Search results for: stroke rehabilitation

Authors: Kwanchai Ratanamanee, Pattra Ahmadi Pirshahid, Yaowaluk Khamphan, Sirinan Thubthimthad

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Obesity is a main global health problem. The obesity rated has continued to be higher and higher. It causes to serious systems, diabetes, coronary artery disease, stroke, and some types of cancer. Oristat is one of the best drugs worldwide used as a pancreatic lipase inhibitor. To develop the new therapeutic drugs from medicinal plant always explored. In this study, 24 medicinal plants were investigated for their pancreatic lipase and cholesterol esterase inhibitory effects with Fluorometer assay and oristat as a positive control. It showed that the ethanolic extract of pods of Acacia concinna (Willd.) D.C., possess pancreatic lipase and cholesterol esterase inhibitory activities of IC50 at 2.73 and 3.77 mg/ml respectively as well as oral acute toxicity of the extract (LD50) was 6,300 mg/kg body weight. The extract of A.concinna should be further investigated in animal testing. The results of pancreatic lipase and cholesterol esterase inhibitor of the extracts will lead us to utilize A.concinna for developing as obesity dietary supplement from a medicinal plant.

Keywords: Acacia concinna (Willd.) D. C., cholesterol esterase, obesity, pancreatic lipase

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Authors: Sangbok Lee

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There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

Procedia PDF Downloads 232

Authors: Kazem Bashirnezhad, Seyed Ahmad Kebriyaee, saeed hoseyngholizadeh moghadam

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The urea–SCR catalyst system has the advantages of high NOx conversion efficiency and a wide range of operating conditions. The key factors for successful implementation of urea–SCR technology is good mixing of urea (ammonia) and gas to reduce ammonia slip. Urea mixer components are required to facilitate evaporation and mixing, because it is difficult to evaporate urea in the liquid state; the injection parameters are the most critical factors affecting mixer performance. In this study, The effect of urea injection on NOx emissions in a six-cylinder, four-stroke internal combustion engine fueled with B80 biodiesel has been experimentally investigated. The results reveal that urea injection leads to a reduction of NOx emissions of B80 biodiesel fuel. Moreover, the influence of injection parameters on NOx reductions has been studied. The findings show that by increasing the injection temperature, more reduction in NOx emissions has been occurred. Also, urea mass flow rate increment leads to more NOx reduction. The same result has been obtained by an increase in spray angle.

Keywords: urea, NOx emissions, diesel engines, biodiesels

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Randall E. Osborne, Seth A. Doty

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As participation in organized sports increases, so does the risk of sustaining an athletic injury. These unfortunate injuries result in missed time from practice and, inevitably, the field of competition. Recovery time plays a pivotal role in the overall rehabilitation of the athlete. With time and rehabilitation, an athlete’s physical injury can be properly treated. However, there seem to be few measures assessing psychological recovery from injury. Although an athlete has been cleared to return to play, there may still be lingering doubt about their injury. Overall, there is a vast difference between being physically cleared to play and being psychologically ready to return to play. Certain personality traits might serve as predictors of an individual’s rate of psychological recovery from an injury. The purpose of this research study is to explore the correlations between athletes’ personality and their recovery from an athletic injury, specifically, examining how locus of control has been utilized through other studies and can be beneficial to the current study. Additionally, this section will examine the link between hardiness and coping strategies. In the current study, mental toughness is being tested, but it is important to determine the link between these two concepts. Hardiness and coping strategies are closely related and can play a major role in an athlete’s mental toughness. It is important to examine competitive trait anxiety to illustrate perceived anxiety during athletic competition. The Big 5 and Social Support will also be examined in conjunction with recovery from athletic injury. Athletic injury is a devastating and common occurrence that can happen in any sport. Injured athletes often require resources and treatment to be able to return to the field of play. Athletes become more involved with physical and mental treatment as the length of recovery time increases. It is very reasonable to assume that personality traits would be predictive of athlete recovery from injury. The current study investigated the potential relationship between personality traits and recovery time; more specifically, the personality traits of locus of control, hardiness, social support, competitive trait anxiety, and the “Big 5” personality traits. Results indicated that athletes with a higher internal locus of control tend to report being physically ready to return to play and “ready” to return to play faster than those with an external locus of control. Additionally, Openness to Experience (among the Big 5 personality dimensions) was also related to the speed of return to play.

Keywords: athlete, injury, personality, readiness to play, recovery

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Authors: Erdinç Vural, Bülent Özdalyan, Serkan Özel

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The four-stroke single cylinder diesel engine has been used in this study, the pistons and valves of the engine have been stabilized, the aluminum oxide (Al₂O₃) in different ratios has been added in the power of zirconium (ZrO₂) magnesium oxide (MgO), and has been coated with the plasma spray method. The pistons and valves of the combustion chamber of the engine are coated with 5 different (ZrO₂ + MgO), (ZrO₂ + MgO + 25% Al₂O₃), (ZrO₂ + MgO + 50% Al₂O₃), (ZrO₂ + MgO + 75% Al₂O₃), (Al₂O₃) sample. The material tests have been made for each of the coated engine parts with the scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD) using Cu Kα radiation surface analysis methods. The engine tests have been repeated for each sample in any electric dynamometer in full power 1600 rpm, 2000 rpm, 2400 rpm and 2800 rpm engine speeds. The material analysis and engine tests have shown that the best performance has been performed with (ZrO₂ + MgO + 50% Al₂O₃). Thus, there is no significant change in HC and Smoke emissions, but NOx emission is increased, as the engine improves power, torque, specific fuel consumption and CO emissions in the tests made with sample A3.

Keywords: ceramic coating, material characterization, engine performance, exhaust emissions

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Mauricio Plaza, Willian Aperador

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Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with a closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is a performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

Keywords: amputation, prosthesis, mobility, hemipelvectomy

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Authors: Krisztina Bohacs, Klaudia Markus

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To author’s best knowledge we are in absence of studies on cognitive program evaluation and we are certainly short of programs that prove to have high effect sizes with strong retention results. The purpose of our study was to investigate the effectiveness of a comprehensive cognitive training program, namely BrainRx. This cognitive rehabilitation program target and remediate seven core cognitive skills and related systems of sub-skills through repeated engagement in game-like mental procedures delivered one-on-one by a clinician, supplemented by digital training. A larger sample of children with learning disability were given pretest and post-test cognitive assessments. The experimental group completed a twenty-week cognitive training program in a BrainRx center. A matched control group received another twenty-week intervention with Feuerstein’s Instrumental Enrichment programs. A second matched control group did not receive training. As for pre- and post-test, we used a general intelligence test to assess IQ and a computer-based test battery for assessing cognition across the lifespan. Multiple regression analyses indicated that the experimental BrainRx treatment group had statistically significant higher outcomes in attention, working memory, processing speed, logic and reasoning, auditory processing, visual processing and long-term memory compared to the non-treatment control group with very large effect sizes. With the exception of logic and reasoning, the BrainRx treatment group realized significantly greater gains in six of the above given seven cognitive measures compared to the Feuerstein control group. Our one-year retention measures showed that all the cognitive training gains were above ninety percent with the greatest retention skills in visual processing, auditory processing, logic, and reasoning. The BrainRx program may be an effective tool to establish long-term cognitive changes in case of students with learning disabilities. Recommendations are made for treatment centers and special education institutions on the cognitive training of students with special needs. The importance of our study is that targeted, systematic, progressively loaded and intensive brain training approach may significantly change learning disabilities.

Keywords: cognitive rehabilitation training, cognitive skills, learning disability, permanent structural cognitive changes

Procedia PDF Downloads 198

Authors: Taylor Brown

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The parent-child attachment bond begins early, often before the birth of the child. Both father and mother begin to form a bond with their child by selecting a name, preparing for the birth, etc. The biological mother carries the child and often breastfeeds the infant after birth. While fathers play an important role in caring for the child as well, the mother is traditionally seen as the caregiver with the primary role of caring for her baby. These core ideas could include how to form bonds, how to communicate emotions, and even how to create and maintain relationships. Mothers tend to shape their children’s minds based on their own. Studies have even shown that when mothers stroke their children’s bodies with their fingers, the child does calm down more than most other methods. The bond between mother and child is one that happens immediately and strengthens over time. This attachment affects the child’s overall development. The mother-child attachment style is directly linked to a multitude of patterns in adolescents, and later on, adults. The researcher believes that the subsequent patterns of communication in romantic relationships are included in the multitude. Awareness of these patterns and their effects could improve experiences in romantic relationships during young adulthood.

Keywords: emotion regulation, parenting, maternal, attachment, romantic

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Authors: Amlan Datta

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Dengue is an arboviral, vector borne infection, quite prevalent in tropical countries such as India. Approximately, 1 to 25% of cases may give rise to neurological complication, such as, seizure, delirium, Guillian-Barre syndrome (GBS), multiple cranial nerve palsies, intracranial thrombosis, stroke-like presentations, to name a few. Dengue fever, as an antecedent to GBS is uncommon, especially in adults.Here, we report a case about a middle aged lady who presented with an acute onset areflexic ascending type of polyradiculoneuropathy along with bilateral lower motor neuron type of facial nerve palsy, as well as abducens and motor component of trigeminal (V3) weakness. Her respiratory and neck muscles were spared. She had an established episode of dengue fever (NS1 and dengue IgM positive) 7 days prior to the weakness. Nerve conduction study revealed a demyelinating polyradiculopathy of both lower limbs and cerebrospinal fluid examination showed albuminocytological dissociation. She was treated with 5 days of intravenous immunoglobulin (IVIg), following which her limb weakness improved considerably. This case highlights GBS as a potential complication following dengue fever.

Keywords: areflexic, demyelinating, dengue, polyradiculoneuropathy

Procedia PDF Downloads 254

Authors: Nouini Adrâa

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Background: The management of dizziness and vertigo can be challenging in the emergency department (ED). It is important to rapidly diagnose vertebrobasilar stroke (VBS), as therapeutic options such as thrombolysis and anticoagulation require prompt decisions. Objective: This study aims to assess the rate of misdiagnosis in patients with dizziness caused by VBS in the ED. Methods and Results: The cohort was comprised of 82 patients with a mean age of 55 years; 51% were women and 49% were men. Among dizzy patients, 15% had VBS. We used Cohen’s kappa test to quantify the agreement between two raters – namely, emergency physicians and neurologists – regarding the causes of dizziness in the ED. The agreement between emergency physicians and neurologists is low for the final diagnosis of central vertigo disorders and moderate for the final diagnosis of VBS. The sensitivity of ED clinal examination for benign conditions such as BPPV was low at 56%. The positive predictive value of the ED clinical examination for VBS was also low at 50%. Conclusion: There is a substantial rate of misdiagnosis in patients with dizziness caused by VBS in the ED. To reduce the number of missing diagnoses of VBS in the future, there is a need to train emergency physicians in neuro vestibular examinations, including the HINTS examination for acute vestibular syndrome (AVS) and the Dix-Hallpike (DH) maneuver for episodic vestibular syndrome. Using video head impulse tests could help reduce the rate of misdiagnosis of VBS in the ED.

Keywords: dizziness, vertigo, vestibular disease, emergency

Procedia PDF Downloads 52

Authors: Karolina Mazur, Stanislaw Kuciel

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Polylactides (PLA) and polyhydroxyalkanoates (PHA) are the two groups of biodegradable and biocompatible thermoplastic polymers most commonly utilised in medicine and rehabilitation. The aim of this work is to determine the changes in the strength properties and the microstructures taking place in biodegradable polymer composites during their long-term storage in a highly cooled environment (i.e. a freezer at -24ºC) and to initially assess the durability of such biocomposites when used as single-use elements of rehabilitation or medical equipment. It is difficult to find any information relating to the feasibility of long-term storage of technical products made of PLA or PHA, but nonetheless, when using these materials to make products such as casings of hair dryers, laptops or mobile phones, it is safe to assume that without storing in optimal conditions their degradation time might last even several years. SEM images and the assessment of the strength properties (tensile, bending and impact testing) were carried out and the density and water sorption of two polymers, PLA and PHA (NaturePlast PLE 001 and PHE 001), filled with cellulose fibres (corncob grain – Rehofix MK100, Rettenmaier&Sohne) up to 10 and 20% mass were determined. The biocomposites had been stored at a temperature of -24ºC for 4 years. In order to find out the changes in the strength properties and the microstructure taking place after such a long time of storage, the results of the assessment have been compared with the results of the same research carried out 4 years before. Results shows a significant change in the manner of fractures – from ductile with developed surface for the PHA composite with corncob grain when the tensile testing was performed directly after the injection into a more brittle state after 4 years of storage, which is confirmed by the strength tests, where a decrease of deformation is observed at point of fracture. The research showed that there is a way of storing medical devices made out of PLA or PHA for a reasonably long time, as long as the required temperature of storage is met. The decrease of mechanical properties found during tensile testing and bending for PLA was less than 10% of the tensile strength, while the modulus of elasticity and deformation at fracturing slightly rose, which may implicate the beginning of degradation processes. The strength properties of PHA are even higher after 4 years of storage, although in that case the decrease of deformation at fracturing is significant, reaching even 40%, which suggests its degradation rate is higher than that of PLA. The addition of natural particles in both cases only slightly increases the biodegradation.

Keywords: biocomposites, PLA, PHA, storage

Procedia PDF Downloads 264

Authors: Yujin Jeong, Youkyung Son, Myounghwan Choi, Sanghyub Lee, Sangyeol Lee, Changho Hwang, Kyo-in Koo

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Dysphasia is difficulty in swallowing food because of oral cavity impairments induced by stroke, muscle damage, tumor. Intermittent oro-esophageal (IOE) tube feeding is one of the well-known feeding methods for the dysphasia patients. However, it is hard to insert at the proper position in esophagus. In this study, we design and fabricate the IOE tube guide using 3-dimensional (3D) printer. The printed IOE tube is tested in a mannequin (Airway Management Trainer, Co., Ltd., Copenhagen, Denmark) mimicking human’s esophagus. The gag reflex point is measured as the design point in the mannequin. To avoid the gag reflex, we design various shapes of IOE tube guide. One structure is separated into three parts; biting part, part through oral cavity, connecting part to oro-esophageal. We designed 6 types of IOE tube guide adjusting length and angle of these three parts. To evaluate the IOE tube guide, it is inserted in the mannequin, and through the inserted guide, an endoscopic camera successfully arrived at the oro-esophageal. We had planned to apply this mannequin-based design experience to patients in near future.

Keywords: dysphagia, feeding method, IOE tube guide, 3-D printer

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Authors: Monique M. Keller, Roline Barnes, Corlia Brandt

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Introduction Scientific evidence on the hand forces and the types of grasps measurement during daily tasks are lacking, leaving a gap in the field of hand rehabilitation and robotics. Measuring the grasp forces and types produced by the individual fingers during daily functional tasks is valuable to inform and grade rehabilitation practices for second to fifth metacarpal fractures with robust scientific evidence. Feix et al, 2016 identified the most extensive and complete grasp study that resulted in the GRASP taxonomy. Covid-19 virus changed data collection across the globe and safety precautions in research are essential to ensure the health of participants and researchers. Methodology A cross-sectional study investigated six healthy adults aged 20 to 59 years, pilot participants’ hand forces during 105 tasks. The tasks were categorized into five sections namely, personal care, transport and moving around, home environment and inside, gardening and outside, and office. The predominant grasp of each task was identified guided by the GRASP Taxonomy. Grasp forces were measured with 13mm force-sensing resistors glued onto a glove attached to each of the dominant and non-dominant hand’s individual fingers. Testing equipment included Flexiforce 13millimetres FSR .5" circle, calibrated prior to testing, 10k 1/4w resistors, Arduino pro mini 5.0v – compatible, Esp-01-kit, Arduino uno r3 – compatible board, USB ab cable - 1m, Ftdi ft232 mini USB to serial, Sil 40 inline connectors, ribbon cable combo male header pins, female to female, male to female, two gloves, glue to attach the FSR to glove, Arduino software programme downloaded on a laptop. Grip strength measurements with Jamar dynamometer prior to testing and after every 25 daily tasks were taken to will avoid fatigue and ensure reliability in testing. Covid-19 precautions included wearing face masks at all times, screening questionnaires, temperatures taken, wearing surgical gloves before putting on the testing gloves 1.5 metres long wires attaching the FSR to the Arduino to maintain social distance. Findings Predominant grasps observed during 105 tasks included, adducted thumb (17), lateral tripod (10), prismatic three fingers (12), small diameter (9), prismatic two fingers (9), medium wrap (7), fixed hook (5), sphere four fingers (4), palmar (4), parallel extension (4), index finger extension (3), distal (3), power sphere (2), tripod (2), quadpod (2), prismatic four fingers (2), lateral (2), large-diameter (2), ventral (2), precision sphere (1), palmar pinch (1), light tool (1), inferior pincher (1), and writing tripod (1). Range of forces applied per category, personal care (1-25N), transport and moving around (1-9 N), home environment and inside (1-41N), gardening and outside (1-26.5N), and office (1-20N). Conclusion Scientifically measurements of finger forces with careful consideration to types of grasps used in daily tasks should guide rehabilitation practices and robotic design to ensure a return to the full participation of the individual into the community.

Keywords: activities of daily living (ADL), Covid-19, force-sensing resistors, grasps, hand forces

Procedia PDF Downloads 186

Authors: Ya-Hui Wang

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Lower speech therapy rate of tracheostomized patient was noted in comparison with previous researches. This study is aim to shed light on the referral status of speech therapy in those patients in Taiwan. This study developed an analysis for the size and key characteristics of the population of tracheostomized in-patient in the Taiwan. Method: We analyzed National Healthcare Insurance data (The Collaboration Center of Health Information Application, CCHIA) from Jan 1 2010 to Dec 31 2010. Result: over ages 3, number of tracheostomized in-patient is directly proportional to age. A high service loading was observed in North region in comparison with other regions. Only 4.87% of the tracheostomized in-patients were referred for speech therapy, and 1.9% for swallow examination, 2.5% for communication evaluation.

Keywords: refer, speech therapy, training, rehabilitation

Procedia PDF Downloads 436

Authors: Chiang-Ho Cheng, An-Shik Yang, Hon-Yi Cheng, Ming-Yu Lai

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This paper presents the design and fabrication of a novel piezoelectric actuator for a gas micropump with check valve having the advantages of miniature size, light weight and low power consumption. The micropump is designed to have eight major components, namely a stainless steel upper cover layer, a piezoelectric actuator, a stainless steel diaphragm, a PDMS chamber layer, two stainless steel channel layers with two valve seats, a PDMS check valve layer with two cantilever-type check valves and an acrylic substrate. A prototype of the gas micropump, with a size of 52 mm × 50 mm × 5.0 mm, is fabricated by precise manufacturing. This device is designed to pump gases with the capability of performing the self-priming and bubble-tolerant work mode by maximizing the stroke volume of the membrane as well as the compression ratio via minimization of the dead volume of the micropump chamber and channel. By experiment apparatus setup, we can get the real-time values of the flow rate of micropump and the displacement of the piezoelectric actuator, simultaneously. The gas micropump obtained higher output performance under the sinusoidal waveform of 250 Vpp. The micropump achieved the maximum pumping rates of 1185 ml/min and back pressure of 7.14 kPa at the corresponding frequency of 120 and 50 Hz.

Keywords: PDMS, check valve, micropump, piezoelectric

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Authors: Kazumoto Tanaka, Takayuki Fujino

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Sports games conducted as a group are a form of therapeutic exercise for aged people with decreased strength and for people suffering from permanent damage of stroke and other conditions. However, it is difficult for patients with different athletic abilities to play a game on an equal footing. This study specifically examines a computer video game designed for therapeutic exercise, and a game system with support given depending on athletic ability. Thereby, anyone playing the game can participate equally. This video-game, to be specific, is a popular variant of balloon volleyball, in which players hit a balloon by hand before it falls to the floor. In this game system, each player plays the game watching a monitor on which the system displays tailor-made video-game images adjusted to the person’s athletic ability, providing players with player-adaptive assist support. We have developed a multiplayer game system with an image generation technique for the tailor-made video-game and conducted tests to evaluate it.

Keywords: therapeutic exercise, computer video game, disability-adaptive assist, tailor-made video-game image

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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Authors: Puchita Chokcharoenying

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Polyphenols are the most abundant antioxidants found in plants, and they are highly effective at scavenging oxidative free radicals. Antioxidants are substances found in medicinal plants to help prevent heart disease, stroke, and some cancers. This study focused on evaluating the flavonoids content of Chrysanthemum Indicum and determine their antioxidant capacity by using DPPH and ABTS radical scavenging capacity assay. The total flavonoid content of C. indicumextract was determined and expressed as quercetin equivalents (QE)/g measured by an aluminiumchloride colorimetric method. The results showed that the IC50 of C. indicum extract were 83.57μg/mL ± 0.875 and52.57μg/mL ± 0.632for DPPH and ABTS, respectively. C. indicumextract exhibited antioxidant activities as a concentration dependent manner. In the DPPH assay, vitamin C was used as a positive control, whereas Trolox was used as a positive control in the ABTS assay. In summary, C. indicum extract is rich in flavonoids, which have potent antioxidant properties. Thus, C. indicum extract is a good source of antioxidants and can be developed for medicinal purposes. Nevertheless, more research on the antioxidant activity of C. indicum extract and in vivo antioxidant studies are still needed.

Keywords: ABTS assay, antioxidant, chrysanthemum indicum, DPPH assay, total flavonoid content

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Authors: Nairy Kechichian

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The original Leclerc Bridge is a covered wooden bridge that is considered a Quebec heritage structure with an index of 60, making it a very important provincial bridge from a historical point of view. It was constructed in 1927 and is in the rural area of Abitibi-Temiscamingue. It is a “town Québécois” type of structure, which is generally rare but common for covered bridges in Abitibi-Temiscamingue. This type of structure is composed of two trusses on both sides formed with diagonals, internal bracings, uprights and top and bottom chords to allow the transmission of loads. This structure is mostly known for its solidity, lightweightness, and ease of construction. It is a single-span bridge with a length of 25.3 meters and allows the passage of one vehicle at a time with a 4.22-meter driving lane. The structure is composed of 2 trusses located at each end of the deck, two gabion foundations at both ends, uprights and top and bottom chords. WSP (Williams Sale Partnership) Canada inc. was mandated by the Transport Minister of Quebec in 2019 to increase the capacity of the bridge from 5 tons to 30.6 tons and rehabilitate it, as it has deteriorated quite significantly over the years. The bridge was damaged due to material deterioration over time, exposure to humidity, high load effects and insect infestation. To allow the passage of 3 axle trucks, as well as to keep the integrity of this heritage structure, the final design chosen to rehabilitate the bridge involved adding a new deck independent from the roof structure of the bridge. Essentially, new steel beams support the deck loads and the desired vehicle loads. The roof of the bridge is linked to the steel deck for lateral support, but it is isolated from the wooden deck. The roof is preserved for aesthetic reasons and remains intact as it is a heritage piece. Due to strict traffic management obstacles, an efficient construction method was put into place, which consisted of building a temporary bridge and moving the existing roof onto it to allow the circulation of vehicles on one side of the temporary bridge while providing a working space for the repairs of the roof on the other side to take place simultaneously. In parallel, this method allowed the demolition and reconstruction of the existing foundation, building a new steel deck, and transporting back the roof on the new bridge. One of the main criteria for the rehabilitation of the wooden bridge was to preserve, as much as possible, the existing patrimonial architectural design of the bridge. The project was completed successfully by the end of 2021.

Keywords: covered bridge, wood-steel, short span, town Québécois structure

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

Procedia PDF Downloads 374

Authors: Parastou Kharazmi, Folke Björk

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Some of the main causes for degradation of polymeric materials are thermal aging, hydrolysis, oxidation or chemical degradation by acids, alkalis or water. The first part of this paper provides a brief summary of advances in technology, methods and specification of composite materials for relining as a rehabilitation technique for sewage systems. The second part summarizes an investigation on frequently used composite materials for relining in Sweden, the rubber filled epoxy composite and reinforced polyester composite when they were immersed in deionized water or in dry conditions, and elevated temperatures up to 80°C in the laboratory. The tests were conducted by visual inspection, microscopy, Dynamic Mechanical Analysis (DMA), Differential Scanning Calorimetry (DSC) as well as mechanical testing, three point bending and tensile testing.

Keywords: composite, epoxy, polyester, relining, sewage

Procedia PDF Downloads 338

Authors: Masni Mat Yusoff, Michael H. Gordon, Keshavan Niranjan

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The study reports on the effect of aqueous enzymatic extraction (AEE) parameters on the Moringa oleifera (MO) oil yield and the formation of emulsion at the end of the process. A mixture of protease and cellulase enzymes was used at 3:1 (w/w) ratio. The highest oil yield of 19% (g oil/g sample) was recovered with the use of a mixture of pH 6, 1:4 material/moisture ratio, and incubation temperature, time, and shaking speed of 50 ⁰C, 12.5 hr, and 300 stroke/min, respectively. The use of pH 6 and 8 resulted in grain emulsions, while solid-intact emulsion was observed at pH 4. Upon fixing certain parameters, higher oil yield was extracted with the use of lower material/moisture ratio and higher shaking speed. Longer incubation time of 24 hr resulted in significantly (p < 0.05) similar oil yield with that of 12.5 hr, and an incubation temperature of 50 ⁰C resulted in significantly (p < 0.05) higher oil yield than that of 60 ⁰C. In overall, each AEE parameter showed significant effects on both the MO oil yields and the emulsions formed. One of the major disadvantages of an AEE process is the formation of emulsions which require further de-emulsification step for higher oil recovery. Therefore, critical studies on the effect of each AEE parameter may assist in minimizing the amount of emulsions formed whilst extracting highest total MO oil yield possible.

Keywords: enzyme, emulsion, Moringa oleifera, oil yield

Procedia PDF Downloads 423

Authors: M. K. Mohd Safee, W. A. B. Wan Abas, F. Ibrahim, N. A. Abu Osman, N. A. Abdul Malik

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This paper investigates the activity of the rectus femoris (RF) and biceps femoris (BF) in healthy subjects during salat (prostration) and specific exercise (squat exercise) using electromyography (EMG). A group of undergraduates aged between 19 to 25 years voluntarily participated in this study. The myoelectric activity of the muscles were recorded and analyzed. The finding indicated that there were contractions of the muscles during the salat and exercise with almost same EMG’s level. From the result, Wilcoxon’s Rank Sum test showed significant difference between prostration and squat exercise (p < 0.05) but the differences was very small; RF (8.63% MVC) and BF (11.43% MVC). Therefore, salat may be useful in strengthening exercise and also in rehabilitation programs for lower limb activities. This pilot study conducted initial research into the bio mechanical responses of human muscles in various positions of salat.

Keywords: electromyography, exercise, muscle, salat

Procedia PDF Downloads 706

Authors: Syue-Wen Lin

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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.

Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns

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Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam

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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.

Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS

Procedia PDF Downloads 348

Authors: Kwok Tak Kit

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Construction and demolition (C&D) waste generated in the process of urbanization which only contribute to approx. 25–35 per cent of municipal solid waste (MSW), and the action to reduce the generation of other MSW is considered more critical. Developed and cities produce a higher percentage of inorganic waste rather than organic waste. Most of the MSW was disposed in landfill, and a large number of the landfills are not effectively and efficiently operated to receive the untreated incoming waste. It is also a global problem that the demands for enhancement of basic infrastructure for waste collection, treatment, and disposal, including rehabilitation of the dump sites, is the urgent priority. This paper is to review the factors taken into consideration of waste management development in relation to circular economy development on development countries and green recovery in the post-pandemic era for further researches use.

Keywords: waste management, waste reduction, circular economy, developed countries, sustainable design goals

Procedia PDF Downloads 133

Authors: Jirathan Pongchababnapa

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Polyphenols are the most common antioxidant found in plants and are efficient in capturing oxidative free radicals. Antioxidants are substances found in medicinal plants which may have a protective role to play in certain conditions such as heart disease, stroke and some cancers. By relying on these benefits, we have traced out the presence of antioxidant in Camellia sinensis leaves extract. This study aims to evaluate flavonoids content in C. sinensisextract and investigate antioxidant activities by using DPPH and ABTS radical scavenging capacity assay. The total flavonoid content of C. Sinensis extract was determined and expressed as quercetin equivalents (QE)/g measured by the aluminum chloride colorimetric method. The results showed that the IC₅₀ of C. Sinensis leaves extract were 40.90 μg/mL ± 0.755 and32.96 μg/mL ± 0.679 for DPPH and ABTS, respectively. C. Sinensis extract at increasing concentration showed antioxidant activities as a concentration dependent manner. In the DPPH assay, vitamin C was used as a positive control, whereas Trolox was used as a positive control in the ABTS assay. In conclusion, C. Sinensis extract consisted of a high amount of flavonoids content which possesses potent antioxidant activity. However, further investigation on the identification of pure compound of this plant and molecular antioxidant assays are still required.

Keywords: ABTS assay, antioxidant, camellia sinensis, DPPH assay, total flavonoid content

Procedia PDF Downloads 205

Authors: Yinjun Tu, Qiang Fang, Glenn I. Matthews, Shuenn-Yuh Lee

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This paper reports an efficient and rigorous self-adaptive stimulus artifacts removal approach for a mixed surface EMG (Electromyography) and stimulus signal during muscle stimulation. The recording of EMG and the stimulation of muscles were performing simultaneously. It is difficult to generate muscle fatigue feature from the mixed signal, which can be further used in closed loop system. A self-adaptive method is proposed in this paper, the stimulation frequency was calculated and verified firstly. Then, a mask was created based on this stimulation frequency to remove the undesired stimulus. 20 EMG signal recordings were analyzed, and the ANOVA (analysis of variance) approach illustrated that the decreasing trend of median power frequencies was successfully generated from the 'cleaned' EMG signal.

Keywords: EMG, FES, stimulus artefacts, self-adaptive

Procedia PDF Downloads 393