Search results for: infant head trauma

Authors: Bing Li, Zhi Li, Yilong Yang

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Web classification can promote the quality of service discovery and management in the service repository. It is widely used to locate developers desired services. Although traditional classification methods based on supervised learning models can achieve classification tasks, developers need to manually mark web services, and the quality of these tags may not be enough to establish an accurate classifier for service classification. With the doubling of the number of web services, the manual tagging method has become unrealistic. In recent years, the attention mechanism has made remarkable progress in the field of deep learning, and its huge potential has been fully demonstrated in various fields. This paper designs a multi-head attention graph convolutional network (MHAGCN) service classification method, which can assign different weights to the neighborhood nodes without complicated matrix operations or relying on understanding the entire graph structure. The framework combines the advantages of the attention mechanism and graph convolutional neural network. It can classify web services through automatic feature extraction. The comprehensive experimental results on a real dataset not only show the superior performance of the proposed model over the existing models but also demonstrate its potentially good interpretability for graph analysis.

Keywords: attention mechanism, graph convolutional network, interpretability, service classification, service discovery

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Authors: Adhimoolam Saravana Kumar, K. N. Govindarajan, B. Devanand, R. Rajakumar

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The quality of Computed Tomography (CT) procedures has improved in recent years due to technological developments and increased diagnostic ability of CT scanners. Due to the fact that CT doses are the peak among diagnostic radiology practices, it is of great significance to be aware of patient’s CT radiation dose whenever a CT examination is preferred. CT radiation dose delivered to patients in the form of volume CT dose index (CTDIvol) values, is displayed on scanner monitors at the end of each examination and it is an important fact to assure that this information is accurate. The objective of this study was to estimate the CTDIvol values for great number of patients during the most frequent CT examinations, to study the comparison between CT dose monitor values and measured ones, as well as to highlight the fluctuation of CTDIvol values for the same CT examination at different centres and scanner models. The output CT dose indices measurements were carried out on single and multislice scanners for available kV, 5 mm slice thickness, 100 mA and FOV combination used. The 100 CT scanners were involved in this study. Data with regard to 15,000 examinations in patients, who underwent routine head, chest and abdomen CT were collected using a questionnaire sent to a large number of hospitals. Out of the 15,000 examinations, 5000 were head CT examinations, 5000 were chest CT examinations and 5000 were abdominal CT examinations. Comprehensive quality assurance (QA) was performed for all the machines involved in this work. Followed by QA, CT phantom dose measurements were carried out in South India using actual scanning parameters used clinically by the hospitals. From this study, we have measured the mean divergence between the measured and displayed CTDIvol values were 5.2, 8.4, and -5.7 for selected head, chest and abdomen procedures for protocols as mentioned above, respectively. Thus, this investigation revealed an observable change in CT practices, with a much wider range of studies being performed currently in South India. This reflects the improved capacity of CT scanners to scan longer scan lengths and at finer resolutions as permitted by helical and multislice technology. Also, some of the CT scanners have used smaller slice thickness for routine CT procedures to achieve better resolution and image quality. It leads to an increase in the patient radiation dose as well as the measured CTDIv, so it is suggested that such CT scanners should select appropriate slice thickness and scanning parameters in order to reduce the patient dose. If these routine scan parameters for head, chest and abdomen procedures are optimized than the dose indices would be optimal and lead to the lowering of the CT doses. In South Indian region all the CT machines were routinely tested for QA once in a year as per AERB requirements.

Keywords: CT dose index, weighted CTDI, volumetric CTDI, radiation dose

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Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka

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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.

Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman

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Authors: Lynn Brunet

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In 2019 the author published a book-length study examining Jung’s Red Book. This study consisted of a close reading of each of the chapters in Liber Novus, focussing on the fantasies themselves and Jung’s accompanying paintings. It found that the plots, settings, characters and symbolism in each of these fantasies are not entirely original but remarkably similar to those found in some of the higher degrees of Continental Freemasonry. Jung was the grandson of his namesake, C.G. Jung (1794–1864), who was a Freemason and one-time Grand Master of the Swiss Masonic Lodge. The study found that the majority of Jung’s fantasies are very similar to those of the Ancient and Accepted Scottish Rite, practiced in Switzerland during the time of Jung’s childhood. It argues that the fantasies appear to be memories of a series of terrifying initiatory ordeals conducted using spurious versions of the Masonic rites. Spurious Freemasonry is a term that Masons use for the ‘irregular’ or illegitimate use of the rituals and are not sanctioned by the Order. Since the 1980s there have been multiple reports of ritual trauma amongst a wide variety of organizations, cults and religious groups that psychologists, counsellors, social workers, and forensic scientists have confirmed. The abusive use of Masonic rites features frequently in these reports. This initial study allows a reading of The Red Book that makes sense of the obscure references, bizarre scenarios and intense emotional trauma described by Jung throughout Liber Novus. It suggests that Jung appears to have undergone a cruel initiatory process as a child. The author is currently examining the extra material found in Jung’s Black Books and the results are confirming the original discoveries and demonstrating a number of aspects not covered in the first publication. These include the complex layering of ancient gods and belief systems in answer to Jung’s question, ‘In which underworld am I?’ It demonstrates that the majority of these ancient systems and their gods are discussed in a handbook for the Scottish Rite, Morals and Dogma by Albert Pike, but that the way they are presented by Philemon and his soul is intended to confuse him rather than clarify their purpose. This new study also examines Jung’s soul’s question ‘I am not a human being. What am I then?’ While further themes that emerge from the Black Books include his struggle with vanity and whether he should continue creating his ‘holy book’; and a comparison between Jung’s ‘mystery plays’ and examples from the Theatre of the Absurd. Overall, it demonstrates that Jung’s experience, while inexplicable in his own time, is now known to be the secret and abusive practice of initiation of the young found in a range of cults and religious groups in many first world countries. This paper will present a brief outline of the original study and then examine the themes that have emerged from the extra material found in the Black Books.

Keywords: C. G. Jung, the red book, the black books, masonic themes, trauma and dissociation, initiation rites, secret societies

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: Safa Gharbi, Hayfa Zgaya, Nesrine Zoghlami, Slim Hammadi, Cyril De Barbarin, Laurent Vinatier, Christiane Coupier

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Increasing productivity and quality of service, improving the working comfort and ensuring the efficiency of all processes are important challenges for every warehouse. The order picking is recognized to be the most important and costly activity of all the process in warehouses. This paper presents a new approach using Augmented Reality (AR) in the field of logistics. It aims to create a Head-Up Display (HUD) interface with a Warehouse Management System (WMS), using AR glasses. Integrating AR technology allows the optimization of order picking by reducing time of picking process, increasing the efficiency and delivering quickly. The picker will be able to access immediately to all the information needed for his tasks. All the information is displayed when needed in the field of vision (FOV) of the operator, without any action requested from him. These research works are part of the industrial project RASL (Réalité Augmentée au Service de la Logistique) which gathers two major partners: the LAGIS (Laboratory of Automatics, Computer Engineering and Signal Processing in Lille-France) and Genrix Group, European leader in warehouses logistics, who provided his software for implementation, and his logistics expertise.

Keywords: Augmented Reality (AR), logistics and optimization, Warehouse Management System (WMS), Head-Up Display (HUD)

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: J. E. Cobbinah

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One of the most challenging issues confronting schools is good leadership succession planning. Experts argue that, although the idea of leadership succession planning is one of the strategies or practices that can help sustain improvement and promote continuity of good leadership, seem to have been neglected in many schools over the years. Appointment of head teachers in senior high schools is based on long service or one’s ability to demonstrate his/her competence in a leadership selection interview. There is no clear and well-structured leadership succession plan, before leadership position is filled, while school leadership succession planning seem to be an issue that nobody talks about. In faith-based schools the issue is even worse, because religious groups impose whoever they consider strong in the faith on schools as leaders, irrespective of the individual competence, ability to take up challenges associated with individuals’ preparedness to take up leadership position. Therefore, the present study examined the nature (including type) of leadership succession plans in faith-based senior high schools and its associated challenges. Convergent mixed method design was employed to effectively achieve the objectives of the study. The data collection strategies involved the use of interviews, questionnaires, and reviews of secondary data. The data was gathered from students, school leaders (head teachers, deputy heads, and head of departments), selected parents teachers associated members, school management committee members and members from school governors. The results show that governors of faith-based schools are making efforts to enhance education quality, by making school leadership accountable, the absence and the neglect of clear, and well-structured leadership succession plan has some negative outcomes. Unsustainable students’ academic performance, lack of support from existing staffs and senior leaders and lack of support in the implementation of school improvement plan. It would be concluded that, faith-based schools should focus on leadership competence and abilities in the selection process of potential school leaders to achieve a good succession plan rather than appointing leaders who are affiliates of one’s faith.

Keywords: school leadership, succession planning, faith-based schools, school governors

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Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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Authors: Inna Vinokurova, N. Savvina

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The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

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Authors: Adhara Puspa Noorita, Azkiyatin Nailil M., Rita Aryanti, Sushanti Nuraini, Pujiati Abbas, Suparmi

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T-Dabuto is a tea made from leaves and fruits of parijoto (Madinella speciosa L.), which flavonoid, saponin and tanin contained in that tea are reported have diarrhea-caused antibacterial activity. However, the in vivo antidiarrhea effect have not clear yet. This study was conducted to determine the effect of T-DABUTO to faecal characteristics in male Balb/C-mice induced oleum ricini. Experimental research with post-test only control group design was conducted using 35 young male mice strain Balb-C which was divided into 5 groups. All groups were induced by 0.7 ml/ head of oleum ricini and 3 hours later followed by aquadest for first group, while the 2nd, 3rd, 4th and 5th group were treated by T-DABUTO solution with 75 mg/kgBW, 150 mg/kgBW, 300 mg/kgBW, and 600 mg/kgBW respectively as 0.7 ml/ head/ 0.5 hous for 8 hours. Feces collected were used to identify the frequency, absorbtion diameter and fecal weight. T-DABUTO on dose 75 mg/kg BW has the highest antidiarrhea activity which the mean of frequency defecation, water feacal absorbsion and feacal weight were 1.71±0.95 times, 0.38±0.49 mm, 0.43±0.28 mg, respectively. The T-DABUTO treatment did not influence the body weight of diarrheal mice. The T-DABUTO is potential as one of natural diarrhea tratment, especially in children.

Keywords: diarrhea, flavonid, tannin, saponin

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Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

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Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

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Authors: Ashwini Shripatwar, Mayur Biyani, Nikhil Rao, Rajendra Bodake, Sachin Sane

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This paper documents the correlation of valve cover sealing, cracking, and warpage Finite Element Modelling with observations on engine test development. The valve cover is a component mounted on engine head with a gasket which provides sealing against oil which flows around camshaft, valves, rockers, and other overhead components. Material nonlinearity and contact nonlinearity characteristics are taken into consideration because the valve cover is made of a composite material having temperature dependent elastic-plastic properties and because the gasket load-deformation curve is also nonlinear. The leakage is observed between the valve cover and the engine head due to the insufficient contact pressure. The crack is observed on the valve cover due to force application at a region with insufficient stiffness and with elevated temperature. The valve cover shrinkage is observed during the disassembly process on hot exhaust side bolt holes after the engine has been running. In this paper, an analytical approach is developed to correlate a Finite Element Model with the observed failures and to address the design issues associated with the failure modes in question by making design changes in the model.

Keywords: cracking issue, gasket sealing analysis, nonlinearity of contact and material, valve cover

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Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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Authors: Yi-Ting Chen, Yu-Fang Huang, Pei-Wei Wang, Hai-Wei Liang, Chun-Hao Lai, Mei-Lien Chen

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Background: Bisphenol A (BPA) is commonly used in consumer products, such as inner coatings of cans and polycarbonated bottles. BPA is considered to be an endocrine disrupting substance (EDs) that affects normal human hormones and may cause adverse effects on human health. Pregnant women and fetuses are susceptible groups of endocrine disrupting substances. Prenatal exposure to BPA has been shown to affect the fetus through the placenta. Therefore, it is important to evaluate the potential health risk of fetal exposure to BPA during pregnancy. The aims of this study were (1) to determine the urinary concentration of BPA in pregnant women, and (2) to investigate the association between BPA exposure during pregnancy and birth outcomes. Methods: This study recruited 117 pregnant women and their fetuses from 2012 to 2014 from the Taiwan Maternal- Infant Cohort Study (TMICS). Maternal urine samples were collected in the third trimester and questionnaires were used to collect socio-demographic characteristics, eating habits and medical conditions of the participants. Information about birth outcomes of the fetus was obtained from medical records. As for chemicals analysis, BPA concentrations in urine were determined by off-line solid-phase extraction-ultra-performance liquid chromatography coupled with a Q-Tof mass spectrometer. The urinary concentrations were adjusted with creatinine. The association between maternal concentrations of BPA and birth outcomes was estimated using the logistic regression model. Results: The detection rate of BPA is 99%; the concentration ranges (μg/g) from 0.16 to 46.90. The mean (SD) BPA levels are 5.37(6.42) μg/g creatinine. The mean ±SD of the body weight, body length, head circumference, chest circumference and gestational age at birth are 3105.18 ± 339.53 g, 49.33 ± 1.90 cm, 34.16 ± 1.06 cm, 32.34 ± 1.37 cm and 38.58 ± 1.37 weeks, respectively. After stratifying the exposure levels into two groups by median, pregnant women in higher exposure group would have an increased risk of lower body weight (OR=0.57, 95%CI=0.271-1.193), smaller chest circumference (OR=0.70, 95%CI=0.335-1.47) and shorter gestational age at birth newborn (OR=0.46, 95%CI=0.191-1.114). However, there are no associations between BPA concentration and birth outcomes reach a significant level (p < 0.05) in statistics. Conclusions: This study presents prenatal BPA profiles and infants in northern Taiwan. Women who have higher BPA concentrations tend to give birth to lower body weight, smaller chest circumference or shorter gestational age at birth newborn. More data will be included to verify the results. This report will also present the predictors of BPA concentrations for pregnant women.

Keywords: bisphenol A, birth outcomes, biomonitoring, prenatal exposure

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: C. G. Sawant, C. S. Patil

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The investigation was conducted during January 2016 on Farmer’s field at Nandur Madhyameshwar, Tq. Niphad, Dist. Nashik (Maharashtra: India) on bio-efficacy of newer insecticides against Plutella xylostella L. infesting cabbage. The cabbage crop (var. Saint) was raised according to package of practices except for plant protection measures. Six newer insecticides along with two conventional insecticides and one synthetic pyrethroid were applied twice at 30 and 55 days after transplanting. Insecticidal solutions were diluted in water (375-500 L ha-1) and applied using knapsack sprayer (16L) with hollow cone nozzle. Treatments included indoxacarb @ 40 g a.i.ha-1, spinosad @ 17.5 g a.i.ha-1, flubendiamide @18.24 g a.i. ha-1, diafenthiuron @ 300 g a. i. ha-1, emamectin benzoate @ 10 g a. i. ha-1, chlorantraniliprole @ 10 g a. i. ha-1, quinalphos @ 250 g a. i. ha-1, triazophos @ 500 g a. i. ha-1, bifenthrin @ 50 g a.i. ha-1 and untreated control. The larvae were counted on head and outside the head. Observations were recorded one day before spray (Precount) and 1,3,7,14 days after spray. Results revealed that all the insecticidal treatments were significantly superior over untreated control by recording lower larval count. Among the insecticidal treatments, significantly lowest number of larvae of diamondback moth was recorded in chlorantraniliprole @ 10 g a.i.ha-1 (1.00 larvae plant-1) followed by spinosad @ 17.5 g a.i. ha-1 (1.45 larvae plant-1 and flubendiamide 18.24 g a.i. ha-1(1.53 larvae plant-1). The efficacy of insecticides reflected on yield of marketable cabbage heads by recording 242.27 qt ha-1 (1:33.38) in the treatment of chlorantraniliprole @ 10 g a.i.ha-1. It was followed by spinosad @ 17.5 g a.i. ha-1 with 236.91 qt ha-1 (1:24.92) and flubendiamide 18.24 g a.i. ha-1 with 228.49 qt ha-1 (1:30.43).

Keywords: bio-efficacy, cabbage, chlorantraniliprole, Plutella xylostella L.

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Authors: Kinneret Segal

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The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world, and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives, has not been sufficiently explored. The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life and organizational commitment among midwifery nurses in Israeli hospitals. 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms and organizational commitment, predicted satisfaction from compassion. Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: traumatic experirnces, midwives, quality of life, burnout, organizational commitment, personal resilience

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Authors: Kalpana Rajouriya, Ajay Taneja

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The objective of the present study is to investigate the regional and lobar deposition of size-segregated PM in respiratory tract of human body. PM in different fractions is monitored using the Grimm portable environmental dust monitor during winter season in Firozabad; a Glass city of India. PM10 concentration (200.817g/m³) was 4.46 and 2.0 times higher than the limits prescribed by WHO (45g/m⁻³) and NAAQS (100g/m⁻³) government agencies. PM2.5 concentration (83.538 g/m3) was 5.56 and 1.39 times higher from WHO (15g/m-3) and NAAQS (60g/m⁻³) limits. Results inferred that PM10 and PM2.5 was highest deposited in head region (0.3477-0.5622 & 0.366-0.4704) followed by pulmonary region, especially in the 9-21year old persons. The variation in deposition percentage in our study is mainly due to the airway geometry, PM size, and its deposition mechanisms. The coarse fraction, due to its large size, cannot follow the airway path and mostly gets deposited by inertial impaction in the head region and its bifurcations. The present study results inferred that Coarse and fine PM deposition was highly visualized in 9 (8.45610⁻⁴ g, 2.91110⁻⁴g) year and 3 (1.49610⁻⁴ g, 8.59310⁻⁵g) month age category. So, the 9year children and 3month infants category have high level of health risk.

Keywords: particulate matter, MPPD model, regional deposition, lobar deposition, health risk

Procedia PDF Downloads 35

Authors: C. Nathanailides, S. Anastasiou, P. Logothetis, G. Kanlis

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Production parameters of gilt head sea bream fish farm such as feeding regimes, mortalities, fish densities were used to calculate the economic efficiency of six different aquaculture sites from West Greece. Samples of farmed sea bream were collected and lipid content, microbial load and filleting yield of the samples were used as quality criteria. The results indicate that Lipid content, filleting yield and microbial load of fish originating from different fish farms varied significantly with improved quality exhibited in fish farms which exhibited improved Feed conversion rates and lower mortalities. Changes in feeding management practices such as feed quality and feeding regimes have a significant impact on the financial performance of sea bass farms. Fish farms which exhibited improved feeding conversion rates also exhibited increased profitability. Improvements in the FCR explained about 13.4 % of the difference in profitability of the different aquaculture sites. Lower mortality and higher growth rates were also exhibited by the fish farms which exhibited improved FCR. It is concluded that best feeding management practices resulted in improved product quality and profitability.

Keywords: aquaculture economics, gilt head sea, production fish, feeding management

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Authors: YingWei Tan, XueFeng Ding

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Attention-based voice activity detection models have gained significant attention in recent years due to their fast training speed and ability to capture a wide contextual range. The inclusion of multi-head style and position embedding in the attention architecture are crucial. Having multiple attention heads allows for differential focus on different parts of the sequence, while position embedding provides guidance for modeling dependencies between elements at various positions in the input sequence. In this work, we propose an approach by considering each head as a node, enabling the application of graph neural networks (GNN) to identify correlations among the different nodes. In addition, we adopt an implementation named rotary position embedding (RoPE), which encodes absolute positional information into the input sequence by a rotation matrix, and naturally incorporates explicit relative position information into a self-attention module. We evaluate the effectiveness of our method on a synthetic dataset, and the results demonstrate its superiority over the baseline CRNN in scenarios with low signal-to-noise ratio and noise, while also exhibiting robustness across different noise types. In summary, our proposed framework effectively combines the strengths of CNN and RNN (LSTM), and further enhances detection performance through the integration of graph neural networks and rotary position embedding.

Keywords: voice activity detection, CRNN, graph neural networks, rotary position embedding

Procedia PDF Downloads 41

Authors: Mohammed E. Ibrahim, Baraa A. Taha, Kamil M. A. Shabban

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Background: Epilepsy is a common but widely misunderstood illness. Consequently, patients with epilepsy suffer from considerable stigmatization in society. This social stigma and discrimination often cause more suffering for the patients than the disease itself. Since very few studies have explored the misperceptions about epilepsy among university students in Sudan, it is not possible to provide focused intervention aimed at eliminating this discrimination. Methods: A cross-sectional study was applied among the first-year medical students at the University of Khartoum between December (2020) and February (2021). A 29-item standardized questionnaire was self-administered by 198 students (out of 320) who agreed to participate in this study. Google form was the tool used to collect the data. The data were analyzed using the Statistical Package for Social Science software version 26. Result: Overall, the results indicate a negative trend in knowledge and attitude toward epilepsy. The vast majority of the respondents (84.8%) have read or heard about epilepsy, while 43.9% had seen someone with epilepsy. Only 7.5% of the participants reported that epilepsy is contagious, whereas 43.4% of them think that epilepsy is a psychological disorder. About 62.2% of students think head/birth trauma is a cause of epilepsy. On the other side, about 15.7% and 5.1% believed that evil spirits and punishment from god can also be a possible cause of epilepsy; we found these false beliefs are more common in participants from rural areas (p-value < 0.05). In regard to attitude, 19.7% of students thought that it is inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother’s education as the percentage is higher for those who have lower mother’s education (through secondary school education and below) (p < 0.05). The majority of Our participant knew that some people with epilepsy need life-long drug treatment; this belief was found to be more common in females than their counterparts(p < 0.05). . Finally, most of the respondents (93.9%) thought that a child with epilepsy Can be successful in a normal class. This belief is four-time as common in participants whose mothers have higher education (through university education and above) compared with corresponding respondents (p < 0.05). Conclusion: This study concludes that students' knowledge about epilepsy is limited and requires immediate intervention through educational campaigns to develop a well-informed and tolerant community.

Keywords: epilepsy, awareness, attitude, university students, Sudan

Procedia PDF Downloads 116

Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni

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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.

Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm

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Authors: Asish Subedi, Krishna Pokharel, Birendra Prasad Sah, Pashupati Chaudhary

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Objectives: To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. Methods: In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1 to 3) and a moderate-severe pain group (NRS 4-10). The Spearman correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. Results: As four patients violated the protocol, the data of 131 patients were analysed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ±9.50 compared to 18.64 ±10 mean N-PCS scores by the no-mild pain group (p<0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r =0.39, [95% CI 0.23-0.52], p<0.001) and total tramadol consumption (r =0.32, [95% CI 0.16-0.47], p<0.001). An increase in catastrophizing scores was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p=0.006) after adjusting for gender, ethnicity and preoperative anxiety. Conclusion: Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain.

Keywords: nepali, pain catastrophizing, postoperative pain, trauma

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Authors: Ghada El-Husseiny, Dina Yousri, Christian Richter

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Social services are often characterized by market failures, which justifies government intervention in the provision of these services. It is widely acknowledged that government intervention breeds corruption since resources are being transferred from one party to another. However, what is still being extensively studied is the magnitude of the negative impact of corruption on publicly provided services and development outcomes. Corruption has the power to hinder development and cripple our march towards the Sustainable Development Goals. Corruption diminishes the efficiency and effectiveness of public health and education spending and directly impacts the outcomes of these sectors. This paper empirically examines the impact of Institutional Failure on public sector services provision, with the sole purpose of studying the impact of corruption on SDG3 and 4; Good health and wellbeing and Quality education, respectively. The paper explores the effect of corruption on these goals from various perspectives and extends the analysis by examining if the impact of corruption on these goals differed when it accounted for the current corruption state. Using Pooled OLS(Ordinary Least Square) and Fixed effects panel estimation on 22 corrupt and 22 clean countries between 2000 and 2017. Results show that corruption in both corrupt and clean countries has a more severe impact on Health than the Education sector. In almost all specifications, corruption has an insignificant effect on School Enrollment rates but a significant effect on Infant Mortality rates. Results further indicate that, on average, a 1 point increase in the CPI(Consumer Price Index) can increase health expenditures by 0.116% in corrupt and clean countries. However, the fixed effects model indicates that the way Health and Education expenditures are determined in clean and corrupt countries are completely country-specific, in which corruption plays a minimal role. Moreover, the findings show that School Enrollment rates and Infant Mortality rates depend, to a large extent, on public spending. The most astounding results-driven is that corrupt countries, on average, have more effective and efficient healthcare expenditures. While some insights are provided as to why these results prevail, they should be further researched. All in all, corruption impedes development outcomes, and any Anti-corrupt policies taken will bring forth immense improvements and speed up the march towards sustainability.

Keywords: corruption, education, health, public spending, sustainable development

Procedia PDF Downloads 149

Authors: Çağla Aras, Kübra Bi̇nay, Aysberg Şamil önlü, Mine Baydan Aran, Dicle Aras

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The purpose of the present research was to investigate the acute effects of 30-min hatha yoga and 30-min resistance-based aerobic exercise (RBAE) on computerized dynamic posturography (CDP) and functional head impulse test (fHIT) scores in adult female yoga practitioners. To reach this aim, ten participants executed CDP and fHIT three times in total: at rest, after yoga, and after RBAE. The yoga practice lasted a total of 30 minutes, including 25 min of asanas and 5 minutes of savasana. RBAE lasted a total of 30 minutes with an intensity of 70-75% of the heart rate reserve method. When the results were examined, no change was observed in any parameters of the fHIT scores due to resting or exercise implementation. On the contrary, some changes were observed in CDP test results depending on the type of exercise. The post-RBAE somatosensory and visual systems values were higher than resting (p<0.05). The composite balance score derived after RBAE was found to be improved when compared to post-yoga and resting values (p<0.01). Lastly, the post-RBAE vestibular system score was found to be statistically significantly higher than the post-Yoga values. In addition, it was observed that body composition parameters, especially decreasing BW, LBM, PBF, MBF and TBW, were associated with improved postural stability values. According to the results, it can be stated that neither hatha yoga nor resistance-based aerobic exercise has an acute effect on functional vestibulo-ocular reflex. In addition, although there was no change in balance level after yoga, it was observed that RBAE performed at 70-75% of the heart rate reserve and for 30 minutes had positive acute effects on postural stability and balance.

Keywords: hatha yoga, resistance training, aerobic training, high intensity training, computerized dynamic posturography, functional head impulse test

Procedia PDF Downloads 23

Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan

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Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.

Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan

Procedia PDF Downloads 27

Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

Procedia PDF Downloads 384

Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

Procedia PDF Downloads 235

Authors: Ione Loots, Marco van Dijk, Jay Bhagwan

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Historically, South Africa had various small-scale hydropower installations in remote areas that were not incorporated in the national electricity grid. Unfortunately, in the 1960s most of these plants were decommissioned when Eskom, the national power utility, rapidly expanded its grid and capability to produce cheap, reliable, coal-fired electricity. This situation persisted until 2008, when rolling power cuts started to affect all citizens. This, together with the rising monetary and environmental cost of coal-based power generation, has sparked new interest in small-scale hydropower development, especially in remote areas or at locations (like wastewater treatment works) that could not afford to be without electricity for long periods at a time. Even though South Africa does not have the same, large-scale, hydropower potential as some other African countries, significant potential for micro- and small-scale hydropower is hidden in various places. As an example, large quantities of raw and potable water are conveyed daily under either pressurized or gravity conditions over large distances and elevations. Due to the relative water scarcity in the country, South Africa also has more than 4900 registered dams of varying capacities. However, institutional capacity and skills have not been maintained in recent years and therefore the identification of hydropower potential, as well as the development of micro- and small-scale hydropower plants has not gained significant momentum. An assessment model and decision support system for low head hydropower development has been developed to assist designers and decision makers with first-order potential analysis. As a result, various potential sites were identified and many of these sites were situated at existing infrastructure like weirs, barrages or pipelines. One reason for the specific interest in existing infrastructure is the fact that capital expenditure could be minimized and another is the reduced negative environmental impact compared to greenfield sites. This paper will explore the case study of retrofitting an unconventional and innovative hydropower plant to the outlet of a wastewater treatment works in South Africa.

Keywords: low head hydropower, retrofitting, small-scale hydropower, wastewater treatment works

Procedia PDF Downloads 223