Search results for: injury predictor
812 Impact of Meaning in Life on Stress and Psychological Well-Being
Authors: Aisha Bano, Rizwan Nazir
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The present study aimed at exploring the impact of meaning in life on psychological well-being and stress among university students. Victor Frankl's paradigm provided the theoretical foundation for this study. A sample of 560 university students was drawn from Quaid-i-Azam University Islamabad. The sample was drawn using stratified random sampling technique. Data were collected using Existence Scale, Warwick-Edinburg Mental Well-Being Scale, and Stress Scale. Results of linear regression analysis reveals that high perception of meaning in life will lead to high psychological well-being and low stress among university students. Non-significant differences are found on meaning in life variable with regard to gender in the sample using t-test. Together these results suggest that meaning in life independent of gender, is a significant predictor of the levels of stress and psychological well-being being directly related to psychological well-being and inversely related to stress levels.Keywords: existential meaning in life, psychological well-being, stress, students
Procedia PDF Downloads 497811 The Outcome of Early Balance Exercises and Agility Training in Sports Rehabilitation for Patients Post Anterior Cruciate Ligament (ACL) Reconstruction
Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun
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Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance
Procedia PDF Downloads 250810 Anti-Inflammatory Effect of Carvedilol 1% Ointment in Topical Application to the Animal Model
Authors: Berina Pilipović, Saša Pilipović, Maja Pašić-Kulenović
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Inflammation is the body's response to impaired homeostasis caused by infection, injury or trauma resulting in systemic and local effects. Inflammation causes the body's response to injury and is characterized by a series of events including inflammatory response, response to pain receptors and the recovery process. Inflammation can be acute and chronic. The inflammatory response is described in three different phases. Free radical is an atom or molecule that has the unpaired electron and is therefore generally very reactive chemical species. Biologically important example of reaction with free radicals is called Lipid peroxidation (LP). Lipid peroxidation reactions occur in biological membranes, and if at the outset is not stopped with the action of antioxidants, it will bring damage to the membrane, which results in partial or complete loss of their physiological functions. Calcium antagonists and beta-adrenergic receptor antagonists are known drugs, and for many years and widely used in the treatment of cardiovascular diseases. Some of these compounds also show antioxidant activity. The mechanism of antioxidant activities of calcium antagonists and beta-blockers is unknown, since their structure varies widely. This research investigated the possible local anti-inflammatory activity of ointments containing 1% carvedilol in the white petrolatum USP. Ear inflammation was induced by 3% croton oil acetone solution, in quantity of 10 µl on both mouse ears. Albino Swiss mouse (n = 8) are treated with 2.5 mg/ear ointment, and control group was treated on the same way as previous with hydrocortisone 1% ointment (2.5 mg/ear). The other ear of the same animal was used as control one. Ointments were administered once per day, on the left ear. After treatment, ears were observed for three days. After three days, we measured mass (mg) of 6 mm ear punch of treated and controlled ears. The results of testing anti-inflammatory effects of ointments with carvedilol in the mouse ear model show stronger observed effect than ointment with 1% hydrocortisone in the same basis. Identical results were confirmed by the difference between the mass of 6 mm ears punch. The results were also confirmed by histological examination. Ointments with carvedilol showed significant reduction of the inflammation process caused by croton oil on the mouse inflammation model.Keywords: antioxidant, carvedilol, inflammation, mouse ear
Procedia PDF Downloads 228809 A Study on the Factors Effecting Store Format Selection between SBOand MBOs for Sportswear and Sports Accessories in the Fashion Capital of India-Shillong, Tier III Indian City
Authors: Arnab Banerjee, Deep Sagar Verma
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Tier 3 cities of India is home to one of the fastest growing socio-economic powers in the world and hence is the focus of a lot of business activity as it is almost a blue ocean giving the first mover a huge strategic advantage. Among the various sectors, the retailing is perhaps one of the most promising sectors. The study caries out 129 successfully structured mall-intercept interviews in the town of Shillong, Meghalaya in an attempt to understand the SBO and MBO shoppers. Demographic variables itself does not show any store format preference although discounts do attract the lower income group more while clear difference is observed among genders when it comes to importance of ambience, and it is more pronounced for SBO patrons. SBO patrons are more focused while MBO patrons are more into leisure shopping. Price is the most important predictor of satisfaction especially for MBO shoppers. The market shows three basic segments i.e experiential, relationship and value shoppers.Keywords: demographic variables, degree of importance, degree of satisfaction, SBO and MBO
Procedia PDF Downloads 284808 A Versatile Standing Cum Sitting Device for Rehabilitation and Standing Aid for Paraplegic Patients
Authors: Sasibhushan Yengala, Nelson Muthu, Subramani Kanagaraj
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The abstract reports on the design related to a modular and affordable standing cum sitting device to meet the requirements of paraplegic patients of the different physiques. Paraplegic patients need the assistance of an external arrangement to the lower limbs and trunk to help patients adopt the correct posture while standing abreast gravity. This support can be from a tilt table or a standing frame which the patient can use to stay in a vertical posture. Standing frames are devices fitting to support a person in a weight-bearing posture. Commonly, these devices support and lift the end-user in shifting from a sitting position to a standing position. The merits of standing for a paraplegic patient with a spinal injury are numerous. Even when there is limited control on muscles that ordinarily support the user using the standing frame in a vertical position, the standing stance improves the blood pressure, increases bone density, improves resilience and scope of motion, and improves the user's feelings of well-being by letting the patient stand. One limitation with standing frames is that these devices are typically function definitely; cannot be used for different purposes. Therefore, users are often compelled to purchase more than one of these devices, each being purposefully built for definite activities. Another concern frequent in standing frames is manoeuvrability; it is crucial to provide a convenient adjustment scope for all users. Thus, there is a need to provide a standing frame with multiple uses that can be economical for a larger population. There is also a need to equip added readjustment means in a standing frame to lessen the shear and to accommodate a broad range of users. The proposed Versatile Standing cum Sitting Device (VSD) is designed to change from standing to a comfortable sitting position using a series of mechanisms. First, a locking mechanism is provided to lock the VSD in a standing stance. Second, a dampening mechanism is provided to make sure that the VSD shifts from a standing to a sitting position gradually when the lock mechanism gets disengaged. An adjustment option is offered for the height of the headrest via the use of lock knobs. This device can be used in clinics for rehabilitation purposes irrespective of patient's anthropometric data due to its modular adjustments. It can facilitate the patient's daily life routine while in therapy and giving the patient the comfort to sit when tired. The device also provides the availability of rehabilitation to a common person.Keywords: paraplegic, rehabilitation, spinal cord injury, standing frame
Procedia PDF Downloads 196807 Development & Standardization of a Literacy Free Cognitive Rehabilitation Program for Patients Post Traumatic Brain Injury
Authors: Sakshi Chopra, Ashima Nehra, Sumit Sinha, Harsimarpreet Kaur, Ravindra Mohan Pandey
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Background: Cognitive rehabilitation aims to retrain brain injured individuals with cognitive deficits to restore or compensate lost functions. As illiterates or people with low literacy levels represent a significant proportion of the world, specific rehabilitation modules for such populations are indispensable. Literacy is significantly associated with all neuropsychological measures and retraining programs widely use written or spoken techniques which essentially require the patient to read or write. So, the aim of the study was to develop and standardize a literacy free neuropsychological rehabilitation program for improving cognitive functioning in patients with mild and moderate Traumatic Brain Injury (TBI). Several studies have pointed out to the impairments seen in memory, executive functioning, and attention and concentration post-TBI, so the rehabilitation program focussed on these domains. Visual item memorization, stick constructions, symbol cancellations, and colouring techniques were used to construct the retraining program. Methodology: The development of the program consisted of planning, preparing, analyzing, and revising the different modules. The construction focussed on areas of retraining immediate and delayed visual memory, planning ability, focused and divided attention, concentration, and response inhibition (to control irritability and aggression). A total of 98 home based retraining modules were prepared in the 4 domains (42 for memory, 42 for executive functioning, 7 for attention and concentration, and 7 for response inhibition). The standardization was done on 20 healthy controls to review, select and edit items. For each module, the time, errors made and errors per second were noted down, to establish the difficulty level of each module and were arranged in increasing level of difficulty over a period of 6 weeks. The retraining tasks were then administered on 11 brain injured individuals (5 after Mild TBI and 6 after Moderate TBI). These patients were referred from the Trauma Centre to Clinical Neuropsychology OPD, All India Institute of Medical Sciences, New Delhi, India. Results: The time was taken, errors made and errors per second were analysed for all domains. Education levels were divided into illiterates, up to 10 years, 10 years to graduation and graduation and above. Mean and standard deviations were calculated. Between group and within group analysis was done using the t-test. The performance of 20 healthy controls was analyzed and only a significant difference was observed on the time taken for the attention tasks and all other domains had non-significant differences in performance between different education levels. Comparing the errors, time taken between patient and control group, there was a significant difference in all the domains at the 0.01 level except the errors made on executive functioning, indicating that the tool can successfully differentiate between healthy controls and patient groups. Conclusions: Apart from the time taken for symbol cancellations, the entire cognitive rehabilitation program is literacy free. As it taps the major areas of impairment post-TBI, it could be a useful tool to rehabilitate the patient population with low literacy levels across the world. The next step is already underway to test its efficacy in improving cognitive functioning in a randomized clinical controlled trial.Keywords: cognitive rehabilitation, illiterates, India, traumatic brain injury
Procedia PDF Downloads 326806 Measuring Student Teachers' Attitude and Intention toward Cell-Phone Use for Learning in Nigeria
Authors: Shittu Ahmed Tajudeen
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This study examines student-teachers’ attitude and intention towards cell-phone use for learning. The study involves one hundred and ninety (190) trainee teachers in one of the Institutes of Education in Nigeria. The data of the study was collected through a questionnaire on a rating of seven point likert-type Scale. The data collected was used to test the hypothesized model of the study using Structural Equation Modeling approach. The finding of the study revealed that Perceived Usefulness (PU), Perceived Ease of Use (PEU), Subjective Norm (SN) and Attitude significantly influence students’ intention towards adoption of cell-phone for learning. The study showed that perceived ease of use stands to be the strongest predictor of cell-phone use. The model of the study exhibits a good-fit with the data and provides an explanation on student- teachers’ attitude and intention towards cell-phone for learning.Keywords: cell-phone, adoption, structural equation modeling, technology acceptance model
Procedia PDF Downloads 446805 A Unique Exact Approach to Handle a Time-Delayed State-Space System: The Extraction of Juice Process
Authors: Mohamed T. Faheem Saidahmed, Ahmed M. Attiya Ibrahim, Basma GH. Elkilany
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This paper discusses the application of Time Delay Control (TDC) compensation technique in the juice extraction process in a sugar mill. The objective is to improve the control performance of the process and increase extraction efficiency. The paper presents the mathematical model of the juice extraction process and the design of the TDC compensation controller. Simulation results show that the TDC compensation technique can effectively suppress the time delay effect in the process and improve control performance. The extraction efficiency is also significantly increased with the application of the TDC compensation technique. The proposed approach provides a practical solution for improving the juice extraction process in sugar mills using MATLAB Processes.Keywords: time delay control (TDC), exact and unique state space model, delay compensation, Smith predictor.
Procedia PDF Downloads 81804 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures
Authors: Brandon Knopp, Matthew Harris
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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation
Procedia PDF Downloads 136803 Antigen Stasis can Predispose Primary Ciliary Dyskinesia (PCD) Patients to Asthma
Authors: Nadzeya Marozkina, Joe Zein, Benjamin Gaston
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Introduction: We have observed that many patients with Primary Ciliary Dyskinesia (PCD) benefit from asthma medications. In healthy airways, the ciliary function is normal. Antigens and irritants are rapidly cleared, and NO enters the gas phase normally to be exhaled. In the PCD airways, however, antigens, such as Dermatophagoides, are not as well cleared. This defect leads to oxidative stress, marked by increased DUOX1 expression and decreased superoxide dismutase [SOD] activity (manuscript under revision). H₂O₂, in high concentrations in the PCD airway, injures the airway. NO is oxidized rather than being exhaled, forming cytotoxic peroxynitrous acid. Thus, antigen stasis on PCD airway epithelium leads to airway injury and may predispose PCD patients to asthma. Indeed, recent population genetics suggest that PCD genes may be associated with asthma. We therefore hypothesized that PCD patients would be predisposed to having asthma. Methods. We analyzed our database of 18 million individual electronic medical records (EMRs) in the Indiana Network for Patient Care research database (INPCR). There is not an ICD10 code for PCD itself; code Q34.8 is most commonly used clinically. To validate analysis of this code, we queried patients who had an ICD10 code for both bronchiectasis and situs inversus totalis in INPCR. We also studied a validation cohort using the IBM Explorys® database (over 80 million individuals). Analyses were adjusted for age, sex and race using a 1 PCD: 3 controls matching method in INPCR and multivariable logistic regression in the IBM Explorys® database. Results. The prevalence of asthma ICD10 codes in subjects with a code Q34.8 was 67% vs 19% in controls (P < 0.0001) (Regenstrief Institute). Similarly, in IBM*Explorys, the OR [95% CI] for having asthma if a patient also had ICD10 code 34.8, relative to controls, was =4.04 [3.99; 4.09]. For situs inversus alone the OR [95% CI] was 4.42 [4.14; 4.71]; and bronchiectasis alone the OR [95% CI] =10.68 (10.56; 10.79). For both bronchiectasis and situs inversus together, the OR [95% CI] =28.80 (23.17; 35.81). Conclusions: PCD causes antigen stasis in the human airway (under review), likely predisposing to asthma in addition to oxidative and nitrosative stress and to airway injury. Here, we show that, by several different population-based metrics, and using two large databases, patients with PCD appear to have between a three- and 28-fold increased risk of having asthma. These data suggest that additional studies should be undertaken to understand the role of ciliary dysfunction in the pathogenesis and genetics of asthma. Decreased antigen clearance caused by ciliary dysfunction may be a risk factor for asthma development.Keywords: antigen, PCD, asthma, nitric oxide
Procedia PDF Downloads 95802 Parenting Styles and Their Relation to Videogame Addiction
Authors: Petr Květon, Martin Jelínek
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We try to identify the role of various aspects of parenting style in the phenomenon of videogame playing addiction. Relevant self-report questionnaires were part of a wider set of methods focused on the constructs related to videogame playing. The battery of methods was administered in school settings in paper and pencil form. The research sample consisted of 333 (166 males, 167 females) elementary and high school students at the age between 10 and 19 years (m=14.98, sd=1.77). Using stepwise regression analysis, we assessed the influence of demographic variables (gender and age) and parenting styles. Age and gender together explained 26.3% of game addiction variance (F(2,330)=58.81, p<.01). By adding four aspect of parenting styles (inconsistency, involvement, control, and warmth) another 10.2% of variance was explained (∆F(4,326)=13.09, p<.01). The significant predictor was gender of the respondent, where males scored higher on game addiction scale (B=0.70, p<.01), age (β=-0.18, p<.01), where younger children showed higher level of addiction, and parental inconsistency (β=0.30, p<.01), where the higher the inconsistency in upbringing, the more developed game playing addiction.Keywords: gender, parenting styles, video games, addiction
Procedia PDF Downloads 347801 Common Soccer Injuries and Its Risk Factors: A Systematic Review
Authors: C. Brandt, R. Christopher, N. Damons
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Background: Soccer is one of the most common sports in the world. It is associated with a significant chance of injury either during training or during the course of an actual match. Studies on the epidemiology of soccer injuries have been widely conducted, but methodological appraisal is lacking to make evidence-based decisions. Objectives: The purpose of this study was to conduct a systematic review of common injuries in soccer and their risk factors. Methods: A systematic review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were searched. The quality of selected studies was rated, and data extracted and tabulated. Plot data analysis was done, and incidence rates and odds ratios were calculated, with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The search yielded 62 studies, of which 21 were screened for inclusion. A total of 16 studies were included for the analysis, ten for qualitative and six for quantitative analysis. The included studies had, on average, a low risk of bias and good methodological quality. The heterogeneity amongst the pooled studies was, however, statistically significant (χ²-p value < 0.001). The pooled results indicated a high incidence of soccer injuries at an incidence rate of 6.83 per 1000 hours of play. The pooled results also showed significant evidence of risk factors and the likelihood of injury occurrence in relation to these risk factors (OR=1.12 95% CI 1.07; 1.17). Conclusion: Although multiple studies are available on the epidemiology of soccer injuries and risk factors, only a limited number of studies were of sound methodology to be included in a review. There was also significant heterogeneity amongst the studies. The incidence rate of common soccer injuries was found to be 6.83 per 1000 hours of play. This incidence rate is lower than the values reported by the majority of previous studies on the occurrence of common soccer injuries. The types of common soccer injuries found by this review support the soccer injuries pattern reported in existing literature as muscle strain and ligament sprain of varying severity, especially in the lower limbs. The risk factors that emerged from this systematic review are predominantly intrinsic risk factors. The risk factors increase the risk of traumatic and overuse injuries of the lower extremities such as hamstrings and groin strains, knee and ankle sprains, and contusion.Keywords: incidence, prevalence, risk factors, soccer injuries
Procedia PDF Downloads 176800 IL6/PI3K/mTOR/GFAP Molecular Pathway Role in COVID-19-Induced Neurodegenerative Autophagy, Impacts and Relatives
Authors: Mohammadjavad Sotoudeheian
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COVID-19, which began in December 2019, uses the angiotensin-converting enzyme 2 (ACE2) receptor to enter and spread through the cells. ACE2 mRNA is present in almost every organ, including nasopharynx, lung, as well as the brain. Ports of entry of SARS-CoV-2 into the central nervous system (CNS) may include arterial circulation, while viremia is remarkable. However, it is imperious to develop neurological symptoms evaluation CSF analysis in patients with COVID-19, but theoretically, ACE2 receptors are expressed in cerebellar cells and may be a target for SARS-CoV-2 infection in the brain. Recent evidence agrees that SARS-CoV-2 can impact the brain through direct and indirect injury. Two biomarkers for CNS injury, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NFL) detected in the plasma of patients with COVID-19. NFL, an axonal protein expressed in neurons, is related to axonal neurodegeneration, and GFAP is over-expressed in CNS inflammation. GFAP cytoplasmic accumulation causes Schwan cells to misfunction, so affects myelin generation, reduces neuroskeletal support over NfLs during CNS inflammation, and leads to axonal degeneration. Interleukin-6 (IL-6), which extensively over-express due to interleukin storm during COVID-19 inflammation, regulates gene expression, as well as GFAP through STAT molecular pathway. IL-6 also impresses the phosphoinositide 3-kinase (PI3K)/STAT/smads pathway. The PI3K/ protein kinase B (Akt) pathway is the main modulator upstream of the mammalian target of rapamycin (mTOR), and alterations in this pathway are common in neurodegenerative diseases. Most neurodegenerative diseases show a disruption of autophagic function and display an abnormal increase in protein aggregation that promotes cellular death. Therefore, induction of autophagy has been recommended as a rational approach to help neurons clear abnormal protein aggregates and survive. The mTOR is a major regulator of the autophagic process and is regulated by cellular stressors. The mTORC1 pathway and mTORC2, as complementary and important elements in mTORC1 signaling, have become relevant in the regulation of the autophagic process and cellular survival through the extracellular signal-regulated kinase (ERK) pathway.Keywords: mTORC1, COVID-19, PI3K, autophagy, neurodegeneration
Procedia PDF Downloads 83799 The Impact of HRM Practices and Brand Performance on Financial Institution Performance: An Empirical Study
Authors: M. Khasro Miah, Chowdhury Hossan Golam, Muhammed Siddique Hossain
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Recently, financial institution brand image is turning out to be pretty weak due to the presence of strong local competitors and this in term is affecting their firm performance also. In this study, four major HR practices, namely employee commitment, empowerment, loyalty, and engagement are considered in order to measure its effects on the brand and financial performance of banking organization. This study finds that the banking institutions of Bangladesh are more customer oriented rather than internal employee oriented, which makes it quite obvious that the internal HR practices will have little or no effect on the banks brand performance. Employee Commitment has emerged out to be the most important predictor, followed by employee loyalty and empowerment. The employees are well-empowered, engaged, and shows loyalty towards the organization, but their activities are not well linked with the brand. Firms should concentrate to create a congenial working atmosphere and employees should feel like a part of the organization.Keywords: HR in bank, employee commitment, empowerment, finance, employee commitment, loyalty and engagement
Procedia PDF Downloads 472798 In-Depth Investigations on the Sequences of Accidents of Powered Two Wheelers Based on Police Crash Reports of Medan, North Sumatera Province Indonesia, Using Decision Aiding Processes
Authors: Bangun F., Crevits B., Bellet T., Banet A., Boy G. A., Katili I.
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This paper seeks the incoherencies in cognitive process during an accident of Powered Two Wheelers (PTW) by understanding the factual sequences of events and causal relations for each case of accident. The principle of this approach is undertaking in-depth investigations on case per case of PTW accidents based on elaborate data acquisitions on accident sites that officially stamped in Police Crash Report (PCRs) 2012 of Medan with criteria, involved at least one PTW and resulted in serious injury and fatalities. The analysis takes into account four modules: accident chronologies, perpetrator, and victims, injury surveillance, vehicles and road infrastructures, comprising of traffic facilities, road geometry, road alignments and weather. The proposal for improvement could have provided a favorable influence on the chain of functional processes and events leading to collision. Decision Aiding Processes (DAP) assists in structuring different entities at different decisional levels, as each of these entities has its own objectives and constraints. The entities (A) are classified into 6 groups of accidents: solo PTW accidents; PTW vs. PTW; PTW vs. pedestrian; PTW vs. motor-trishaw; and PTW vs. other vehicles and consecutive crashes. The entities are also distinguished into 4 decisional levels: level of road users and street systems; operational level (crash-attended police officers or CAPO and road engineers), tactical level (Regional Traffic Police, Department of Transportation, and Department of Public Work), and strategic level (Traffic Police Headquarters (TCPHI)), parliament, Ministry of Transportation and Ministry of Public Work). These classifications will lead to conceptualization of Problem Situations (P) and Problem Formulations (I) in DAP context. The DAP concerns the sequences process of the incidents until the time the accident occurs, which can be modelled in terms of five activities of procedural rationality: identification on initial human features (IHF), investigation on proponents attributes (PrAT), on Injury Surveillance (IS), on the interaction between IHF and PrAt and IS (intercorrelation), then unravel the sequences of incidents; filtering and disclosure, which include: what needs to activate, modify or change or remove, what is new and what is priority. These can relate to the activation or modification or new establishment of law. The PrAt encompasses the problems of environmental, road infrastructure, road and traffic facilities, and road geometry. The evaluation model (MP) is generated to bridge P and I since MP is produced by the intercorrelations among IHF, PrAT and IS extracted from the PCRs 2012 of Medan. There are 7 findings of incoherences: lack of knowledge and awareness on the traffic regulations and the risks of accidents, especially when riding between 0 < x < 10 km from house, riding between 22 p.m.–05.30 a.m.; lack of engagements on procurement of IHF Data by CAPO; lack of competency of CAPO on data procurement in accident-sites; no intercorrelation among IHF and PrAt and IS in the database systems of PCRs; lack of maintenance and supervision on the availabilities and the capacities of traffic facilities and road infrastructure; instrumental bias with wash-back impacts towards the TCPHI; technical robustness with wash-back impacts towards the CAPO and TCPHI.Keywords: decision aiding processes, evaluation model, PTW accidents, police crash reports
Procedia PDF Downloads 154797 Company's Orientation and Human Resource Management Evolution in Technological Startup Companies
Authors: Yael Livneh, Shay Tzafrir, Ilan Meshoulam
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Technological startup companies have been recognized as bearing tremendous potential for business and economic success. However, many entrepreneurs who produce promising innovative ideas fail to implement them as successful businesses. A key argument for such failure is the entrepreneurs' lack of competence in adaptation of the relevant level of formality of human resource management (HRM). The purpose of the present research was to examine multiple antecedents and consequences of HRM formality in growing startup companies. A review of the research literature identified two central components of HRM formality: HR control and professionalism. The effect of three contextual predictors was examined. The first was an intra-organizational factor: the development level of the organization. We based on a differentiation between knowledge exploration and knowledge exploitation. At a given time, the organization chooses to focus on a specific mix of these orientations, a choice which requires an appropriate level of HRM formality, in order to efficiently overcome the challenges. It was hypothesized that the mix of orientations of knowledge exploration and knowledge exploitation would predict HRM formality. The second predictor was the personal characteristics the organization's leader. According the idea of blueprint effect of CEO's on HRM, it was hypothesized that the CEO's cognitive style would predict HRM formality. The third contextual predictor was an external organizational factor: the level of investor involvement. By using the agency theory, and based on Transaction Cost Economy, it was hypothesized that the level of investor involvement in general management and HRM would be positively related to the HRM formality. The effect of formality on trust was examined directly and indirectly by the mediation role of procedural justice. The research method included a time-lagged field study. In the first study, data was obtained using three questionnaires, each directed to a different source: CEO, HR position-holder and employees. 43 companies participated in this study. The second study was conducted approximately a year later. Data was recollected using three questionnaires by reapplying the same sample. 41 companies participated in the second study. The organizations samples included technological startup companies. Both studies included 884 respondents. The results indicated consistency between the two studies. HRM formality was predicted by the intra-organizational factor as well as the personal characteristics of the CEO, but not at all by the external organizational context. Specifically, the organizational orientations was the greatest contributor to both components of HRM formality. The cognitive style predicted formality to a lesser extent. The investor's involvement was found not to have any predictive effect on the HRM formality. The results indicated a positive contribution to trust in HRM, mainly via the mediation of procedural justice. This study contributed a new concept for technological startup company development by a mixture of organizational orientation. Practical implications indicated that the level of HRM formality should be matched to that of the company's development. This match should be challenged and adjusted periodically by referring to the organization orientation, relevant HR practices, and HR function characteristics. A relevant matching could enhance further trust and business success.Keywords: control, formality, human resource management, organizational development, professionalism, technological startup company
Procedia PDF Downloads 257796 Early Metastatic Cancer: A Review of Its Management and Outcomes
Authors: Diwei Lin, Amanda Jia Hui Tan
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In 2012, testicular cancer was estimated to account for 940 disability adjusted life years in Australia; of these, 450 were years lost due to premature death and 500 were years of healthy life lost due to disease, disability or injury. Testicular choriocarcinoma is one of the rarest variants of testicular germ cell tumours, accounting for less than 1% of testicular germ cell tumours and only about 0.19% of all testicular tumours. Management involves radical orchiectomy followed by chemotherapy. Even then, the prognosis is extremely poor. This case report describes a 20-year-old male with pure testicular choriocarcinoma with pulmonary metastases.Keywords: testicular cancer, choriocarcinoma, cryptorchidism, chemotherapy, metastatic testicular cancer
Procedia PDF Downloads 356795 Employing Motivation, Enjoyment and Self-Regulation to Predict Aural Vocabulary Knowledge
Authors: Seyed Mohammad Reza Amirian, Seyedeh Khadije Amirian, Maryam Sabouri
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The present study aimed to investigate second language (L2) motivation, enjoyment, and self-regulation as the main variables for explaining variance in the process, and to find out the outcome of L2 Aural Vocabulary Knowledge (AVK) development by focusing on the Iranian EFL students at Hakim Sabzevari University. To this end, 122 EFL students (86 females) and (36 males) participated in this study. The students filled out the Motivation Questionnaire, Foreign Language Enjoyment Questionnaire, and Self-Regulation Questionnaire and also took Aural Vocabulary Knowledge (AVK) Test. Using SPSS software, the data were analyzed through multiple regressions and path analysis. A preliminary Pearson correlation analysis revealed that 2 out of 3 independent variables were significantly linked to AVK. According to the obtained regression model, self-regulation was a significant predictor of aural vocabulary knowledge test. Finally, the results of the mediation analysis showed that the indirect effect of enjoyment on AVK through self- regulation was significant. These findings are discussed, and implications are offered.Keywords: aural vocabulary knowledge, enjoyment, motivation, self-regulation
Procedia PDF Downloads 146794 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes
Authors: M. Walmsley, S. Elmatarri, S. Mannion
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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management
Procedia PDF Downloads 177793 High Injury Prevalence in Adolescent Field Hockey Players: Implications for Future Practice
Authors: Pillay J. D., D. De Wit, J. F. Ducray
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Field hockey is a popular international sport which is played in more than 100 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk of pain and injury to the lumbar spine. The aim of this study was to determine the prevalence and incidence of low back pain (LBP) in male adolescent field hockey players and the characteristics of LBP in terms of location, chronicity, disability, and treatment sought, as well as its association with selected risk factors. A survey was conducted on 112 male adolescent field hockey players in the eThekwini Municipality of KwaZulu-Natal, South Africa. The questionnaire contained sections on the demographics of participants, general characteristics of participants, health and lifestyle characteristics, low back pain patterns, treatment of low back pain, and the level of disability associated with LBP. The data were statistically analysed using IBM SPSS version 25 with statistical significance set at p-value <0.05. Descriptive statistics such as mean and standard deviation were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi-square test and t-tests as appropriate. A total of 68 questionnaires were completed for analysis (67% participation rate); the period prevalence of LBP was 63.2% (35.0%:beginning of the season, 32.4%:mid-season, 22.1%: end of season). Incidence was 38.2%. The most common location for LBP was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their LBP. An interesting finding was the association between hydration and LBP (p = 0.050), i.e., those individuals who did not hydrate frequently during matches and training were significantly more likely to experience LBP. The results of this study, although limited to a select group of adolescents, showed a higher prevalence of LBP than that of previous studies. More importantly, even though most participants did not experience LBP classified as a disability, LBP still had a large impact on participants, as nearly half of the participants consulted with a medical professional for treatment. Need for the application of further strategies in the prevention and management of LBP in field hockey, such as adequate warm-up and cool-down, stretching exercises, rest between sessions, etc., are recommended as simple strategies to reduce LBP prevalence.Keywords: adolescents, field hockey players, incidence, low back pain, prevalence, risk factors
Procedia PDF Downloads 53792 Work-Related Shoulder Lesions and Labor Lawsuits in Brazil: Cross-Sectional Study on Worker Health Actions Developed by Employers
Authors: Reinaldo Biscaro, Luciano R. Ferreira, Leonardo C. Biscaro, Raphael C. Biscaro, Isabela S. Vasconcelos, Laura C. R. Ferreira, Cristiano M. Galhardi, Erica P. Baciuk
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Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.Keywords: work-related accidents, cross-sectional study, shoulder lesions, labor lawsuits
Procedia PDF Downloads 207791 Managing and Sustaining Strategic Relationships with Distributors by Electronic Agencies in Jordan
Authors: Abdallah Q. Bataineh
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The electronics market in Jordan is facing extraordinary expectations from consumers, whose opinions are progressively more essential and have effective power on the overall marketing strategy preparation and execution by electronics agents. This research aimed to explore the effect of price volatile, follow-up, maintenance and warranty policy on distributor’s retention. Focus group, in-depth interviews, and self-administered questionnaire were held with a total sample of 50 electronics distribution stores who have a direct contact and purchase frequently from electronic agencies. By using descriptive statistics and multiple regression tests, the main findings of this research is that there is an impact of price volatile, follow-up, maintenance and warranty policy on distributor’s retention, and the key predictor variable was price volatile. Thus, the researcher recommended flat rate pricing strategy to ensure that all distributors will sell the product on the same pricing base, regardless of the generated margin by each one of them. Moreover, conclusion and future research were also discussed.Keywords: distributors retention, follow-up, maintenance, price volatile, warranty policy
Procedia PDF Downloads 235790 Analysing the Variables That Affect Digital Game-Based L2 Vocabulary Learning
Authors: Jose Ramon Calvo-Ferrer
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Video games have been extensively employed in educational contexts to teach contents and skills, upon the premise that they engage students and provide instant feedback, which makes them adequate tools in the field of education and training. Term frequency, along with metacognition and implicit corrective feedback, has often been identified as powerful variables in the learning of vocabulary in a foreign language. This study analyses the learning of L2 mobile operating system terminology by a group of students and uses the data collected by the video game The Conference Interpreter to identify the predictive strength of term frequency (times a term is shown), positive metacognition (times a right answer is provided), and negative metacognition (times a term is shown as wrong) regarding L2 vocabulary learning and perceived learning outcomes. The regression analysis shows that the factor ‘positive metacognition’ is a positive predictor of both dependent variables, whereas the other factors seem to have no statistical effect on any of them.Keywords: digital game-based learning, feedback, metacognition, frequency, video games
Procedia PDF Downloads 148789 Detecting and Secluding Route Modifiers by Neural Network Approach in Wireless Sensor Networks
Authors: C. N. Vanitha, M. Usha
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In a real world scenario, the viability of the sensor networks has been proved by standardizing the technologies. Wireless sensor networks are vulnerable to both electronic and physical security breaches because of their deployment in remote, distributed, and inaccessible locations. The compromised sensor nodes send malicious data to the base station, and thus, the total network effectiveness will possibly be compromised. To detect and seclude the Route modifiers, a neural network based Pattern Learning predictor (PLP) is presented. This algorithm senses data at any node on present and previous patterns obtained from the en-route nodes. The eminence of any node is upgraded by their predicted and reported patterns. This paper propounds a solution not only to detect the route modifiers, but also to seclude the malevolent nodes from the network. The simulation result proves the effective performance of the network by the presented methodology in terms of energy level, routing and various network conditions.Keywords: neural networks, pattern learning, security, wireless sensor networks
Procedia PDF Downloads 401788 Sportomics Analysis of Metabolic Responses in Olympic Sprint Canoeists
Authors: A. Magno-França, A. M. Magalhães-Neto, F. Bachini, E. Cataldi, A. Bassini, L. C. Cameron
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Sprint canoeing (SC) is part of the Olympic Games since 1936. Athletes compete in solo or double races of 200m and 1000m (40 sec and 240 sec, respectively). Due to its high intensity and duration, SC is extremely useful to study the blood kinetics of some metabolites in high energetic demand. Sportomics is a field of study combining “-omics” sciences with classical biochemical analyses in order to understand sports induced systemic changes. Here, we compare Sportomics findings during SC training sessions to describe metabolic responses of five top-level canoeists. Five Olympic world-class male athletes were evaluated during two days of training.Keywords: biochemistry of exercise, metabolomics, injury markers, sportomics
Procedia PDF Downloads 514787 Estimation of Functional Response Model by Supervised Functional Principal Component Analysis
Authors: Hyon I. Paek, Sang Rim Kim, Hyon A. Ryu
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In functional linear regression, one typical problem is to reduce dimension. Compared with multivariate linear regression, functional linear regression is regarded as an infinite-dimensional case, and the main task is to reduce dimensions of functional response and functional predictors. One common approach is to adapt functional principal component analysis (FPCA) on functional predictors and then use a few leading functional principal components (FPC) to predict the functional model. The leading FPCs estimated by the typical FPCA explain a major variation of the functional predictor, but these leading FPCs may not be mostly correlated with the functional response, so they may not be significant in the prediction for response. In this paper, we propose a supervised functional principal component analysis method for a functional response model with FPCs obtained by considering the correlation of the functional response. Our method would have a better prediction accuracy than the typical FPCA method.Keywords: supervised, functional principal component analysis, functional response, functional linear regression
Procedia PDF Downloads 67786 Heart Attack Prediction Using Several Machine Learning Methods
Authors: Suzan Anwar, Utkarsh Goyal
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Heart rate (HR) is a predictor of cardiovascular, cerebrovascular, and all-cause mortality in the general population, as well as in patients with cardio and cerebrovascular diseases. Machine learning (ML) significantly improves the accuracy of cardiovascular risk prediction, increasing the number of patients identified who could benefit from preventive treatment while avoiding unnecessary treatment of others. This research examines relationship between the individual's various heart health inputs like age, sex, cp, trestbps, thalach, oldpeaketc, and the likelihood of developing heart disease. Machine learning techniques like logistic regression and decision tree, and Python are used. The results of testing and evaluating the model using the Heart Failure Prediction Dataset show the chance of a person having a heart disease with variable accuracy. Logistic regression has yielded an accuracy of 80.48% without data handling. With data handling (normalization, standardscaler), the logistic regression resulted in improved accuracy of 87.80%, decision tree 100%, random forest 100%, and SVM 100%.Keywords: heart rate, machine learning, SVM, decision tree, logistic regression, random forest
Procedia PDF Downloads 135785 Language Anxiety and Motivation as Predictors of English as a Foreign Language Achievement
Authors: Fakieh Alrabai
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The present study examines the predictive power of foreign language anxiety and motivation, as two significant affective variables, in English as a foreign language (EFL) achievement. It also explores the causal relationship between these two factors (i.e. which variable causes the other); and which one of them best predicts other affective factors including learner attitude, self-esteem, and autonomy. The study utilized experimental treatments among 210 Saudi EFL learners divided into four groups. Group 1 was exposed to anxiety-controlling moments, group 2 was exposed to motivational moments, group 3 was exposed to anxiety-controlling and motivational moments together, and group 4 was exposed to no specific anxiety or motivation strategies. The influence of the treatment on the study variables was evaluated using a triangulation of measurements including questionnaires, classroom observations, and achievement tests. Descriptive analysis, ANOVA, ANCOVA, and regression analyses have been deployed to figure out the study findings. While both motivation and anxiety significantly predicted learners EFL achievement, motivation has been found to be the best predictor of learners’ achievement; and therefore, operates as the mediator of EFL achievement.Keywords: motivation, anxiety, achievement, autonomy
Procedia PDF Downloads 121784 A Comparative Study to Evaluate Changes in Intraocular Pressure with Thiopentone Sodium and Etomidate in Patients Undergoing Surgery for Traumatic Brain Injury
Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur
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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.Keywords: etomidate, intraocular pressure, thiopentone, traumatic
Procedia PDF Downloads 122783 Socio-Demographic Predictors of Divorce Adjustment in Pakistani Women
Authors: Rukhsana Kausar, Nida Zafar
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The present research investigated socio-demographic predictors of divorce adjustment in Pakistani women. The sample comprised of 80 divorced women from different areas of Lahore. Self developed Socio-Demographic predictor scale and Divorce Adjustment Scale by (Fisher, 2001) was used for assessment. Analyses showed that working divorced women living with joint family system are more adjusted as compared to non-working divorced women living with joint family system. Women having one child are more adjusted as compared to women having more than one child. Findings highlight importance of presence of father for healthy development of adolescents. Adjustment of divorcee women was positively associated with income, social support from the family, having favorable attitudes toward marital dissolution prior to divorce, and being the partner who initiated the divorce. In addition, older women showed some evidence of poorer adjustment than did younger women. Findings highlight importance of support for divorce adjustment.Keywords: socio-demographic, adjustment, women, divorce
Procedia PDF Downloads 461