Search results for: behaviour and cognitive intervention

Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

Abstract:

Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

Procedia PDF Downloads 195

Authors: Rui Lin, Jimmy Xiangji Huang, Gary Spraakman

Abstract:

This forthcoming systematic review will underscore the imperative of leveraging technology to mitigate social isolation in older adults, particularly in the context of unprecedented global challenges such as the COVID-19 pandemic. With the continual evolution of technology, it becomes crucial to scrutinize the efficacy of interventions and discern how they can alleviate social isolation and augment social well-being among the elderly. This review will strive to clarify the best methods for older adults to utilize cost-effective and user-friendly technology and will investigate how the adaptation and execution of such interventions can be fine-tuned to maximize their positive outcomes. The study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to filter pertinent studies. We foresee conducting an analysis of articles and executing a narrative analysis to discover themes and indicators related to quality of life and, technology use and well-being. The review will examine how involving older adults at the community level, applying top practices from community-based participatory research, can establish efficient strategies to implement technology-based interventions designed to diminish social isolation and boost digital use self-efficacy. Applications based on mobile technology and virtual platforms are set to assume a crucial role not only in enhancing connections within families but also in connecting older adults to vital healthcare resources, fostering both physical and mental well-being. The review will investigate how technological devices and platforms can address the cognitive, visual, and auditory requirements of older adults, thus strengthening their confidence and proficiency in digital use—a crucial factor during enforced social distancing or self-isolation periods during pandemics. This review will endeavor to provide insights into the multifaceted benefits of technology for older adults, focusing on how tailored technological interventions can be a beacon of social and mental wellness in times of social restrictions. It will contribute to the growing body of knowledge on the intersection of technology and elderly well-being, offering nuanced understandings and practical implications for developing user-centric, effective, and inclusive technological solutions for older populations.

Keywords: older adults, health service delivery, digital health, social isolation, social well-being

Procedia PDF Downloads 56

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

Procedia PDF Downloads 109

Authors: Yiorgos Hadjichristou

Abstract:

The paper will focus on the strategic development deriving from the evolution of the traditional courtyard spatial organization towards a new, contemporary sustainable way of living. New sustainable approaches that engulf the social issues, the notion of place, the understanding of weather architecture blended together with the bioclimatic behaviour will be seen through a series of experimental case studies in the island of Cyprus, inspired and originated from its traditional wisdom, ranging from small scale of living to urban interventions. Weather and nature will be seen as co-architectural authors with architects as intelligently claimed by Jonathan Hill in his Weather Architecture discourse. Furthermore, following Pallasmaa’s understanding, the building will be seen not as an end itself and the elements of an architectural experience as having a verb form rather than being nouns. This will further enhance the notion of merging the subject-human and the object-building as discussed by Julio Bermudez. This eventually will enable to generate the discussion of the understanding of the building constructed according to the specifics of place and inhabitants, shaped by its physical and human topography as referred by Adam Sharr in relation to Heidegger’s thinking. The specificities of the divided island and the dealing with sites that are in vicinity with the diving Green Line will further trigger explorations dealing with the regeneration issues and the social sustainability offering unprecedented opportunities for innovative sustainable ways of living. The above premises will lead us to develop innovative strategies for a profound, both technical and social sustainability, which fruitfully yields to innovative living built environments, responding to the ever changing environmental and social needs. As a starting point, a case study in Kaimakli in Nicosia a refurbishment with an extension of a traditional house, already engulfs all the traditional/ vernacular wisdom of the bioclimatic architecture. It aims at capturing not only its direct and quite obvious bioclimatic features, but rather to evolve them by adjusting the whole house in a contemporary living environment. In order to succeed this, evolutions of traditional architectural elements and spatial conditions are integrated in a way that does not only respond to some certain weather conditions, but they integrate and blend the weather within the built environment. A series of innovations aiming at maximum flexibility is proposed. The house can finally be transformed into a winter enclosure, while for the most part of the year it turns into a ‘camping’ living environment. Parallel to experimental interventions in existing traditional units, we will proceed examining the implementation of the same developed methodology in designing living units and complexes. Malleable courtyard organizations that attempt to blend the traditional wisdom with the contemporary needs for living, the weather and nature with the built environment will be seen tested in both horizontal and vertical developments. A new social identity of people, directly involved and interacting with the weather and climatic conditions will be seen as the result of balancing the social with the technological sustainability, the immaterial and the material aspects of the built environment.

Keywords: building as a verb, contemporary living, traditional bioclimatic wisdom, weather architecture

Procedia PDF Downloads 415

Authors: Jiyoung Lee, Andrew D. Gershoff, Jerry Jisang Han

Abstract:

Most extant research on consumer privacy concerns and their willingness to share personal data has focused on contextual factors (e.g., types of information collected, type of compensation) that lead to consumers’ personal information disclosure. Unfortunately, the literature lacks a clear understanding of how consumers’ incidental psychological needs may influence consumers’ decisions to share their personal information with companies or brands. In this research, we investigate how social exclusion, which is an increasing societal problem, especially since the onset of the COVID-19 pandemic, leads to increased information disclosure intentions for consumers. Specifically, we propose and find that when consumers become socially excluded, their desire for social connection increases, and this desire leads to a greater willingness to disclose their personal information with firms. The motivation to form and maintain interpersonal relationships is one of the most fundamental human needs, and many researchers have found that deprivation of belongingness has negative consequences. Given the negative effects of social exclusion and the universal need to affiliate with others, people respond to exclusion with a motivation for social reconnection, resulting in various cognitive and behavioral consequences, such as paying greater attention to social cues and conforming to others. Here, we propose personal information disclosure as another form of behavior that can satisfy such social connection needs. As self-disclosure can serve as a strategic tool in creating and developing social relationships, those who have been socially excluded and thus have greater social connection desires may be more willing to engage in self-disclosure behavior to satisfy such needs. We conducted four experiments to test how feelings of social exclusion can influence the extent to which consumers share their personal information with brands. Various manipulations and measures were used to demonstrate the robustness of our effects. Through the four studies, we confirmed that (1) consumers who have been socially excluded show greater willingness to share their personal information with brands and that (2) such an effect is driven by the excluded individuals’ desire for social connection. Our findings shed light on how the desire for social connection arising from exclusion influences consumers’ decisions to disclose their personal information to brands. We contribute to the consumer disclosure literature by uncovering a psychological need that influences consumers’ disclosure behavior. We also extend the social exclusion literature by demonstrating that exclusion influences not only consumers’ choice of products but also their decision to disclose personal information to brands.

Keywords: consumer-brand relationship, consumer information disclosure, consumer privacy, social exclusion

Procedia PDF Downloads 120

Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

Abstract:

Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

Procedia PDF Downloads 71

Authors: Scott Andersen

Abstract:

Perhaps simply and rather unadornedly, consciousness is having multiple goals for action and the continuously adjudication of such goals to implement action, referred to as the Maps of Meaning (MoM) Consciousness Theory. The MoM theory triangulates through three parallel corollaries, action (behavior), mechanism (morphology/pathophysiology), and goals (teleology). (1) An organism’s consciousness contains a fluid, nested goals. These goals are not intentionality, but intersectionality, embodiment meeting the world. i.e., Darwinian inclusive fitness or randomization, then survival of the fittest. These goals form via gradual descent under inclusive fitness, the goals being the abstraction of a ‘match’ between the evolutionary environment and organism. Human consciousness implements the brain efficiency hypothesis, genetics, epigenetics, and experience crystallize efficiencies, not necessitating best or objective but fitness, i.e., perceived efficiency based on one’s adaptive environment. These efficiencies are objectively arbitrary, but determine the operation and level of one’s consciousness, termed extreme thrownness. Since inclusive fitness drives efficiencies in physiologic mechanism, morphology and behavior (action) and originates one’s goals, embodiment is necessarily entangled to human consciousness as its the intersection of mechanism or action (both necessitating embodiment) occurring in the world that determines fitness. Perception is the operant process of consciousness and is the consciousness’ de facto goal adjudication process. Goal operationalization is fundamentally efficiency-based via one’s unique neuronal mapping as a byproduct of genetics, epigenetics, and experience. Perception involves information intake and information discrimination, equally underpinned by efficiencies of inclusive fitness via extreme thrownness. Perception isn’t a ‘frame rate,’ but Bayesian priors of efficiency based on one’s extreme thrownness. Consciousness and human consciousness is a modular (i.e., a scalar level of richness, which builds up like building blocks) and dimensionalized (i.e., cognitive abilities become possibilities as emergent phenomena at various modularities, like stratified factors in factor analysis). The meta dimensions of human consciousness seemingly include intelligence quotient, personality (five-factor model), richness of perception intake, and richness of perception discrimination, among other potentialities. Future consciousness research should utilize factor analysis to parse modularities and dimensions of human consciousness and animal models.

Keywords: consciousness, perception, prospection, embodiment

Procedia PDF Downloads 50

Authors: Richard Roberts, Anna Kravtcova

Abstract:

Introduction: The realisation that personality can change over the course of a lifetime has led to a new companion model to the Big Five, the behavioural, emotional, and social skills approach (BESSA). BESSA hypothesizes that this set of skills represents how the individual is thinking, feeling, and behaving when the situation calls for it, as opposed to traits, which represent how someone tends to think, feel, and behave averaged across situations. The five major skill domains share parallels with the Big Five Factor (BFF) model creativity and innovation (openness), self-management (conscientiousness), social engagement (extraversion), cooperation (agreeableness), and emotional resilience (emotional stability) skills. We point to noteworthy limitations in the current operationalisation of BESSA skills (i.e., via Likert-type items) and offer up a different measurement approach: forced choice. Method: In this forced-choice paradigm, individuals were given three skill items (e.g., managing my time) and asked to select one response they believed they were “worst at” and “best at”. The Thurstonian IRT models allow these to be placed on a normative scale. Two multivariate studies (N = 1178) were conducted with a 22-item forced-choice version of the BESSA, a published measure of the BFF, and various criteria. Findings: Confirmatory factor analysis of the forced-choice assessment showed acceptable model fit (RMSEA<0.06), while reliability estimates were reasonable (around 0.70 for each construct). Convergent validity evidence was as predicted (correlations between 0.40 and 0.60 for corresponding BFF and BESSA constructs). Notable was the extent the forced-choice BESSA assessment improved upon test-criterion relationships over and above the BFF. For example, typical regression models find BFF personality accounting for 25% of the variance in life satisfaction scores; both studies showed incremental gains over the BFF exceeding 6% (i.e., BFF and BESSA together accounted for over 31% of the variance in both studies). Discussion: Forced-choice measurement models offer up the promise of creating equated test forms that may unequivocally measure skill gains and are less prone to fakability and reference bias effects. Implications for practitioners are discussed, especially those interested in selection, succession planning, and training and development. We also discuss how the forced choice method can be applied to other constructs like emotional immunity, cross-cultural competence, and self-estimates of cognitive ability.

Keywords: Big Five, forced-choice method, BFF, methods of measurements

Procedia PDF Downloads 93

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

Abstract:

Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

Procedia PDF Downloads 364

Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Voice is multidimensional which convey emotion, feelings, and communication. Voice disorders have an adverse effect on the physical, emotional and functional domains of an individual. Self-rating by clients about their voice problem helps the clinicians to plan intervention strategies. Voice handicap index is one such self-rating scale contains 30 questions that quantify the functional, physical and emotional impacts of a voice disorder on a patient’s quality of life. Each subsection has 10 questions. Though adapted and validated versions of VHI are available in other Indian languages but not in Telugu, which is a Dravidian language native to India. It is mainly spoken in Andhra Pradesh and neighbouring states in southern India. Objectives: To adapt and validate the English version of Voice Handicap Index (VHI) into Telugu language and evaluate its internal consistency and clinical validate in Telugu speaking population. Materials: The study carried out in three stages. First stage was a forward translation of English version of VHI, was given to ten experts, who were well proficient in writing and reading Telugu and five speech-language pathologists to translate into Telugu. Second Stage was backward translation where translated version of Telugu was given to a different group of ten experts (who were well proficient in writing and reading Telugu) and five speech-language pathologists who were native Telugu speakers and had good proficiency in Telugu and English. The third stage was an administration of translated version on Telugu to the targeted population. Totally 40 clinical subjects and 40 normal controls served as participants, and each group had 26 males and 14 females’ age range of 20 to 60 years. Clinical group comprised of individuals with laryngectomee with the Tracheoesophageal puncture (n=18), laryngitis (n=11), vocal nodules (n=7) and vocal fold palsy (n=4). Participants were asked to mark of their each experience on a 5 point equal appearing scale (0=never, 1=almost never, 2=sometimes, 3=almost always, 4=always) with a maximum total score of 120. Results: Statistical analysis was made by using SPSS software (22.0.0 Version). Mean, standard deviation and percentage (%) were calculated all the participants for both the groups. Internal consistency of VHI in Telugu was found to be excellent with the consistency scores for all the domains such as physical, emotional and functional are 0.742, 0.934and 0.938. The validity of scores showed a significant difference between clinical population and control group for domains like physical, emotional and functional and total scores. P value found to be less than 0.001( < 0.001). Negative correlation found in age and gender among self-domains such as physical, emotional and functional total scores in dysphonic and control group. Conclusion: The present study indicated that VHI in Telugu is able to discriminate participants having voice pathology from normal populations, which make this as a valid tool to collect information about their voice from the participants.

Keywords: adaptation, Telugu Version, translation, Voice Handicap Index (VHI)

Procedia PDF Downloads 274

Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

Abstract:

Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

Procedia PDF Downloads 141

Authors: Stephanie PB Caligiuri, Harold M Aukema, Delfin Rodriguez-Leyva, Amir Ravandi, Randy Guzman, Grant N. Pierce

Abstract:

Background: Hypertension leads to cardiac and cerebral events and therefore is the leading risk factor attributed to death in the world. Oxylipins may be mediators in these events as they can regulate vascular tone and inflammation. Oxylipins are derived from fatty acids. Dietary flaxseed is rich in the n3 fatty acid, alpha-linolenic acid, and, therefore, may have the ability to change the substrate profile of oxylipins. As a result, this could alter blood pressure. Methods: A randomized, double-blinded, controlled clinical trial, the Flax-PAD trial, was used to assess the impact of dietary flaxseed on blood pressure (BP), and to also assess the relationship of plasma oxylipins to BP in 81 patients with peripheral arterial disease (PAD). Patients with PAD were chosen for the clinical trial as they are at an increased risk for hypertension and cardiac and cerebral events. Thirty grams of ground flaxseed were added to food products to consume on a daily basis for 6 months. The control food products contained wheat germ, wheat bran, and mixed dietary oils instead of flaxseed. Central BP, which is more significantly associated to organ damage, cardiac, and cerebral events versus brachial BP, was measured by pulse wave analysis at baseline and 6 months. A plasma profile of 43 oxylipins was generated using solid phase extraction, HPLC-MS/MS, and stable isotope dilution quantitation. Results: At baseline, the central BP (systolic/diastolic) in the placebo and flaxseed group were, 131/73 ± 2.5/1.4 mmHg and 128/71 ± 2.6/1.4 mmHg, respectively. After 6 months of intervention, the flaxseed group exhibited a decrease in blood pressure of 4.0/1.0 mmHg. The 6 month central BP in the placebo and flaxseed groups were, 132/74 ± 2.9/1.8 mmHg and 124/70 ± 2.6/1.6 mmHg (P<0.05). Correlation and logistic regression analyses between central blood pressure and oxylipins were performed. Significant associations were observed between central blood pressure and 17 oxylipins, primarily produced from arachidonic acid. Every 1 nM increase in 16-hydroxyeicosatetraenoic acid (HETE) increased the odds of having high central systolic BP by 15-fold, of having high central diastolic BP by 6-fold and of having high central mean arterial pressure by 15-fold. In addition, every 1 nM increase in 5,6-dihydroxyeicosatrienoic acid (DHET) and 11,12-DHET increased the odds of having high central mean arterial pressure by 45- and 18-fold, respectively. Flaxseed induced a significant decrease in these as well as 4 other vasoconstrictive oxylipins. Conclusion: Dietary flaxseed significantly lowered blood pressure in patients with PAD and hypertension. Plasma oxylipins were strongly associated with central blood pressure and may have mediated the flaxseed-induced decrease in blood pressure.

Keywords: hypertension, flaxseed, oxylipins, peripheral arterial disease

Procedia PDF Downloads 462

Authors: Mansur Agzamov, Valery Bersnev, Natalia Ivanova, Istam Agzamov, Timur Khayrullaev, Yulduz Agzamova

Abstract:

Objectives. Treatment of hypertensive intracerebral hematoma (ICH) is controversial. Advantage of one surgical method on other has not been established. Recent reports suggest a favorable effect of minimally invasive surgery. We conducted a small comparative study of different surgical methods. Methods. We analyzed the result of surgical treatment of 176 patients with intracerebral hematomas at the age from 41 to 78 years. Men were been113 (64.2%), women - 63 (35.8%). Level of consciousness: conscious -18, lethargy -63, stupor –55, moderate coma - 40. All patients on admission and in the dynamics underwent computer tomography (CT) of the brain. ICH was located in the putamen in 87 cases, thalamus in 19, in the mix area in 50, in the lobar area in 20. Ninety seven patients of them had an intraventricular hemorrhage component. The baseline volume of the ICH was measured according to a bedside method of measuring CT intracerebral hematomas volume. Depending on the intervention of the patients were divided into three groups. Group 1 patients, 90 patients, operated open craniotomy. Level of consciousness: conscious-11, lethargy-33, stupor–18, moderate coma -18. The hemorrhage was located in the putamen in 51, thalamus in 3, in the mix area in 25, in the lobar area in 11. Group 2 patients, 22 patients, underwent smaller craniotomy with endoscopic-assisted evacuation. Level of consciousness: conscious-4, lethargy-9, stupor–5, moderate coma -4. The hemorrhage was located in the putamen in 5, thalamus in 15, in the mix area in 2. Group 3 patients, 64 patients, was conducted minimally invasive removal of intracerebral hematomas using the original device (patent of Russian Federation № 65382). The device - funnel cannula - which after the special markings introduced into the hematoma cavity. Level of consciousness: conscious-3, lethargy-21, stupor–22, moderate coma -18. The hemorrhage was located in the putamen in 31, in the mix area in 23, thalamus in 1, in the lobar area in 9. Results of treatment were evaluated by Glasgow outcome scale. Results. The study showed that the results of surgical treatment in three groups depending on the degree of consciousness, the volume and localization of hematoma. In group 1, good recovery observed in 8 cases (8.9%), moderate disability in 22 (24.4%), severe disability - 17 (18.9%), death-43 (47.8%). In group 2, good recovery observed in 7 cases (31.8%), moderate disability in 7 (31.8%), severe disability - 5 (29.7%), death-7 (31.8%). In group 3, good recovery was observed in 9 cases (14.1%), moderate disability-17 (26.5%), severe disability-19 (29.7%), death-19 (29.7%). Conclusions. The method of using cannulae allowed to abandon from open craniotomy of the majority of patients with putaminal hematomas. Minimally invasive technique reduced the postoperative mortality and improves treatment outcomes of these patients.

Keywords: nontraumatic intracerebral hematoma, minimal invasive surgical technique, funnel canula, differentiated surcical treatment

Procedia PDF Downloads 79

Authors: Shulamit Sternin, Raymond M. McKie, Carter Winberg, Robb N. Travers, Terry P. Humphreys, Elke D. Reissing

Abstract:

Issues surrounding sexual consent negotiation have become a major topic of societal concern. The majority of current research focuses on the complexities of sexual consent negotiations and the multitude of nuanced issues that surround the consent obtainment of heterosexual adults in post-secondary educational institutions. To date, the only study that has addressed sexual consent negotiation behaviour in same-sex relationships focused on the extent to which individuals used a variety of different verbal and nonverbal sexual consent behaviours to initiate or respond to sexual activity. The results were consistent with trends found within heterosexual individuals; thus, suggesting that the current understanding of sexual consent negotiation, which is grounded in heterosexual research, can serve as a strong foundation for further exploration of sexual consent negotiation within same-sex relationships populations. The current study quantitatively investigated the differences between heterosexual men and gay and bisexual men (GBM) in their understanding of sexual consent negotiation. Exploring how the perceptions of GBM differ from heterosexual males provides insight into some of the unique challenges faced by GBM. Data were collected from a sample of 252 heterosexual men and 314 GBM from Canada, the United States, and Western Europe. Participants responded to the question, 'do you think sexual consent and sex negotiation is different for heterosexual men compared to gay men? If so, how?' by completed an online survey. Responses were analysed following Braun & Clarke’s (2006) six phase thematic analysis guidelines. Inter-rater coding was validated using Cohen’s Kappa value and was calculated at (ϰ = 0.84), indicating a very strong level of agreement between raters. The final thematic structure yielded four major themes: understanding of sexual interaction, unique challenges, scripted role, and universal consent. Respondents spoke to their understanding of sexual interaction, believing GBM sexual consent negotiation to be faster and more immediate. This was linked to perceptions of emotional attachment and the idea that sexual interaction and emotional involvement were distinct and separate processes in GBM sexual consent negotiation, not believed to be the case in heterosexual interactions. Unique challenges such as different protection concerns, role declaration, and sexualization of spaces were understood to hold differing levels of consideration for heterosexual men and GBM. The perception of a clearly defined sexual script for GBM was suggested as a factor that may create ambiguity surrounding sexual consent negotiation, which in turn holds significant implications on unwanted sexual experiences for GBM. Broadening the scope of the current understanding of sexual consent negotiation by focusing on heterosexual and GBM population, the current study has revealed variations in perception of sexual consent negotiation between these two populations. These differences may be understood within the context of sexual scripting theory and masculinity gender role theory. We suggest that sexual consent negotiation is a health risk factor for GBM that has not yet been adequately understood and addressed. Awareness of the perceptions that surround the sexual consent negotiation of both GBM and heterosexual men holds implications on public knowledge, which in turn can better inform policy making, education, future research, and clinical treatment.

Keywords: sexual consent, negotiation, heterosexual men, GBM, sexual script

Procedia PDF Downloads 197

Authors: Olena Kovalchuk

Abstract:

How to define the understanding of social responsibility issues by Ukrainian companies is a contravention question. Thus, one of the practical uses of social responsibility is a diagnostic tool development for educational, business or scientific purposes. So the purpose of this research is to develop a tool for measurement of social responsibility in organization. Methodology: A 21-item questionnaire “Organization Social Responsibility Scale” was developed. This tool was adapted for the Ukrainian sample and based on the questionnaire “Perceived Role of Ethics and Social Responsibility” which connects ethical and socially responsible behavior to different aspects of the organizational effectiveness. After surveying the respondents, the factor analysis was made by the method of main compounds with orthogonal rotation VARIMAX. On the basis of the obtained results the 21-item questionnaire was developed (Cronbach’s alpha – 0,768; Inter-Item Correlations – 0,34). Participants: 121 managers at all levels of Ukrainian organizations (57 males; 65 females) took part in the research. Results: Factor analysis showed five ethical dilemmas concerning the social responsibility and profit compatibility in Ukrainian organizations. Below we made an attempt to interpret them: — Social responsibility vs profit. Corporate social responsibility can be a way to reduce operational costs. A firm’s first priority is employees’ morale. Being ethical and socially responsible is the priority of the organization. The most loaded question is "Corporate social responsibility can reduce operational costs". Significant effect of this factor is 0.768. — Profit vs social responsibility. Efficiency is much more important to a firm than ethics or social responsibility. Making the profit is the most important concern for a firm. The dominant question is "Efficiency is much more important to a firm than whether or not the firm is seen as ethical or socially responsible". Significant effect of this factor is 0.793. — A balanced combination of social responsibility and profit. Organization with social responsibility policy is more attractive for its stakeholders. The most loaded question is "Social responsibility and profitability can be compatible". Significant effect of this factor is 0.802. — Role of Social Responsibility in the successful organizational performance. Understanding the value of social responsibility and business ethics. Well-being and welfare of the society. The dominant question is "Good ethics is often good business". Significant effect of this factor is 0.727. — Global vision of social responsibility. Issues related to global social responsibility and sustainability. Innovative approaches to poverty reduction. Awareness of climate change problems. Global vision for successful business. The dominant question is "The overall effectiveness of a business can be determined to a great extent by the degree to which it is ethical and socially responsible". Significant effect of this factor is 0.842. The theoretical contribution. The perspective of the study is to develop a tool for measurement social responsibility in organizations and to test questionnaire’s adequacy for social and cultural context. Practical implications. The research results can be applied for designing a training programme for business school students to form their global vision for successful business as well as the ability to solve ethical dilemmas in managerial practice. Researchers interested in social responsibility issues are welcome to join the project.

Keywords: corporate social responsibility, Cronbach’s alpha, ethical behaviour, psychodiagnostic tool

Procedia PDF Downloads 361

Authors: Olanrewaju Aladeitan, Obiageli Phina Anaghara-Uzor

Abstract:

Despite the abundance of natural gas deposits in Nigeria and the immense potential, this presents both for the domestic and export oriented revenue, there exists an imbalance in the preference for export as against the development and optimal utilization of natural gas for the domestic industry. Considerable amounts of gas are still being wasted by flaring in the country to this day. Although the government has set in place initiatives to harness gas at the flare and thereby reduce volumes flared, the gas producers would rather direct the gas produced to the export market whereas gas apportioned to the domestic market is often marred by the low domestic gas price which is often discouraging to the gas producers. The exported fraction of gas production no doubt yields healthy revenues for the government and an encouraging return on investment for the gas producers and for this reason export sales remain enticing and preferable to the domestic sale of gas. This export pull impacts negatively if left unchecked, on the domestic market which is in no position to match the price at the international markets. The issue of gas price remains critical to the optimal development of the domestic gas industry, in that it comprises the basis for investment decisions of the producers on the allocation of their scarce resources and to what project to channel their output in order to maximize profit. In order then to rebalance the domestic industry and streamline the market for gas, the Gas Aggregation Company of Nigeria, also known as the Strategic Aggregator was proposed under the Nigerian Gas Master Plan of 2008 and then established pursuant to the National Gas Supply and Pricing Regulations of 2008 to implement the domestic gas supply obligation which focuses on ramping-up gas volumes for domestic utilization by mandatorily requiring each gas producer to dedicate a portion of its gas production for domestic utilization before having recourse to the export market. The 2008 Regulations further stipulate penalties in the event of non-compliance. This study, in the main, assesses the adequacy of the legal framework for the Nigerian Gas Industry, given that the operational laws are structured more for oil than its gas counterpart; examine the legal basis for the Strategic Aggregator in the light of the Domestic Gas Supply and Pricing Policy 2008 and the National Domestic Gas Supply and Pricing Regulations 2008 and makes a case for a review of the pivotal role of the Aggregator in the Nigerian Gas market. In undertaking this assessment, the doctrinal research methodology was adopted. Findings from research conducted reveal the reawakening of the Federal Government to the immense potential of its gas industry as a critical sector of its economy and the need for a sustainable domestic natural gas market. A case for the review of the ownership structure of the Aggregator to comprise a balanced mix of the Federal Government, gas producers and other key stakeholders in order to ensure the effective implementation of the domestic supply obligations becomes all the more imperative.

Keywords: domestic supply obligations, natural gas, Nigerian gas sector, strategic gas aggregator

Procedia PDF Downloads 221

Authors: Sundaresan Soundararajan, George Ezekiel Silvananthan, Chor Ngee Tan

Abstract:

Introduction: Transforaminal Interbody Fusion (TLIF) has been adopted for many decades now, however, XLIF, still in relative infancy, has grown to be accepted as a new Minimally Invasive Surgery (MIS) option. There is a paucity of reports directly comparing lateral approach surgery to other MIS options such as TLIF in the treatment of lumbar degenerative disc diseases. Aims/Objectives: The objective of this study was to compare the efficacy and clinical outcomes between Minimally Invasive Transforaminal Interbody Fusion (TLIF) and Minimally Invasive Lateral Interbody Fusion (XLIF) in the treatment of patients with degenerative disc disease of the lumbar spine. Methods: A single center, retrospective cohort study involving a total of 38 patients undergoing surgical intervention between 2010 and 2013 for degenerative disc disease of lumbar spine at single L4/L5 level. 18 patients were treated with MIS TLIF, and 20 patients were treated with XLIF. Results: The XLIF group showed shorter duration of surgery compared to the TLIF group (176 mins vs. 208.3 mins, P = 0.03). Length of hospital stay was also significantly shorter in XLIF group (5.9 days vs. 9 days, p = 0.03). Intraoperative blood loss was favouring XLIF as 85% patients had blood loss less than 100cc compared to 58% in the TLIF group (P = 0.03). Radiologically, disc height was significantly improved post operatively in the XLIF group compared to the TLIF group (0.56mm vs. 0.39mm, P = 0.01). Foraminal height increment was also higher in the XLIF group (0.58mm vs. 0.45mm , P = 0.06). Clinically, back pain and leg pain improved in 85% of patients in the XLIF group and 78% in the TLIF group. Post op hip flexion weakness was more common in the XLIF group (40%) than in the TLIF group (0%). However, this weakness resolved within 6 months post operatively. There was one case of dural tear and surgical site infection in the TLIF group respectively and none in the XLIF group. Visual Analog Scale (VAS) score 6 months post operatively showed comparable reduction in both groups. TLIF group had Owsterty Disability Index (ODI) improvement on 67% while XLIF group showed improvement of 70% of its patients. Conclusions: Lateral approach surgery shows comparable clinical outcomes in resolution of back pain and radiculopathy to conventional MIS techniques such as TLIF. With significantly shorter duration of surgical time, minimal blood loss and shorter hospital stay, XLIF seems to be a reasonable MIS option compared to other MIS techniques in treating degenerative lumbar disc diseases.

Keywords: extreme lateral interbody fusion, lateral approach, minimally invasive, XLIF

Procedia PDF Downloads 213

Authors: Noura Al Akkari, Aurélie Foucquier, Sylvain Lespinats

Abstract:

Load monitoring is a management process for energy consumption towards energy savings and energy efficiency. Non Intrusive Load Monitoring (NILM) is one method of load monitoring used for disaggregation purposes. NILM is a technique for identifying individual appliances based on the analysis of the whole residence data retrieved from the main power meter of the house. Our NILM framework starts with data acquisition, followed by data preprocessing, then event detection, feature extraction, then general appliance modeling and identification at the final stage. The event detection stage is a core component of NILM process since event detection techniques lead to the extraction of appliance features. Appliance features are required for the accurate identification of the household devices. In this research work, we aim at developing a new event detection methodology with accurate load disaggregation to extract appliance features. Time-domain features extracted are used for tuning general appliance models for appliance identification and classification steps. We use unsupervised algorithms such as Dynamic Time Warping (DTW). The proposed method relies on detecting areas of operation of each residential appliance based on the power demand. Then, detecting the time at which each selected appliance changes its states. In order to fit with practical existing smart meters capabilities, we work on low sampling data with a frequency of (1/60) Hz. The data is simulated on Load Profile Generator software (LPG), which was not previously taken into consideration for NILM purposes in the literature. LPG is a numerical software that uses behaviour simulation of people inside the house to generate residential energy consumption data. The proposed event detection method targets low consumption loads that are difficult to detect. Also, it facilitates the extraction of specific features used for general appliance modeling. In addition to this, the identification process includes unsupervised techniques such as DTW. To our best knowledge, there exist few unsupervised techniques employed with low sampling data in comparison to the many supervised techniques used for such cases. We extract a power interval at which falls the operation of the selected appliance along with a time vector for the values delimiting the state transitions of the appliance. After this, appliance signatures are formed from extracted power, geometrical and statistical features. Afterwards, those formed signatures are used to tune general model types for appliances identification using unsupervised algorithms. This method is evaluated using both simulated data on LPG and real-time Reference Energy Disaggregation Dataset (REDD). For that, we compute performance metrics using confusion matrix based metrics, considering accuracy, precision, recall and error-rate. The performance analysis of our methodology is then compared with other detection techniques previously used in the literature review, such as detection techniques based on statistical variations and abrupt changes (Variance Sliding Window and Cumulative Sum).

Keywords: electrical disaggregation, DTW, general appliance modeling, event detection

Procedia PDF Downloads 73

Authors: E. H. Szeto, E. Ammendola, J. V. Tabares, A. Starkey, J. Hay, J. G. McClung, C. J. Bryan

Abstract:

Introduction: Suicide is a leading cause of death globally, which accounts for more deaths annually than war, acquired immunodeficiency syndrome, homicides, and car accidents, while an estimated 140 million individuals have significant suicide ideation (SI) each year in the United States. Typical risk factors such as hopelessness, depression, and psychiatric disorders can predict suicide ideation but cannot distinguish between those who ideate from those who attempt suicide (SA). The Fluid Vulnerability Theory of suicide posits that a person’s activation of the suicidal mode is predicated on one’s predisposition, triggers, baseline/acute risk, and protective factors. The current study compares self-conscious cognitive-affective states (including guilt, shame, anger towards the self, and suicidal beliefs) among patients based on the endorsement of recent SI (i.e., past two weeks; acute risk) and lifetime SA (i.e., baseline risk). Method: A total of 2,722 individuals in an outpatient primary care setting were included in this cross-sectional, observational study; data for 2,584 were valid and retained for analysis. The Differential Emotions Scale measuring guilt, shame, and self-anger and the Suicide Cognitions Scale measuring suicide cognitions were administered. Results: A total of 2,222 individuals reported no recent SI or lifetime SA (Group 1), 161 reported recent SI only (Group 2), 145 reported lifetime SA only (Group 3), 56 reported both recent SI and lifetime SA (Group 4). The Kruskal-Wallis test showed that guilt, shame, self-anger, and suicide cognitions were the highest for Group 4 (both recent SI and lifetime SA), followed by Group 2 (recent SI-only), then Group 3 (lifetime SA-only), and lastly, Group 1 (no recent SI or lifetime SA). Conclusion: The results on recent SI-only versus lifetime SA-only contribute to the literature on the Fluid Vulnerability Theory of suicide by capturing SI and SA in two different time periods, which signify the acute risks and chronic baseline risks of the suicidal mode, respectively. It is also shown that: (a) people with a lifetime SA reported more severe symptoms than those without, (b) people with recent SI reported more severe symptoms than those without, and (c) people with both recent SI and lifetime SA were the most severely distressed. Future studies may replicate the findings here with other pertinent risk factors such as thwarted belongingness, perceived burdensomeness, and acquired capability, the last of which is consistently linked to attempting among ideators.

Keywords: suicide, guilt, shame, self-anger, suicide cognitions, suicide ideation, suicide attempt

Procedia PDF Downloads 159

Authors: Manushi Srivastava

Abstract:

Introduction: Doctor’s role, and relation with respect to patient care is at the core of medical ethics. The rapid pace of medical advances along with increasing consumer awareness about their rights and hike in cost of effective health care demand a robust, transparent and patient-friendly medical care system. However, doctors’ role performance is still in the frame of activity-passivity model of Doctor-Patient Relationship (DPR) where doctors act as parent and use to instruct their patients, without their consensus that is not going to help in the 21st century. Thus the current situation is a new challenge for traditional doctor-patient relationship after the introduction of Consumer Protection Act (CPA) in medical profession and the same is evidenced by increasing cases of medical litigation. To strengthen this system of medical services, the doctor plays a vital role, and the same should be reviewed in the present context. Objective: To understand the opinion of consultants regarding medical negligence and effect of Consumer Protection Act in terms of current practices of patient care. Method: This is a cross-sectional study in which both quantitative and qualitative methods are applied. Total 69 consultants were selected from multi-specialty hospitals of densely populated Varanasi city catering a population of about 1.8 million. Two-stage sampling was used for selection of respondents. At the first stage, selection of major wards (Medicine, Surgery, Ophthalmology, Gynaecology, Orthopaedics, and Paediatrics) was carried out, which are more susceptible to medical negligence. At the second stage, selection of consultants from the respective wards was carried out. In-depth Interviews were conducted with the help of semi-structured schedule. Two case studies of medical negligence were also carried out as part of the qualitative study. Analysis: Data were analyzed with the help of SPSS software (21.0 trial version). Semi-structured research tool was used to know consultant’s opinion about the pattern of medical negligence cases, litigations and claims made by patient community and inclusion of government medical services in CPA. Statistical analysis was done to describe data, and non-parametric test was used to observe the association between the variables. Analysis of Verbatim was used in case-study. Findings and Conclusion: Majority (92.8%) of consultants felt changes in the behaviour of community (patient) after implementation of CPA, as it had increased awareness about their rights. Less than half of the consultants opined that Medical Negligence is an Unintentional act of doctors and generally occurs due to communication gap and behavioural problem between doctor and patients. Experienced consultants ( > 10 years) pointed out that unethical practice by doctors and mal-intention of patient to harass doctors were additional reasons of Medical Negligence. In-depth interview revealed that now patients’ community expects more transparency and hence they demand cafeteria approach in diagnosis and management of cases. Thus as study results, we propose ‘Agreement Model’ of DPR to re-ensure ethical practice in medical profession.

Keywords: doctors, communication, consumer protection act (CPA), medical error

Procedia PDF Downloads 157

Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

Abstract:

This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

Procedia PDF Downloads 168

Authors: Rebin Mzhda Mohammed, Hoshmand Ali Hama Agha

Abstract:

Excess skin, often consequential to substantial weight loss or the aging process, introduces physical discomfort, obstructs daily activities, and undermines an individual's self-esteem. As these challenges become increasingly prevalent, the need to explore viable solutions grows in significance. Extra skin removal surgery, colloquially known as body contouring surgery, has emerged as a compelling intervention to ameliorate the physical and psychological burdens of excess skin. This study undertakes a comprehensive review to illuminate the intricacies of extra skin removal surgery, encompassing its diverse procedures, associated risks, benefits, and psychological implications on patients. The methodological approach adopted involves a systematic and exhaustive review of pertinent scholarly literature sourced from reputable databases, including PubMed, Google Scholar, and specialized cosmetic surgery journals. Articles are meticulously curated based on their relevance, credibility, and recency. Subsequently, data from these sources are synthesized and categorized, facilitating a comprehensive understanding of the subject matter. Qualitative analysis serves to unravel the nuanced psychological effects, while quantitative data, where available, are harnessed to underpin the study's conclusions. In terms of major findings, the research underscores the manifold advantages of extra skin removal surgery. Patients experience a notable improvement in physical comfort, amplified mobility, enhanced self-confidence, and a newfound ability to don clothing comfortably. Nonetheless, the benefits are juxtaposed with potential risks, encompassing infection, scarring, hematoma, delayed healing, and the challenge of achieving symmetry. A salient discovery is the profound psychological impact of the surgery, as patients consistently report elevated body image satisfaction, heightened self-esteem, and a substantial enhancement in overall quality of life. In summation, this research accentuates the pivotal role of extra skin removal surgery in ameliorating the intricate interplay of physical and psychological difficulties posed by excess skin. By elucidating the diverse procedures, associated risks, and psychological outcomes, the study contributes to a comprehensive and informed comprehension of the surgery's multifaceted effects. Therefore, individuals contemplating this transformative surgical option are equipped with comprehensive insights, ultimately fostering informed decision-making, guided by the expertise of medical professionals.

Keywords: extra skin removal surgery, body contouring, abdominoplasty, brachioplasty, thigh lift, body lift, benefits, risks, psychological effects

Procedia PDF Downloads 64

Authors: Rajkumar Ghosh, Shyama Pada Gorai

Abstract:

Access to safe drinking water is a fundamental human right; however, regions like Purulia, Bankura, Birbhum, Malda, Dinajpur in West Bengal, India, face formidable challenges due to heightened fluoride levels. This paper delves into the hurdles of fresh drinking water production, presenting comprehensive solutions derived from literature reviews, field surveys, and scientific analyses. Encompassing fluoride-affected areas in Purulia, Bankura, Birbhum, Malda, North-South Dinajpur, and South 24 Parganas, the study emphasizes an integrated and sustainable approach. Employing a multidisciplinary methodology, combining scientific analysis and community engagement, the study identifies key factors influencing water quality and proposes sustainable strategies. Elevated fluoride concentrations exceeding international health standards (Purulia: 0.126 – 8.16 mg/L, Bankura: 0.1 – 12.2 mg/L, Malda: 0.1 – 4.54 mg/L, Birbhum: 0.023 – 18 mg/L) necessitate urgent intervention. Infrastructure deficiencies impede water treatment and distribution, while limited awareness obstructs community participation. The proposed solutions embrace advanced water treatment technologies, infrastructure development, community education, and sustainable water management practices. This comprehensive effort aims to provide clean drinking water, safeguarding the health of affected populations. Building on these foundations, the study explores the potential of rooftop rainwater harvesting as an effective and sustainable strategy to mitigate challenges in fresh drinking water production. By addressing fluoride contamination concerns and promoting community involvement, this approach presents a holistic solution to water quality issues in affected regions. The findings underscore the importance of integrating sustainable practices with community engagement to achieve long-term water security in Purulia, Bankura, Birbhum, Malda, North-South Dinajpur, and South 24 Parganas. This study serves as a cornerstone for further research and policy development, addressing fluoride contamination's impact on public health in affected areas. Recommendations include the establishment of long-term monitoring programs to assess the effectiveness of implemented solutions and conducting health impact studies to understand the long-term effects of fluoride contamination on the local population.

Keywords: fluoride mitigation, rainwater harvesting, water quality, sustainable water management, community engagement

Procedia PDF Downloads 63

Authors: Andreas Aceranti, Simonetta Vernocchi, Marco Colorato, Daniel Zaccariello

Abstract:

Our study explores the usefulness of implementing facial expression recognition capabilities and using the Facial Action Coding System (FACS) in contexts where the other person is wearing a mask. In the communication process, the subjects use a plurality of distinct and autonomous reporting systems. Among them, the system of mimicking facial movements is worthy of attention. Basic emotion theorists have identified the existence of specific and universal patterns of facial expressions related to seven basic emotions -anger, disgust, contempt, fear, sadness, surprise, and happiness- that would distinguish one emotion from another. However, due to the COVID-19 pandemic, we have come up against the problem of having the lower half of the face covered and, therefore, not investigable due to the masks. Facial-emotional behavior is a good starting point for understanding: (1) the affective state (such as emotions), (2) cognitive activity (perplexity, concentration, boredom), (3) temperament and personality traits (hostility, sociability, shyness), (4) psychopathology (such as diagnostic information relevant to depression, mania, schizophrenia, and less severe disorders), (5) psychopathological processes that occur during social interactions patient and analyst. There are numerous methods to measure facial movements resulting from the action of muscles, see for example, the measurement of visible facial actions using coding systems (non-intrusive systems that require the presence of an observer who encodes and categorizes behaviors) and the measurement of electrical "discharges" of contracting muscles (facial electromyography; EMG). However, the measuring system invented by Ekman and Friesen (2002) - "Facial Action Coding System - FACS" is the most comprehensive, complete, and versatile. Our study, carried out on about 1,500 subjects over three years of work, allowed us to highlight how the movements of the hands and upper part of the face change depending on whether the subject wears a mask or not. We have been able to identify specific alterations to the subjects’ hand movement patterns and their upper face expressions while wearing masks compared to when not wearing them. We believe that finding correlations between how body language changes when our facial expressions are impaired can provide a better understanding of the link between the face and body non-verbal language.

Keywords: facial action coding system, COVID-19, masks, facial analysis

Procedia PDF Downloads 70

Authors: Stephanie Jo Marchese

Abstract:

This oral presentation is a reflective piece regarding current social work teaching methods that value and devalue the lived experiences of survivor students. This presentation grounds the term ‘survivor’ in feminist frameworks. A survivor-defined approach to feminist advocacy assumes an individual’s agency, considers each case and needs independent of generalizations, and provides resources and support to empower victims. Feminist ideologies are ripe arenas to update and influence the rapport-building schools of social work have with these students. Survivor-based frameworks are rooted in nuanced understandings of intersectional realities, staunchly combat both conscious and unconscious deficit lenses wielded against victims, elevate lived experiences to the realm of experiential expertise, and offer alternatives to traditional power structures and knowledge exchanges. Actively importing a survivor framework into the methodology of social work teaching breaks open barriers many survivor students have faced in institutional settings, this author included. The profession of social work is at an important crux of change, both in the United States and globally. The United States is currently undergoing a radical change in its citizenry and outlier communities have taken to the streets again in opposition to their othered-ness. New waves of students are entering this field, emboldened by their survival of personal and systemic oppressions- heavily influenced by third-wave feminism, critical race theory, queer theory, among other post-structuralist ideologies. Traditional models of sociological and psychological studies are actively being challenged. The profession of social work was not founded on the diagnosis of disorders but rather a grassroots-level activism that heralded and demanded resources for oppressed communities. Institutional and classroom acceptance and celebration of survivor narratives can catapult the resurgence of these values needed in the profession’s service-delivery models and put social workers back in the driver's seat of social change (a combined advocacy and policy perspective), moving away from outsider-based intervention models. Survivor students should be viewed as agents of change, not solely former victims and clients. The ideas of this presentation proposal are supported through various qualitative interviews, as well as reviews of ‘best practices’ in the field of education that incorporate feminist methods of inclusion and empowerment. Curriculum and policy recommendations are also offered.

Keywords: deficit lens bias, empowerment theory, feminist praxis, inclusive teaching models, strengths-based approaches, social work teaching methods

Procedia PDF Downloads 286

Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

Abstract:

Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

Procedia PDF Downloads 403

Authors: Joy Chadwick

Abstract:

This Study of Teaching and Learning (SoTL) research focused on the experiences of teacher candidates involved in an inclusive education methods course within a four-year direct entry Bachelor of Education program. The placement of this course within the final fourteen-week practicum semester is designed to facilitate deeper theory-practice connections between effective inclusive pedagogical knowledge and the real life of classroom teaching. The course focuses on supporting teacher candidates to understand that effective instruction within an inclusive classroom context must be intentional, responsive, and relational. Diversity is situated not as exceptional but rather as expected. This interpretive qualitative study involved the analysis of twenty-nine teacher candidate reflective journals and six individual teacher candidate semi-structured interviews. The journal entries were completed at the start of the semester and at the end of the semester with the intent of having teacher candidates reflect on their beliefs of what it means to be an effective inclusive educator and how the course and practicum experiences impacted their understanding and approaches to teaching in inclusive classrooms. The semi-structured interviews provided further depth and context to the journal data. The journals and interview transcripts were coded and themed using NVivo software. The findings suggest that instructional frameworks such as universal design for learning (UDL), differentiated instruction (DI), response to intervention (RTI), social emotional learning (SEL), and self-regulation supported teacher candidate’s abilities to meet the needs of their students more effectively. Course content that focused on specific exceptionalities also supported teacher candidates to be proactive rather than reactive when responding to student learning challenges. Teacher candidates also articulated the importance of reframing their perspective about students in challenging moments and that seeing the individual worth of each child was integral to their approach to teaching. A persisting question for teacher educators exists as to what pedagogical knowledge and understanding is most relevant in supporting future teachers to be effective at planning for and embracing the diversity of student needs within classrooms today. This research directs us to consider the critical importance of addressing personal attributes and mindsets of teacher candidates regarding children as well as considering instructional frameworks when designing coursework. Further, the alignment of an inclusive education course during a teaching practicum allows for an iterative approach to learning. The practical application of course concepts while teaching in a practicum allows for a deeper understanding of instructional frameworks, thus enhancing the confidence of teacher candidates. Research findings have implications for teacher education programs as connected to inclusive education methods courses, practicum experiences, and overall teacher education program design.

Keywords: inclusion, inclusive education, pre-service teacher education, practicum experiences, teacher education

Procedia PDF Downloads 65

Authors: Sarah J. C. Slabbert

Abstract:

The uptake of research as part of the diffusion or adoption of innovation by practitioners, whether individuals or organisations, has been a popular topic in agricultural development studies for many decades. In the classical, linear model of innovation theory, the innovation originates from an expert source such as a state-supported research organisation or academic institution. The changing context of agriculture led to the development of the agricultural innovation systems model, which recognizes innovation as a complex interaction between individuals and organisations, which include private industry and collective action organisations. In terms of this model, an innovation can be developed and adopted without any input or intervention from a state or parastatal research organisation. This evolution in the diffusion of agricultural innovation has put forward new challenges for state or parastatal research organisations, which have to demonstrate the impact of their research to the legislature or a regulatory authority: Unless the organisation and the research it produces cross the knowledge paths of the intended audience, there will be no awareness, no uptake and certainly no impact. It is therefore critical for such a research organisation to base its communication strategy on a thorough understanding of the knowledge needs, information sources and knowledge networks of the intended target audience. In 2016, the South African Water Research Commission (WRC) commissioned a study to investigate the knowledge needs, information sources and knowledge networks of Water User Associations and commercial irrigators with the aim of improving uptake of its research on efficient water use in irrigation. The first phase of the study comprised face-to-face interviews with the CEOs and Board Chairs of four Water User Associations along the Orange River in South Africa, and 36 commercial irrigation farmers from the same four irrigation schemes. Intermediaries who act as knowledge conduits to the Water User Associations and the irrigators were identified and 20 of them were subsequently interviewed telephonically. The study found that irrigators interact regularly with grower organisations such as SATI (South African Table Grape Industry) and SAPPA (South African Pecan Nut Association) and that they perceive these organisations as credible, trustworthy and reliable, within their limitations. State and parastatal research institutions, on the other hand, are associated with a range of negative attributes. As a result, the awareness of, and interest in, the WRC and its research on water use efficiency in irrigated agriculture are low. The findings suggest that a communication strategy that involves collaboration with these grower organisations would empower the WRC to participate much more efficiently and with greater impact in agricultural innovation networks. The paper will elaborate on the findings and discuss partnering frameworks and opportunities to manage perceptions and uptake.

Keywords: agricultural innovation systems, communication strategy, diffusion of innovation, irrigated agriculture, knowledge paths, research organisations, target audiences, water use efficiency

Procedia PDF Downloads 110

Authors: Chumki Payun, Bidisha Som

Abstract:

The Mising language, spoken by the Mising community in Assam, belongs to the Tibeto-Burman family of languages. This is one of the smaller languages of the region and is facing endangerment due to the dominance of the larger languages, like Assamese. The language is spoken in close in-group scenarios and is gradually losing ground to the dominant languages, partly also due to the education setup where schools use only dominant languages. While there are a number of factors for the current contemporary status of the language, and those can be studied using sociolinguistic tools, the current work aims to contribute to the understanding of language attrition through language processing in order to establish if the effect of second language dominance is more than mere ‘usage’ patterns and has an impact on cognitive strategies. When bilingualism spreads widely in society and results in a language shift, speakers perform people often do better in their second language (L2) than in their first language (L1) across a variety of task settings, in both comprehension and production tasks. This phenomenon was investigated in the case of Mising-Assamese bilinguals, using a picture naming task, in two districts of Jorhat and Tinsukia in Assam, where the relative dominance of L2 is slightly different. This explorative study aimed to investigate if the L2 dominance is visible in their performance and also if the pattern is different in the two different places, thus pointing to the degree of language loss in this case. The findings would have implications for native language education, as education in one’s mother tongue can help reverse the effect of language attrition helping preserve the traditional knowledge system. The hypothesis was that due to the dominance of the L2, subjects’ performance in the task would be better in Assamese than that of Missing. The experiment: Mising-Assamese bilingual participants (age ranges 21-31; N= 20 each from both districts) had to perform a picture naming task in which participants were shown pictures of familiar objects and asked to name them in four scenarios: (a) only in Mising; (b) only in Assamese; (c) a cued mix block: an auditory cue determines the language in which to name the object, and (d) non-cued mix block: participants are not given any specific language cues, but instructed to name the pictures in whichever language they feel most comfortable. The experiment was designed and executed using E-prime 3.0 and was conducted responses were recorded using the help of a Chronos response box and was recorded with the help of a recorder. Preliminary analysis reveals the presence of dominance of L2 over L1. The paper will present a comparison of the response latency, error analysis, and switch cost in L1 and L2 and explain the same from the perspective of language attrition.

Keywords: bilingualism, language attrition, language processing, Mising language.

Procedia PDF Downloads 7

Authors: Mai Alharthy, Agnes Shiel, Hynes Sinead

Abstract:

Objectives: The objectives of the study are to translate and culturally adapt the RBMT-3 to be appropriate for use within an Arabic-speaking population and to achieve maximum equivalency between the translated and original versions and to evaluate the psychometric properties of the Arabic version of the RBMT-3. Participants' numbers are 16 (10 females and 6 males). All participants are bilingual speakers of Arabic and English, above 18 years old and with no current nor past memory impairment. Methods: The study was conducted in two stages: Translation and cultural adaptation stage: Forward and backward translations were completed by professional translators. Five out of the 14 RBMT-3 subtests required cultural adaptations. Half of the faces in the face recognition subtests were replaced with Arabic faces by a professional photographer. Pictures that are irrelevant to the Arabic culture in the picture recognition subtests were replaced. Names, story and orientations subtests were also adapted to suit the Arabic culture. An expert committee was formed to compare the translated and original versions and to advise on further changes required for test materials. Validation of the Arabic RBMT-3- pilot: 16 Participants were tested on version 1 of the English version and the two versions of the Arabic RBMT-3 ( counterbalanced ). The assessment period was 6 weeks long, with two weeks gap between tests. All assessments took place in a quiet room in the National University of Ireland Galway. Two qualified occupational therapists completed the assessments. Results: Wilcox signed-rank test was used to compare between subtest scores. Significant differences were found in the story, orientation and names subtests between the English and Arabic versions. No significant differences were found in subtests from both Arabic versions except for the story subtest. Conclusion: The story and orientation subtests should be revised by the expert committee members to make further adaptations. The rest of the Arabic RBMT-3 subtests are equivalent to the subtests of the English version. The psychometric properties of the Arabic RBMT-3 will be investigated in a larger Arabic-speaking sample in Saudi Arabia. The outcome of this research is to provide clinicians and researchers with a reliable tool to assess memory problems in Arabic speaking population.

Keywords: memory impairment, neuropsychological assessment, cultural adaptation, cognitive assessment

Procedia PDF Downloads 253