ester (biodiesel) product by using a 0.5% wt KOH catalyst with canola and methanol ratio 1:8 at 60°C.

Keywords: biodiesel, canola oil, KOH, trans-esterification

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5067 Effects of Using a Recurrent Adverse Drug Reaction Prevention Program on Safe Use of Medicine among Patients Receiving Services at the Accident and Emergency Department of Songkhla Hospital Thailand

Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

Abstract:

Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

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5066 Efficient GIS Based Public Health System for Disease Prevention

Authors: K. M. G. T. R. Waidyarathna, S. M. Vidanagamachchi

Abstract:

Public Health System exists in Sri Lanka has a satisfactory complete information flow when compared to other systems in developing countries. The availability of a good health information system contributed immensely to achieve health indices that are in line with the developed countries like US and UK. The health information flow at the moment is completely paper based. In Sri Lanka, the fields like banking, accounting and engineering have incorporated information and communication technology to the same extent that can be observed in any other country. The field of medicine has behind those fields throughout the world mainly due to its complexity, issues like privacy, confidentially and lack of people with knowledge in both fields of Information Technology (IT) and Medicine. Sri Lanka’s situation is much worse and the gap is rapidly increasing with huge IT initiatives by private-public partnerships in all other countries. The major goal of the framework is to support minimizing the spreading diseases. To achieve that a web based framework should be implemented for this application domain with web mapping. The aim of this GIS based public health system is a secure, flexible, easy to maintain environment for creating and maintaining public health records and easy to interact with relevant parties.

Keywords: DHIS2, GIS, public health, Sri Lanka

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5065 Peer-To-Peer Lending and Macroeconomics: Searching for a Link

Authors: Asror Nigmonov Asqar Ogli, Sitora Inoyatova Amonovna

Abstract:

It has been a decade when the crowdfunding and P2P lending opportunities were created. Today, the market of these modern alternative investments is becoming increasingly complex to navigate. There are overwhelming amount of peer-to-peer lending platforms both in developed and emerging economies. This study looks into this market via the cross country empirical study. In this respect, it tests the effect of various macroeconomic factors on P2P loan lending. Based on the existing literature that largely lacks empirical investigations, it builds regression model that aims to explore the relationship between economy and P2P lending. Though the author found it extremely difficult to compare the findings with earlier studies, this paper had identified certain tendencies in the data and had certain policy implications. However, the paper could not find any significant effect of economic variables on P2P lending. The paper can be considered as a starting point in empirical investigation of P2P lending and highlights room further research based on limitations of the study.

Keywords: peer-to-peer lending, crowdfunding, marketplace lending, alternative finance, fintech

Procedia PDF Downloads 199
5064 The Missing Link in Holistic Health Care: Value-Based Medicine in Entrustable Professional Activities for Doctor-Patient Relationship

Authors: Ling-Lang Huang

Abstract:

Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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5063 New Recipes of Communication in the New Linguistic World Order: End of Road for Aged Pragmatics

Authors: Shailendra Kumar Singh

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With the rise of New Linguistic World Order in the 21st century, the Aged Pragmatics is palpitating on the edge of theoretical irrelevance. What appears to be a new sociolinguistic reality is that the enlightening combination of alternative west, inclusive globalization and techno-revolution is adding novel recipes to communicative actions, style and gain among new linguistic breed which is being neither dominated nor powered by the western supremacy. The paper has the following main, interrelated, aims: it is intended to introduce the concept of alternative pragmatics that can offer what exactly is needed for our emerging societal realities; it asserts as to how the basic pillar of linguistic success in the new linguistic world order rests upon linguistic temptation and calibration of all; and it also reviews an inevitability of emerging economies in shaping the communication trends at a time when the western world is struggling to maintain the same control on the others exercised in the past. In particular, the paper seeks answers for the following questions: (a) Do we need an alternative pragmatics, one with alternativist leaning in an era of inclusive globalization and alternative west? (b) What are the pulses of shift which are encapsulating emergence of new communicative behavior among the new linguistic breed by breaking yesterday’s linguistic rigidity? (c) Or, what are those shifts which are making linguistic shift more perceptible? (d) Is New Linguistic World Order succeeding in reversing linguistic priorities of `who speaks, what language, where, how, why, to whom and in which condition’ with no parallel in the history? (e) What is explicit about the contemporary world of 21st century which makes linguistic world all exciting and widely celebrative phenomenon and that is also forced into our vision? (f) What factors will hold key to the future of yesterday’s `influential languages’ and today’s `emerging languages’ as world is in the paradigm transition? (g) Is the collapse of Aged Pragmatics good for the 21st century for understanding the difference between pragmatism of old linguistic world and new linguistic world order? New Linguistic world Order today, unlike in the past, is about a branding of new world with liberal world view for a particular form of ideal to be imagined in the 21st century. At this time without question it is hope that a new set of ideals with popular vocabulary will become the implicit pragmatic model as one of benign majoritarianism in all aspects of sociolinguistic reality. It appears to be a reality that we live in an extraordinary linguistic world with no parallel in the past. In particular, the paper also highlights the paradigm shifts: Demographic, Social-psychological, technological and power. These shifts are impacting linguistic shift which is unique in itself. The paper will highlight linguistic shift in details in which alternative west plays a major role without challenging the west because it is an era of inclusive globalization in which almost everyone takes equal responsibility.

Keywords: inclusive globalization, new linguistic world order, linguistic shift, world order

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5062 Decision Making in Medicine and Treatment Strategies

Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi

Abstract:

Three reasons make good use of the decision theory in medicine: 1. Increased medical knowledge and their complexity makes it difficult treatment information effectively without resorting to sophisticated analytical methods, especially when it comes to detecting errors and identify opportunities for treatment from databases of large size. 2. There is a wide geographic variability of medical practice. In a context where medical costs are, at least in part, by the patient, these changes raise doubts about the relevance of the choices made by physicians. These differences are generally attributed to differences in estimates of probabilities of success of treatment involved, and differing assessments of the results on success or failure. Without explicit criteria for decision, it is difficult to identify precisely the sources of these variations in treatment. 3. Beyond the principle of informed consent, patients need to be involved in decision-making. For this, the decision process should be explained and broken down. A decision problem is to select the best option among a set of choices. The problem is what is meant by "best option ", or know what criteria guide the choice. The purpose of decision theory is to answer this question. The systematic use of decision models allows us to better understand the differences in medical practices, and facilitates the search for consensus. About this, there are three types of situations: situations certain, risky situations, and uncertain situations: 1. In certain situations, the consequence of each decision are certain. 2. In risky situations, every decision can have several consequences, the probability of each of these consequences is known. 3. In uncertain situations, each decision can have several consequences, the probability is not known. Our aim in this article is to show how decision theory can usefully be mobilized to meet the needs of physicians. The decision theory can make decisions more transparent: first, by clarifying the data systematically considered the problem and secondly by asking a few basic principles should guide the choice. Once the problem and clarified the decision theory provides operational tools to represent the available information and determine patient preferences, and thus assist the patient and doctor in their choices.

Keywords: decision making, medicine, treatment strategies, patient

Procedia PDF Downloads 579
5061 Microgrid: An Alternative of Electricity Supply to an Island in Thailand

Authors: Pawitchaya Srijaiwong, Surin Khomfoi

Abstract:

There are several solutions to supply electricity to an island in Thailand such as diesel generation, submarine power cable, and renewable energy power generation. However, each alternative has its own limitation like fuel and pollution of diesel generation, submarine power cable length resulting in loss of cable and cost of investment, and potential of renewable energy in the local area. This paper shows microgrid system which is a new alternative for power supply to an island. It integrates local power plant from renewable energy, energy storage system, and microgrid controller. The suitable renewable energy power generation on an island is selected from geographic location and potential evaluation. Thus, photovoltaic system and hydro power plant are taken into account. The capacity of energy storage system is also estimated by transient stability study in order to supply electricity demand sufficiently under normal condition. Microgrid controller plays an important role in conducting, communicating and operating for both sources and loads on an island so that its functions are discussed in this study. The conceptual design of microgrid operation is investigated in order to analyze the reliability and power quality. The result of this study shows that microgrid is able to operate in parallel with the main grid and in case of islanding. It is applicable for electricity supply to an island and a remote area. The advantages of operating microgrid on an island include the technical aspect like improving reliability and quality of power system and social aspects like outage cost saving and CO₂ reduction.

Keywords: energy storage, islanding, microgrid, renewable energy

Procedia PDF Downloads 328
5060 Utilization of Juncus acutus as Alternative Feed Resource in Ruminants

Authors: Nurcan Cetinkaya

Abstract:

The aim of this paper is to bring about the utilization of Juncus acutus as an alternative roughage resource in ruminant nutrition. In Turkey, JA is prevailing plant of the natural grassland in Kizilirmak Delta, Samsun. Crude nutrient values such as crude protein (CP), ether extract (EE), organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), and acid detergent lignin(ADL) including antioxidant activity, total phenolic and flavonoid compounds, total organic matter digestibility (OMD) and metabolisable energy (ME) values of Juncus acutus stem, seed, and also its mixture with maize silage were estimated. and published. Furthermore, the effects of JA over rumen cellulolitic bacteria were studied. The obtained results from different studies conducted on JA by our team show that Juncus acutus may be a new roughage source in ruminant nutrition.

Keywords: antioxidant activity, cellulolytic bacteria, Juncus acutus, organic matter digestibility

Procedia PDF Downloads 283
5059 One Step Synthesis of Molybdenum Carbide Nanoparticles for Efficient Hydrogen Evolution Reaction

Authors: Sanjay Upadhyay, Om Prakash Pandey

Abstract:

Hydrogen has been promoted as an alternative source of energy, which is renewable, cost-effective, and nature-friendly. Hydrogen evolution reaction (HER) can be used for mass production of hydrogen at a very low cost through electrochemical water splitting. An active and efficient electrocatalyst is required to perform this reaction. Till date, platinum (Pt) is a stable and efficient electrocatalyst towards HER. But its high cost and low abundance hiders its large scale uses. Molybdenum carbide having a similar electronic structure to platinum can be a great alternative to costly platinum. In this study, pure phase molybdenum carbide (Mo₂C) has been synthesized in a single step. Synthesis temperature and holding time have been optimized to obtain pure phases of Mo₂C. The surface, structural and morphological properties of as-synthesized compounds have been studied. The HER activity of as-synthesized compounds has been explored in detail.

Keywords: capacitance, hydrogen fuel, molybdenum carbide, nanoparticles

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5058 Determination of Critical Organ Doses for Liver Scintigraphy Using Cr-51

Authors: O. Maranci, A. B. Tugrul

Abstract:

Scintigraphy is an imaging method of nuclear events provoked by collisions or charged current interactions with radiation. It is used for diagnostic test used in nuclear medicine via radiopharmaceuticals emitting radiation which is captured by gamma cameras to form two-dimensional images. Liver scintigraphy is widely used in nuclear medicine.Tc-99m and Cr-51 gamma radioisotopes can be used for this purpose. Cr-51 usage is more important for patients’ organ dose that has higher energy and longer half-life as compared to Tc-99m. In this study, it is aimed to determine the required dose for critical organs of patient through liver scintigraphy via Cr-51 gamma radioisotope. Experimental studies were conducted on patients even though conducting experimental studies on patients is extremely difficult for determination of critical organ doses. Torso phantom was utilized to simulate the liver scintigraphy by using 20 mini packages of Cr-51 that were placed on the organ. The radioisotope was produced by irradiation in central thimble of TRIGA MARK II Reactor at 250 KW power. As the results of the study, critical organ doses were determined and evaluated with different critic organs.

Keywords: critical organ doses, liver, scintigraphy, TRIGA Mark-II

Procedia PDF Downloads 556
5057 The Concurrent Effect of Autistic and Schizotypal Traits on Convergent and Divergent Thinking

Authors: Ahmad Abu-Akel, Emilie De Montpellier, Sophie Von Bentivegni, Lyn Luechinger, Alessandro Ishii, Christine Mohr

Abstract:

Convergent and divergent thinking are two main components of creativity that have been viewed as complementary. While divergent thinking refers to the fluency and flexibility of generating new ideas, convergent thinking refers to the ability to systematically apply rules and knowledge to arrive at the optimal solution or idea. These creativity components have been shown to be susceptible to variation in subclinical expressions of autistic and schizotypal traits within the general population. Research, albeit inconclusively, mainly linked positive schizotypal traits with divergent thinking and autistic traits with convergent thinking. However, cumulative evidence suggests that these trait dimensions can co-occur in the same individual more than would be expected by chance and that their concurrent effect can be diametric and even interactive. The current study aimed at investigating the concurrent effect of these trait dimensions on tasks assessing convergent and divergent thinking abilities. We predicted that individuals with high positive schizotypal traits alone would perform particularly well on the divergent thinking task, whilst those with high autistic traits alone would perform particularly well on the convergent thinking task. Crucially, we also predicted that individuals who are high on both autistic and positive schizotypal traits would perform particularly well on both the divergent and convergent thinking tasks. This was investigated in a non-clinical sample of 142 individuals (Males = 45%; Mean age = 21.45, SD = 2.30), sufficient to minimally observe an effect size f² ≥ .10. Divergent thinking was evaluated using the Alternative Uses Task, and convergent thinking with the Anagrams Task. Autistic and schizotypal traits were respectively assessed with the Autism Quotient Questionnaire (AQ) and the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). Regression analyses revealed that the positive association of autistic traits with convergent thinking scores was qualified with an interaction with positive schizotypal traits. Specifically, positive schizotypal traits were negatively associated with convergent thinking scores when AQ scores were relatively low, but this trend was reversed when AQ scores were high. Conversely, the positive effect of AQ scores on convergent thinking progressively increased with increasing positive schizotypal traits. The results of divergent thinking task are currently being analyzed and will be reported at the conference. The association of elevated autistic and positive schizotypal traits with convergent thinking may represent a unique profile of creative thinkers who are able to simultaneously draw on trait-specific advantages conferred by autistic and positively schizotypal traits such as local and global processing. This suggests that main-effect models can tell an incomplete story regarding the effect of autistic and positive schizotypal traits on creativity-related processes. Future creativity research should consider their interaction and the benefits conferred by their co-presence.

Keywords: autism, schizotypy, convergent thinking, divergent thinking, comorbidity

Procedia PDF Downloads 180
5056 The Influense of Alternative Farming Systems on Physical Parameters of the Soil

Authors: L. Masilionyte, S. Maiksteniene

Abstract:

Alternative farming systems are used to cultivate high quality food products and retain the viability and fertility of soil. The field experiments of different farming systems were conducted at Joniškėlis Experimental Station of the Lithuanian Research Centre for Agriculture and Forestry in 2006–2013. The soil of the experimental site was Endocalcari-Endohypogleyic Cambisol (CMg-n-w-can). In different farming systems, farmyard manure, straw and green manure catch crops used for fertilization both in the soil low in humus and in the soil moderate in humus. In the 0–20 cm depth layer, it had a more significant effect on soil moisture than on other physical soil properties. In the agricultural systems, in which catch crops had been grown, soil physical characteristics did not differ significantly before their biomass incorporation, except for the moisture content, which was lower in rainy periods and higher in drier periods than in the soil without catch crops. Soil bulk density and porosity in the topsoil layer were more dependent on soil humus content than on agricultural measures used: in the soil moderate in humus content, compared with the soil low in humus, bulk density was by 1.4 % lower, and porosity by 1.8 % higher. The research findings create a possibility to make improvements in alternative cropping systems by choosing organic fertilizers and catch crops’ combinations that have the sustainable effect on soil and that maintain the sustainability of soil productivity parameters. Rational fertilization systems, securing the stability of soil productivity parameters and crop rotation productivity will promote a development of organic agriculture.

Keywords: agro-measures, soil physical parameters, organic farming, sustainable farming

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5055 An Efficient and Provably Secure Three-Factor Authentication Scheme with Key Agreement

Authors: Mohan Ramasundaram, Amutha Prabakar Muniyandi

Abstract:

Remote user authentication is one of the important tasks for any kind of remote server applications. Several remote authentication schemes are proposed by the researcher for Telecare Medicine Information System (TMIS). Most of the existing techniques have limitations, vulnerable to various kind attacks, lack of functionalities, information leakage, no perfect forward security and ineffectiveness. Authentication is a process of user verification mechanism for allows him to access the resources of a server. Nowadays, most of the remote authentication protocols are using two-factor authentications. We have made a survey of several remote authentication schemes using three factors and this survey shows that the most of the schemes are inefficient and subject to several attacks. We observed from the experimental evaluation; the proposed scheme is very secure against various known attacks that include replay attack, man-in-the-middle attack. Furthermore, the analysis based on the communication cost and computational cost estimation of the proposed scheme with related schemes shows that our proposed scheme is efficient.

Keywords: Telecare Medicine Information System, elliptic curve cryptography, three-factor, biometric, random oracle

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5054 Palliative Care Referral Behavior Among Nurse Practitioners in Hospital Medicine

Authors: Sharon Jackson White

Abstract:

Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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5053 Prevalence of Cyp2d6 and Its Implications for Personalized Medicine in Saudi Arabs

Authors: Hamsa T. Tayeb, Mohammad A. Arafah, Dana M. Bakheet, Duaa M. Khalaf, Agnieszka Tarnoska, Nduna Dzimiri

Abstract:

Background: CYP2D6 is a member of the cytochrome P450 mixed-function oxidase system. The enzyme is responsible for the metabolism and elimination of approximately 25% of clinically used drugs, especially in breast cancer and psychiatric therapy. Different phenotypes have been described displaying alleles that lead to a complete loss of enzyme activity, reduced function (poor metabolizers – PM), hyperfunctionality (ultrarapid metabolizers–UM) and therefore drug intoxication or loss of drug effect. The prevalence of these variants may vary among different ethnic groups. Furthermore, the xTAG system has been developed to categorized all patients into different groups based on their CYP2D6 substrate metabolization. Aim of the study: To determine the prevalence of the different CYP2D6 variants in our population, and to evaluate their clinical relevance in personalized medicine. Methodology: We used the Luminex xMAP genotyping system to sequence 305 Saudi individuals visiting the Blood Bank of our Institution and determine which polymorphisms of CYP2D6 gene are prevalent in our region. Results: xTAG genotyping showed that 36.72% (112 out of 305 individuals) carried the CYP2D6_*2. Out of the 112 individuals with the *2 SNP, 6.23% had multiple copies of *2 SNP (19 individuals out of 305 individuals), resulting in an UM phenotype. About 33.44% carried the CYP2D6_*41, which leads to decreased activity of the CYP2D6 enzyme. 19.67% had the wild-type alleles and thus had normal enzyme function. Furthermore, 15.74% carried the CYP2D6_*4, which is the most common nonfunctional form of the CYP2D6 enzyme worldwide. 6.56% carried the CYP2D6_*17, resulting in decreased enzyme activity. Approximately 5.73% carried the CYP2D6_*10, consequently decreasing the enzyme activity, resulting in a PM phenotype. 2.30% carried the CYP2D6_*29, leading to decreased metabolic activity of the enzyme, and 2.30% carried the CYP2D6_*35, resulting in an UM phenotype, 1.64% had a whole-gene deletion CYP2D6_*5, thus resulting in the loss of CYP2D6 enzyme production, 0.66% carried the CYP2D6_*6 variant. One individual carried the CYP2D6_*3(B), producing an inactive form of the enzyme, which leads to decrease of enzyme activity, resulting in a PM phenotype. Finally, one individual carried the CYP2D6_*9, which decreases the enzyme activity. Conclusions: Our study demonstrates that different CYP2D6 variants are highly prevalent in ethnic Saudi Arabs. This finding sets a basis for informed genotyping for these variants in personalized medicine. The study also suggests that xTAG is an appropriate procedure for genotyping the CYP2D6 variants in personalized medicine.

Keywords: CYP2D6, hormonal breast cancer, pharmacogenetics, polymorphism, psychiatric treatment, Saudi population

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5052 The Capabilities Approach as a Future Alternative to Neoliberal Higher Education in the MENA Region

Authors: Ranya Elkhayat

Abstract:

This paper aims at offering a futures study for higher education in the Middle East. Paying special attention to the negative impacts of neoliberalism, the paper will demonstrate how higher education is now commodified, corporatized and how arts and humanities are eschewed in favor of science and technology. This conceptual paper argues against the neoliberal agenda and aims at providing an alternative exemplified in the Capabilities Approach with special reference to Martha Nussbaum’s theory. The paper is divided into four main parts: the current state of higher education under neoliberal values, a prediction of the conditions of higher education in the near future, the future of higher education using the theoretical framework of the Capabilities Approach, and finally, some areas of concern regarding the approach. The implications of the study demonstrate that Nussbaum’s Capabilities Approach will ensure that the values of education are preserved while avoiding the pitfalls of neoliberalism.

Keywords: capabilities approach, education future, higher education, MENA

Procedia PDF Downloads 197
5051 Using Photo-Elicitation to Explore the Cosmology of Personal Training

Authors: John Gray, Andy Smith, Hazel James

Abstract:

With the introduction of projects such as GP referral and other medical exercise schemes, there has been a shift in the cosmology underpinning exercise leadership. That is, the knowledge base of exercise leaders, specifically personal trainers, has moved from a cosmology based on aesthetic and physical fitness demands to one requiring interaction with the dominant biomedical model underpinning contemporary medicine. In line with this shift research has demonstrated that personal trainer education has aligned itself to a biotechnological model. However, whilst there is a need to examine exercise as medicine, and consider the role of personal trainers as prescribers of these interventions, the possible issues surrounding the growing medicalization of the exercise cosmology have not been explored. Using a phenomenological methodology, and the novel approach of photo-elicitation, this research examined the practices of successful personal trainers. The findings highlight that a growing focus on an iatro-biological based scientific process of exercise prescription may prove problematical. Through the development of a model of practitioner-based knowledge, it is argued there is a possible growing disconnection between the theoretical basis of exercise science and the working cosmology of exercise practitioners.

Keywords: biomedicine, cosmology, personal training, photo-elicitation

Procedia PDF Downloads 380