Search results for: chronic illnesses
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1596

Search results for: chronic illnesses

1086 The Study of Musculoskeletal Disorders Produced by Excess Physical Effort in Marines

Authors: R. Domínguez, A. Castro, N. Fernandez, F. Hidalgo, F. Ortiz

Abstract:

Aims: Study musculoskeletal disorders produced by excess physical exertion in marines Introduction: Musculoskeletal injuries during military training are an important medical problem faced by military organizations throughout the world. Military occupations are physically demanding, which represents a high risk of injury "and subsequent disability, these injuries represent important risk factors for hospitalization, disability, and discharge Methodology: This is a causal correlational study in which data were collected in order to find a cause-effect relationship between the physical effort in marines during their career in the Chilean Navy and the musculoskeletal disorders that occur in some from them. Results:100% had experienced musculoskeletal pain in some part of the body and 73.52% of the respondents had experienced limitations in the ability to work, as a consequence forced to change jobs due to musculoskeletal pain. The neck, shoulders and the lumbar dorsal region were the regions with the highest prevalence of pain, as well as pain that limit the ability to work. Conclusion: Musculoskeletal injuries and illnesses related to injuries are common in marines, both in those who operate in campus Charles, as in another operational unit due to the nature of the work. Many of these injuries occur during physical training and sports and various studies have dealt with the descriptive epidemiology of musculoskeletal injuries in military personnel.

Keywords: physical effort, marines, musculoskeletal disorders produced (MSD), training

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1085 Evaluation of Existence of Antithyroid Antibodies, Anti-Thyroid Peroxidase and Anti-Thyroglobulin in Patients with Hepatitis C Viral Infections

Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

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Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

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1084 Dietary Quality among U.S. Adults with Diabetes, Osteoarthritis, and Rheumatoid Arthritis: Age-Specific Associations from NHANES 2011-2022

Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Limited research has examined the variations in dietary quality among U.S. adults diagnosed with chronic conditions like diabetes mellitus (DM), osteoarthritis (OA), and rheumatoid arthritis (RA), particularly across different age groups. Understanding how diet differs in relation to these conditions is crucial to developing targeted nutritional interventions. This cross-sectional study analyzed data from adult participants in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2021. Dietary quality was measured using the Healthy Eating Index (HEI)-2015 scores, encompassing both total and component scores for different dietary factors. Self-reported disease statuses for DM, OA, and RA were obtained, with age groups stratified into younger adults (20–59 years, n = 10,050) and older adults (60 years and older, n = 5,200). Logistic regression models, adjusted for demographic factors like sex, race/ethnicity, education, income, weight status, physical activity, and smoking, were used to examine the relationship between disease status and dietary quality, accounting for NHANES' complex survey design. Among younger adults, 8% had DM, 10% had OA, and 4% had RA. Among older adults, 22% had DM, 35% had OA, and 7% had RA. The results showed a consistent association between excess added sugar intake and DM in both age groups. In younger adults, excess sodium intake was also linked to DM, while low seafood and plant protein intake was associated with a higher prevalence of RA. Among older adults, a poor overall dietary pattern was strongly associated with RA, while OA showed varying associations depending on the intake of specific nutrients like fiber and saturated fats. The dietary quality of U.S. adults with DM, OA, and RA varies significantly by age group and disease type. Younger adults with these conditions demonstrated more specific dietary inadequacies, such as high sodium and low protein intake, while older adults exhibited a broader pattern of poor dietary quality, particularly in relation to RA. These findings suggest that personalized nutritional strategies are needed to address the unique dietary challenges faced by individuals with chronic conditions in different age groups.

Keywords: dietary, diabetes, osteoarthritis, rheumatoid arthritis, logistic regression

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1083 The Application of Transcranial Direct Current Stimulation (tDCS) Combined with Traditional Physical Therapy to Address Upper Limb Function in Chronic Stroke: A Case Study

Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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1082 Increased Risk of Adverse Birth Outcomes of Newborns in Arsenic Exposed- Women with Gestational Diabetes

Authors: Tania Mannan, Rahelee Zinnat, Fatema Jebunnesa, Israt Ara Hossain

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Background: Exposure to arsenic has known toxic effects but the effect on pregnancy outcomes is not as widely documented especially in women with diabetes. Growing evidence has suggested a potential role of arsenic exposure in the development of gestational diabetes mellitus (GDM). Therefore, we aimed to investigate the association of urinary arsenic (UAs) with birth outcomes in GDM subjects. Methods: Under an observational cross-sectional design a total of 263 GDM subjects (age in years, M±SD, 21±3.7) residing in an arsenic affected area of Bangladesh, were subjected to a 2 sample OGTT at the third trimester of gestation. Among them, 73 GDM and 190 non-GDM subjects enrolled in this study. Clinical and anthropometric measurements were done by standard techniques. Degree of chronic arsenic exposure was assessed by the level of UAs level. According to World Health Organization (WHO) criteria, GDM was diagnosed and neonatal outcomes using APGAR (Activity Pulse Grimace Appearance Respirations) Score, birth weight and size were assessed by a specialist obstetrician. Serum glucose was measured by the Glucose Oxidase method and UAs level was determined by ultraviolet/visible spectrophotometry. Result: Out of the 263 pregnant women, 28% developed GDM. Urinary Arsenic was significantly higher in the GDM as compared to the non-GDM group [UAs, µg/l, M±SD (range), 204.2±67.0 (67.0-377.0) vs 77.3±38.1 (22.0-99.0), p < 0.001]. Activity Pulse Grimace Appearance Respirations Score of the neonates from GDM mothers was significantly lower compared to the neonates from non-GDM mothers [APGAR Score, M±SD, 4.7±0.8 vs. 6.4±0.7, p<0.001]. Pearson’s correlation analysis in GDM subjects revealed that UA levels were found to have a significant positive correlation with both fasting and postprandial serum glucose levels (p < 0.001) and (p < 0.001) respectively. Again, a significant inverse correlation of UAs with birth weight and size was observed (p < 0.001). The APGAR Score of the neonates were found to have a significant negative correlation (p < 0.001) with UAs level. Conclusion: The effect of chronic arsenic exposure is associated with glucose intolerance during pregnancy and it also adversely affects birth outcomes. The study suggests further research on the impact of total arsenic exposure on pregnancy outcomes.

Keywords: APGAR score, arsenic exposure, birth outcome, gestational diabetes mellitus,

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1081 A 30 Year Audit of the Vascular Complications of Ports: Permanent Intravascular Access Devices

Authors: S. Kershaw, P. J. Barry, K. Webb

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Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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1080 The Psychosocial Issues and Support Needs of Patients with Chronic Kidney Disease Undergoing Hemodialysis: A Qualitative Study from Nepal

Authors: Akriti Kafle Baral, Ruixing Zhang, Dzifa K Lalit, Manthar M Alli

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Introduction: Hemodialysis is the most common type of dialysis globally approximately million are reported to receive this type of dialysis. Psychosocial issues in hemodialysis are the psychological and socioeconomic burdens emanating from the initiation and course of treatment and have the potential for gross deterioration in the quality of life and general well-being of patients. Understanding the psychosocial issues and needs of patients undergoing hemodialysis could pave the way for comprehensive support and therapies designed to reduce stress, improve social support, and foster mental resilience. Objectives: The aim of this study was to explore the psychosocial issues and support needs of patients undergoing hemodialysis at a tertiary care center in Nepal. Methods: A qualitative descriptive study was conducted among 20 purposefully selected patients attending hemodialysis treatment at Pokhara Academy of Health Sciences, Nepal. Data was analyzed via thematic analysis. Results: The study resulted in three major themes which included Emotional, psychological, and spiritual struggles, Social and economic impacts, and Support and information needs. Moreover, 16 sub-themes emerged which are Frustration with daily life, Constant fear of death, Thoughts of self-harm, Perceived Burden on Family, Sense of Divine Punishment, Sense of Unfairness, Fear about future uncertainties, Social avoidance, Social stigmatization, Loss of employment, Financial strain, Transportation challenges, Need for early, clear and comprehensive information, Need for support and reassurance from family, Support through peer connections, and Reassurance from healthcare providers. Conclusion: The findings of this study indicate that patients undergoing hemodialysis in Nepal experience numerous hardships and multifaceted struggles that require support from different dimensions. Establishing robust support systems that include family involvement, peer networks, and effective communication from healthcare professionals can significantly mitigate feelings of anxiety and isolation.

Keywords: hemodialysis, psychosocial issues, support needs, chronic kidney disease, end stage renal disease, Nepal

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1079 Digitial Communication – The Future of Chronic Disease Management Is Healthcare Apps

Authors: Kirstin Griffin

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During a period of increased anxiety and stress, communication became the essential tool to help the public stay informed and feel prepared during the Covid-19 pandemic. However, certain groups of patients were not feeling as reassured. The news and media blasted the message that patients with diabetes were “high-risk" in regards to contracting the Covid-19 infection. Routine clinics were being cancelled, GP practices were closing their doors, and patients with type 1 diabetes were understandably scared. The influx of calls to diabetes specialists nurses from concerned patients highlighted the need for better and more specialised information. An Application specifically for patients with type 1 diabetes was created to deliver this information, and it proved to be the essential communication tool that was desperately needed. The Application for patients with type 1 diabetes aimed to deliver specialist information to patients in regards to their diagnosis, management, and ongoing follow-up commitments. The Application gives practical advice on multiple areas of diabetes management, including sick-day rules and diabetic emergencies, as well as up-to-date information on technology, including setting up Libre devices and downloading glucose meters to facilitate attending virtual clinics. Delivery of this information in an easy-to-understand and comprehensive way is intended to improve patient engagement with diabetes services and ultimately empower patients in the control of their own disease. The application also offers a messaging service to allow the diabetes team to send out alerts to patient groups on specific issues, such as changes to clinics, or respond to recent news updates regarding Covid-19. The App was launched in NHS Fife in June 2020 and has amassed 800 active users so far. There is growing engagement with the App since its launch, with over 1000 user interactions in the last month alone. Feedback shows that 100% of users like the App and have found it useful in the management of their diabetes. The App has proven to be an essential tool in communication with one of the most vulnerable groups during the Covid-19 pandemic, and its ongoing development will continue to increase patient engagement and improve glycaemic control for patients with type 1 diabetes. The future of chronic disease management should involve digital solutions such as apps to further empower patients in their healthcare.

Keywords: diabetes, endocrinology, digital healthcare, medical apps

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1078 Beyond the Dust: Workers' Perspectives on Enhancing Silica Exposure Control in Tunnel Construction

Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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The construction industry, particularly tunnel construction, exposes workers to respirable crystalline silica (RCS), which can cause incurable illnesses such as silicosis and lung cancer. Despite various control measures, exposures remain inadequately controlled. This research aimed to examine what workers on a tunnelling project in Australia think should be done to reduce exposure to dust to protect them from RCS exposure. A qualitative research approach consisting of interviews and focus group discussions was employed for this research. The preliminary analysis of the data reveals a diverse array of solutions proposed to address the different sociotechnical factors that present challenges for effectively reducing dust exposure. Solutions are proposed to address challenges such as cost, time pressure, low-risk perception, inadequate awareness, inadequate enforcement and compliance with personal protective equipment. The findings highlight the need to make dust control a level playing field for all contractors during the bidding process, with more collaboration and enforcement after the signing of contracts. The research highlights that although improvements have been made in the past years regarding dust controls, many opportunities exist to reduce worker exposure to RCS.

Keywords: tunnel, respirable crystalline silica, RCS, dust exposure, personal protective equipment, worker perspectives

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1077 Sufism as Therapy of Terrorism and Extremism with Special Reference to the Teaching of Khawaja Ghulam Fareed and Bulleh Shah

Authors: Arshad Munir, Naseem Akhtar

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The determination of the Sufi is to effort towards unity. His main purpose is to bring humanity, separated as it is into so many different units, closer together in the deeper understanding of life. His mission is to bring about brotherhood among races, nations and faiths and to respect one another's faith, scripture and teacher. Sufi is to confer sympathy on these lives, to impart love, compassion and kindheartedness on all creations. The Sufi message is the resonance of the same Divine message which has always come and will always come to inform humanity. It is the continuation of all the pronounced religions which have come at several times and it is amalgamation of them all, which was the wish of all the prophets. Pakistan, who came into being in the name of Islam unfortunately, have linked with terrorism. It is a disgrace that in contemporary day Pakistan, mullahism and the recent cancer of Talibanisation are gradually eating into what had kept us integral as a society. Terrorism has grown-up to develop a prime safety pressure to the area. The terrorism has deadly caused decrease in overseas and local investment, exports, physical infrastructure, and wealth stock ultimately leading to damage of the socio-economic status of Pakistan. Main reasons are ignorance about the actual teaching of Islam both by Muslim and non-Muslim, exploitation by the religious and political influential, sectarianism and extremism, lack of tolerance and broadmindedness and reaction and retortion by the sufferer. The key treatment and therapy of the abovementioned illnesses exist in the messages of Sufism.

Keywords: sufism, love, Pakistan, terrorism

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1076 Cost-Effectiveness of a Certified Service or Hearing Dog Compared to a Regular Companion Dog

Authors: Lundqvist M., Alwin J., Levin L-A.

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Background: Assistance dogs are dogs trained to assist persons with functional impairment or chronic diseases. The assistance dog concept includes different types: guide dogs, hearing dogs, and service dogs. The service dog can further be divided into subgroups of physical services dogs, diabetes alert dogs, and seizure alert dogs. To examine the long-term effects of health care interventions, both in terms of resource use and health outcomes, cost-effectiveness analyses can be conducted. This analysis can provide important input to decision-makers when setting priorities. Little is known when it comes to the cost-effectiveness of assistance dogs. The study aimed to assess the cost-effectiveness of certified service or hearing dogs in comparison to regular companion dogs. Methods: The main data source for the analysis was the “service and hearing dog project”. It was a longitudinal interventional study with a pre-post design that incorporated fifty-five owners and their dogs. Data on all relevant costs affected by the use of a service dog such as; municipal services, health care costs, costs of sick leave, and costs of informal care were collected. Health-related quality of life was measured with the standardized instrument EQ-5D-3L. A decision-analytic Markov model was constructed to conduct the cost-effectiveness analysis. Outcomes were estimated over a 10-year time horizon. The incremental cost-effectiveness ratio expressed as cost per gained quality-adjusted life year was the primary outcome. The analysis employed a societal perspective. Results: The result of the cost-effectiveness analysis showed that compared to a regular companion dog, a certified dog is cost-effective with both lower total costs [-32,000 USD] and more quality-adjusted life-years [0.17]. Also, we will present subgroup results analyzing the cost-effectiveness of physicals service dogs and diabetes alert dogs. Conclusions: The study shows that a certified dog is cost-effective in comparison with a regular companion dog for individuals with functional impairments or chronic diseases. Analyses of uncertainty imply that further studies are needed.

Keywords: service dogs, hearing dogs, health economics, Markov model, quality-adjusted, life years

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1075 Compliance with the Health and Safety Standards/Regulations in the South African Mining Industry: A Literature Review

Authors: Livhuwani Muthelo, Tebogo Maria Mothiba, Rambelani Nancy Malema

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Background: Despite occupational legislation/standards being in place in the industry, there are many reported health and safety incidents, including both occupational injuries and illnesses in the South African mining industry. Purpose: This systematic literature review aimed to describe and identify the existing gaps in health and safety compliance within the South African mining industry and propose future research areas. Methodology: A systematic literature review was conducted using the key concepts of health and safety, compliance, standards, and mining. A total of 102 papers issued from 1994 to April 2020 were extracted from an online database search, which included a combination of South African and international government OHS legislation documents, policies, standards, reports from the mineral departments and international labour office, qualitative and quantitative journal articles, dissertations, seminars and conference proceedings. Results: The literature review revealed that, though there are laws, regulations, standards to guide the industry on health and safety issues in South Africa, the main challenge is with the compliance with the existing health and safety systems, wherein systems are not being implemented. Conclusion: Gaps between research, policy, and implementation in occupational health practice in the South African mining industry were also identified.

Keywords: circumstances, non-compliance, health and safety, standards, mining industry

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1074 Therapeutic Efficacy and Safety Profile of Tolvaptan Administered in Hyponatremia Patients

Authors: Sree Vennela P., V. Samyuktha Bhardwaj

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Hyponatremia is an electrolyte disturbance in which the sodium ion concentration in the serum is lower than normal. Sodium is the dominant extracellular cation (positive ion) and cannot freely cross from the interstitial space through the cell membrane, into the cell. Its homeostasis (stability of concentration) inside the cell is vital to the normal function of any cell. Normal serum sodium levels are between 135 and 145 mEq/L. Hyponatremia is defined as a serum level of less than 135 mEq/L and is considered severe when the serum level is below 125 mEq/L. In the vast majority of cases, Hyponatremia occurs as a result of excess body water diluting the serum sodium (salt level in the blood). Hyponatremia is often a complication of other medical illnesses in which excess water accumulates in the body at a higher rate than can be excreted (for example in congestive heart failure, syndrome of inappropriate antidiuretic hormone, SIADH, or polydipsia). Sometimes it may be a result of over-hydration (drinking too much water).Lack of sodium (salt) is very rarely the cause of Hyponatremia, although it can promote Hyponatremia indirectly. In particular, sodium loss can lead to a state of volume depletion (loss of blood volume in the body), with volume depletion serving as a signal for the release of ADH (anti-diuretic hormone). As a result of ADH-stimulated water retention (too much water in the body), blood sodium becomes diluted and Hyponatremia results.

Keywords: Tolvaptan, hyponatremia, syndrome of insufficient anti diuretic hormone (SIADH), euvolemic hyponatremia

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1073 Anti-Methicillin-Resistant Staphylococcus aureus (MRSA) Compounds from Bauhinia kockiana Korth and Their Mechanism of Antibacterial Activity

Authors: Yik Ling Chew, Adlina Maisarah Mahadi, Joo Kheng Goh

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Bauhinia kockiana originates from Peninsular Malaysia, and it is grown as a garden ornamental plant. However, it is used as medicinal plant by Malaysia ‘Kelabit’ ethic group in treating various diseases and illnesses. This study focused on the assessment of the antibacterial activity of B. kockiana towards MRSA, to purify and identify the antibacterial compounds, and to determine the mechanism of antibacterial activity. Antibacterial activity of B. kockiana flower is evaluated qualitatively and quantitatively using disc diffusion assay and microbroth dilution method to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of extracts. Phytochemical analysis is performed to determine the classes of phytochemicals in the extracts. Bioactivity-guided isolation is performed to purify the antibacterial agents and identified the chemical structures via various spectroscopy methods. Scanning electron microscopy (SEM) technique is adopted to evaluate the antibacterial mechanism of extract and compounds isolated. B. kockiana flower is found to exhibit fairly strong antibacterial activity towards both strains of MRSA bacteria. Gallic acid and its ester derivatives are purified from ethyl acetate extract and the antibacterial activity is evaluated. SEM has revealed the mechanism of the extracts and compounds isolated.

Keywords: alkyl gallates, Bauhinia kockiana, MRSA, scanning electron microscopy

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1072 Possible Endocrinal and Liver Enzymes Toxicities Associated with Long Term Exposure to Benzene in Saudi Arabia

Authors: Faizah Asiri, Mohammed Fathy, Saeed Alghamdi, Nahlah Ayoub, Faisal Asiri

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Background: - The strategies for this study were based on the toxic effect of long-term inhalation of Benzene on hormones and liver enzymes and various parameters related to it. The following databases were searched: benzene, hepatotoxic, benzene metabolism, hormones, testosterone, hemotoxic, and prolonged exposure. A systematic strategy is designed to search the literature that links benzene with the multiplicity and different types of intoxication or the medical abbreviations of diseases relevant to benzene exposure. Evidence suggests that getting rid of inhaled gasoline is by exhalation. Absorbed benzene is metabolized by giving phenolic acid as well as meconic acid, followed by urinary excretion of conjugate sulfates and glucuronides. Materials and Methods :- This work was conducted in the Al-Khadra laboratory in Taif 2020/2021 and aimed to measure some of the possible endocrinal and liver toxicities associated with benzene's long-term exposure in Saudi Arabia at the station workers who are considered the most exposed category to gasoline. One hundred ten station workers were included in this study. They were divided into four patient groups according to the chronic exposure rate to benzene, one control group, and three other groups of exposures. As follows: patient Group 1 (controlled group), patient Group 2 (exposed less than 1y), patient Group 3 (exposed 1-5 y), patient Group 4 (more than 5). Each group is compared with blood sample parameters (ALT, FSH and Testosterone, TSH). Blood samples were drawn from the participants, and statistical tests were performed. Significant change (p≤0.05) was examined compared to the control group. Workers' exposure to benzene led to a significant change in hematological, hormonal, and hepatic factors compared to the control group. Results:- The results obtained a relationship between long-term exposure to benzene and a decrease in the level of testosterone and FSH hormones, including that it poses a toxic risk in the long term (p≤0.05) when compared to the control. We obtained results confirming that there is no significant coloration between years of exposure and TSH level (p≤0.05) when compared to the control. Conclusion:- We conclude that some hormones and liver enzymes are affected by chronic doses of benzene through inhalation after our study was on the group most exposed to benzene, which is gas station workers.

Keywords: toxicities, benzene, hormones, station workers

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1071 An Investigation of the Compliance of Kermanian College Students' Diet with Who/Fao Nutrition Targets

Authors: Farideh Doostan, Sahar Mohseni Taklloo, Mohammad Nosrati

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Chronic diseases are non-communicable and largely preventable by lifestyle changes including healthy diet consumption. They are the most common cause of death in the world and projected to increase by 15% globally between 2010 and 2020.The hazardous effects of behavioral and dietary risk factors on chronic disease have been established in prospective cohort studies and randomized trials. Because of some changes occur in college students’ lifestyle, assessment of dietary risk factors is important in these populations. Objective: This research was the first study that conducted to evaluate dietary intakes of Kermanian college students with WHO/FAO nutritional objectives. Material and Methods: In this descriptive cross-sectional study, 229 healthy college students of health faculty in Kerman University of Medical Sciences that do not intake any medical drugs were recruited using multistage sampling in 2013.Usual dietary intake was collected using a valid Food Frequency Questionnaire (FFQ) and diet quality was calculated based on WHO nutrient goals. To analysis of data between two groups, independent sample t. test and man whitney were applied. Results: Two hundred and twenty-nine college students; 151 females (65.9%) and 78 males (34.1%), the mean age of 21.9 years were studied. The mean of the Body Mass Index (Kg/m2) and Waist Circumference (cm) in males were 22.34 ±3.52 and 80.76±11.16 and in females were 21.19±2.62 and 73.67±7.65 respectively. Mean of daily cholesterol intake in males was significantly more than females (305±101 VS 268±98; P=0.008) and more than WHO/FAO recommendation (less than 300 mg/day). The mean of daily sodium intake in men and women were 10.4±1 and 10.9±5.3 respectively. These amounts were more than WHO/FAO recommendation (less than 2g/day). In addition, women were consumed fruit and vegetables more than men (839±336 VS 638±281; p ‹ 0.001) and these amounts were more than WHO/FAO recommendation (more than 400g/day) in both groups. Other intake indices were in the range of WHO/FAO recommendations, So that Percent of calories intake from total fat, saturated fatty acids, polyunsaturated fatty acids and added sugar were in compliance with WHO/FAO recommendations. Conclusion: Cholesterol intake in men and sodium intake in all participants were more than WHO/FAO recommendation. These dietary components are the most important causes of cardiovascular disease (one of the main causes of death in our population). These results indicated that proper nutritional education and interventions are needed in this population.

Keywords: college students, food intake, WHO /FAO nutrient intake goals, Kerman

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1070 LncRNA-miRNA-mRNA Networks Associated with BCR-ABL T315I Mutation in Chronic Myeloid Leukemia

Authors: Adenike Adesanya, Nonthaphat Wong, Xiang-Yun Lan, Shea Ping Yip, Chien-Ling Huang

Abstract:

Background: The most challenging mutation of the oncokinase BCR-ABL protein T315I, which is commonly known as the “gatekeeper” mutation and is notorious for its strong resistance to almost all tyrosine kinase inhibitors (TKIs), especially imatinib. Therefore, this study aims to identify T315I-dependent downstream microRNA (miRNA) pathways associated with drug resistance in chronic myeloid leukemia (CML) for prognostic and therapeutic purposes. Methods: T315I-carrying K562 cell clones (K562-T315I) were generated by the CRISPR-Cas9 system. Imatinib-treated K562-T315I cells were subjected to small RNA library preparation and next-generation sequencing. Putative lncRNA-miRNA-mRNA networks were analyzed with (i) DESeq2 to extract differentially expressed miRNAs, using Padj value of 0.05 as cut-off, (ii) STarMir to obtain potential miRNA response element (MRE) binding sites of selected miRNAs on lncRNA H19, (iii) miRDB, miRTarbase, and TargetScan to predict mRNA targets of selected miRNAs, (iv) IntaRNA to obtain putative interactions between H19 and the predicted mRNAs, (v) Cytoscape to visualize putative networks, and (vi) several pathway analysis platforms – Enrichr, PANTHER and ShinyGO for pathway enrichment analysis. Moreover, mitochondria isolation and transcript quantification were adopted to determine the new mechanism involved in T315I-mediated resistance of CML treatment. Results: Verification of the CRISPR-mediated mutagenesis with digital droplet PCR detected the mutation abundance of ≥80%. Further validation showed the viability of ≥90% by cell viability assay, and intense phosphorylated CRKL protein band being detected with no observable change for BCR-ABL and c-ABL protein expressions by Western blot. As reported by several investigations into hematological malignancies, we determined a 7-fold increase of H19 expression in K562-T315I cells. After imatinib treatment, a 9-fold increment was observed. DESeq2 revealed 171 miRNAs were differentially expressed K562-T315I, 112 out of these miRNAs were identified to have MRE binding regions on H19, and 26 out of the 112 miRNAs were significantly downregulated. Adopting the seed-sequence analysis of these identified miRNAs, we obtained 167 mRNAs. 6 hub miRNAs (hsa-let-7b-5p, hsa-let-7e-5p, hsa-miR-125a-5p, hsa-miR-129-5p, and hsa-miR-372-3p) and 25 predicted genes were identified after constructing hub miRNA-target gene network. These targets demonstrated putative interactions with H19 lncRNA and were mostly enriched in pathways related to cell proliferation, senescence, gene silencing, and pluripotency of stem cells. Further experimental findings have also shown the up-regulation of mitochondrial transcript and lncRNA MALAT1 contributing to the lncRNA-miRNA-mRNA networks induced by BCR-ABL T315I mutation. Conclusions: Our results have indicated that lncRNA-miRNA regulators play a crucial role not only in leukemogenesis but also in drug resistance, considering the significant dysregulation and interactions in the K562-T315I cell model generated by CRISPR-Cas9. In silico analysis has further shown that lncRNAs H19 and MALAT1 bear several complementary miRNA sites. This implies that they could serve as a sponge, hence sequestering the activity of the target miRNAs.

Keywords: chronic myeloid leukemia, imatinib resistance, lncRNA-miRNA-mRNA, T315I mutation

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1069 Treatment of Full-Thickness Rotator Cuff Tendon Tear Using Umbilical Cord Blood-Derived Mesenchymal Stem Cells and Polydeoxyribonucleotides in a Rabbit Model

Authors: Sang Chul Lee, Gi-Young Park, Dong Rak Kwon

Abstract:

Objective: The aim of this study was to investigate regenerative effects of ultrasound (US)-guided injection with human umbilical cord blood-derived mesenchymal stem cells (UCB-MSCs) and/or polydeoxyribonucleotide (PDRN) injection in a chronic traumatic full-thickness rotator cuff tendon tear (FTRCTT) in a rabbit model. Material and Methods: Rabbits (n = 32) were allocated into 4 groups. After a 5-mm sized FTRCTT just proximal to the insertion site on the subscapularis tendon was created by excision, the wound was immediately covered by silicone tube to prevent natural healing. After 6 weeks, 4 injections (0.2 mL normal saline, G1; 0.2 mL PDRN, G2; 0.2 mL UCB-MSCs, G3; and 0.2 mL UCB-MSCs with 0.2ml PDRN, G4) were injected into FTRCTT under US guidance. We evaluated gross morphologic changes on all rabbits after sacrifice. Masson’s trichrome, anti-type 1 collagen antibody, bromodeoxyuridine, proliferating cell nuclear antigen, vascular endothelial growth factor and platelet endothelial cell adhesion molecule stain were performed to evaluate histological changes. Motion analysis was also performed. Results: The gross morphologic mean tendon tear size in G3 and 4 was significantly smaller than that of G1 and 2 (p < .05). However, there were no significant differences in tendon tear size between G3 and 4. In G4, newly regenerated collagen type 1 fibers, proliferating cells activity, angiogenesis, walking distance, fast walking time, and mean walking speed were greater than in the other three groups on histological examination and motion analysis. Conclusion: Co-injection of UCB-MSCs and PDRN was more effective than UCB-MSCs injection alone in histological and motion analysis in a rabbit model of chronic traumatic FTRCTT. However, there was no significant difference in gross morphologic change of tendon tear between UCB-MSCs with/without PDRN injection. The results of this study regarding the combination of UCB-MSCs and PDRN are worth additional investigations.

Keywords: mesenchymal stem cell, umbilical cord, polydeoxyribonucleotides, shoulder, rotator cuff, ultrasonography, injections

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1068 The Comparation of Limits of Detection of Lateral Flow Immunochromatographic Strips of Different Types of Mycotoxins

Authors: Xinyi Zhao, Furong Tian

Abstract:

Mycotoxins are secondary metabolic products of fungi. These are poisonous, carcinogens and mutagens in nature and pose a serious health threat to both humans and animals, causing severe illnesses and even deaths. The rapid, simple and cheap detection methods of mycotoxins are of immense importance and in great demand in the food and beverage industry as well as in agriculture and environmental monitoring. Lateral flow immunochromatographic strips (ICSTs) have been widely used in food safety, environment monitoring. Forty-six papers were identified and reviewed on Google Scholar and Scopus for their limit of detection and nanomaterial on Lateral flow immunochromatographic strips on different types of mycotoxins. The papers were dated 2001-2021. Twenty five papers were compared to identify the lowest limit of detection of among different mycotoxins (Aflatoxin B1: 10, Zearalenone:5, Fumonisin B1: 5, Trichothecene-A: 5). Most of these highly sensitive strips are competitive. Sandwich structure are usually used in large scale detection. In conclusion, the mycotoxin receives that most researches is aflatoxin B1 and its limit of detection is the lowest. Gold-nanopaticle based immunochromatographic test strips has the lowest limit of detection. Five papers involve smartphone detection and they all detect aflatoxin B1 with gold nanoparticles. In these papers, quantitative concentration results can be obtained when the user uploads the photograph of test lines using the smartphone application.

Keywords: aflatoxin B1, limit of detection, gold nanoparticle, lateral flow immunochromatographic strips, mycotoxins

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1067 Prevalence of Chronic Diseases and Predictors of Mortality in Home Health Care Service: Data From Saudi Arabia

Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

Abstract:

Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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1066 Major Depressive Disorder: Diagnosis based on Electroencephalogram Analysis

Authors: Wajid Mumtaz, Aamir Saeed Malik, Syed Saad Azhar Ali, Mohd Azhar Mohd Yasin

Abstract:

In this paper, a technique based on electroencephalogram (EEG) analysis is presented, aiming for diagnosing major depressive disorder (MDD) among a potential population of MDD patients and healthy controls. EEG is recognized as a clinical modality during applications such as seizure diagnosis, index for anesthesia, detection of brain death or stroke. However, its usability for psychiatric illnesses such as MDD is less studied. Therefore, in this study, for the sake of diagnosis, 2 groups of study participants were recruited, 1) MDD patients, 2) healthy people as controls. EEG data acquired from both groups were analyzed involving inter-hemispheric asymmetry and composite permutation entropy index (CPEI). To automate the process, derived quantities from EEG were utilized as inputs to classifier such as logistic regression (LR) and support vector machine (SVM). The learning of these classification models was tested with a test dataset. Their learning efficiency is provided as accuracy of classifying MDD patients from controls, their sensitivities and specificities were reported, accordingly (LR =81.7 % and SVM =81.5 %). Based on the results, it is concluded that the derived measures are indicators for diagnosing MDD from a potential population of normal controls. In addition, the results motivate further exploring other measures for the same purpose.

Keywords: major depressive disorder, diagnosis based on EEG, EEG derived features, CPEI, inter-hemispheric asymmetry

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1065 The Developing of Knowledge-Based System for the Medical Treatment with Herbs

Authors: Rujijan Vichivanives

Abstract:

This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: developing, herbs, knowledge-based system, medical treatment

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1064 Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Authors: Andrea Zielke-Nadkarni

Abstract:

Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: pain management, migrants, sociocultural context, palliative care

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1063 Analysis of Sickle Cell Disease and Maternal Mortality in United Kingdom

Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

Abstract:

Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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1062 The Second Generation of Tyrosine Kinase Inhibitor Afatinib Controls Inflammation by Regulating NLRP3 Inflammasome Activation

Authors: Shujun Xie, Shirong Zhang, Shenglin Ma

Abstract:

Background: Chronic inflammation might lead to many malignancies, and inadequate resolution could play a crucial role in tumor invasion, progression, and metastases. A randomised, double-blind, placebo-controlled trial shows that IL-1β inhibition with canakinumab could reduce incident lung cancer and lung cancer mortality in patients with atherosclerosis. The process and secretion of proinflammatory cytokine IL-1β are controlled by the inflammasome. Here we showed the correlation of the innate immune system and afatinib, a tyrosine kinase inhibitor targeting epidermal growth factor receptor (EGFR) in non-small cell lung cancer. Methods: Murine Bone marrow derived macrophages (BMDMs), peritoneal macrophages (PMs) and THP-1 were used to check the effect of afatinib on the activation of NLRP3 inflammasome. The assembly of NLRP3 inflammasome was check by co-immunoprecipitation of NLRP3 and apoptosis-associated speck-like protein containing CARD (ASC), disuccinimidyl suberate (DSS)-cross link of ASC. Lipopolysaccharide (LPS)-induced sepsis and Alum-induced peritonitis were conducted to confirm that afatinib could inhibit the activation of NLRP3 in vivo. Peripheral blood mononuclear cells (PBMCs) from non-small cell lung cancer (NSCLC) patients before or after taking afatinib were used to check that afatinib inhibits inflammation in NSCLC therapy. Results: Our data showed that afatinib could inhibit the secretion of IL-1β in a dose-dependent manner in macrophage. Moreover, afatinib could inhibit the maturation of IL-1β and caspase-1 without affecting the precursors of IL-1β and caspase-1. Next, we found that afatinib could block the assembly of NLRP3 inflammasome and the ASC speck by blocking the interaction of the sensor protein NLRP3 and the adaptor protein ASC. We also found that afatinib was able to alleviate the LPS-induced sepsis in vivo. Conclusion: Our study found that afatinib could inhibit the activation of NLRP3 inflammasome in macrophage, providing new evidence that afatinib could target the innate immune system to control chronic inflammation. These investigations will provide significant experimental evidence in afatinib as therapeutic drug for non-small cell lung cancer or other tumors and NLRP3-related diseases and will explore new targets for afatinib.

Keywords: inflammasome, afatinib, inflammation, tyrosine kinase inhibitor

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1061 Monstrous Beauty: Disability and Illness in Contemporary Pop Culture

Authors: Grzegorz Kubinski

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In the proposed paper, we would like to present the phenomenon of disease and disability as an element of discourse redefining the contemporary canons of beauty and the category of normativity. In widely understood media, and above all in social media and fashion industry, the use of the disease as an aesthetic category has long been observed. There is an interesting case of promoting and maintaining a certain, ideal pattern of physical beauty, while at the same time very clear exploitation of various types of illnesses. The categories of disease and disabled body are shown as an element of the expression of the individuality and originality of one's own identity, while at the same time the disabled person is still experiencing social exclusion. Illness or body abnormality as an aesthetic category also functions as an ethical-political category. The analysis of the interrelations of these discourses will be presented on the example of selected projects present in social media, like Instagram or Facebook. We would like to present how old forms of 'curiosities' or 'abnormalities' turned into mainstream forms of a new aesthetic. For marginalized disabled people, there is a new form of expression and built their identity. But, there is an interesting point: are this contemporary forms of using disability and illness really new? Or maybe this is just another form of Wunderkammer or even cabinets of curiosities? We propose to analyze contemporary cultural and social context in order to clarify this issue. On the other hand, we would like to present some examples from personal interviews with disabled internet influencers and statements disabled persons concerning the role of the different body in society (e.g. #bodypositive, #perfeclyflawed).

Keywords: disability, new media, defect, fashion

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1060 Mental Illness on Youtube: Exploring Identity Performance in the Virtual Space

Authors: P. Saee, Baiju Gopal

Abstract:

YouTube has seen a surge in the recent years in the number of creators opening up about their mental illness on the video-sharing platform. In documenting their mental health, YouTubers perform an identity of their mental illness in the online world. Identity performance is a theory under identity research that has been readily applied to illness narratives and internet studies. Furthermore, in India, suffering from mental illnesses is regarded with stigma, making the act of taking mental health from a personal to a public space on YouTube a phenomenon worth exploring. Thus, the aim of this paper is to analyse the mental illness narratives of Indian YouTubers for understanding its performance in the virtual world. For this purpose, thematic narrative analysis on the interviews of four Indian YouTubers was conducted. This data was synthesized with analysis of the videos the YouTubers had uploaded on their channel sharing about their mental illness. The narratives of the participants shed light on two significant presentations that they engage in: (a) the identity of a survivor/fighter and (b) the identity of a silent sufferer. Further, the participants used metaphors to describe their illness, thereby co-constructing a corresponding identity based on their particular metaphors. Lastly, the process of bringing mental illness from back stage to front stage on YouTube involves a shift in the audience, from being rejecting and invalidating in real life to being supportive and encouraging in the virtual space. Limitations and implications for future research were outlined.

Keywords: cyber-psychology, internet, media, mental health, mental illness, technology

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1059 The State of Herb Medicine in Oriental Morocco: Cases of Debdou, Taourirt and Guerssif Districts

Authors: Himer Khalid, Alami Ilyass, Kharchoufa Loubna, Elachouri Mostafa

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It has been estimated by the World Health Organization that 80% of the world's population relies on traditional medicine to meet their daily health requirements. In Morocco reliance on such medicine is partly owing to the high cost of conventional medicine and the inaccessibility of modern health care facilities. There was high agreement in the use of plants as medicine in Oriental Morocco. Our objective is to evaluate the informant’s knowledge on medicinal plants by the local population and to document the uses of medicinal plants by this community, for the treatment of different illnesses. Using an ethnopharmacological approach, we collected information concerning the traditional medicinal knowledge and the medicinal plants used, by interviewing successfully 458 informants living in oriental Morocco (from Debdou, Taourirt, Guersif a,d Laayoune districts). The data were analyzed by statistical methods (Component Analysis “CA”, Factorial Analysis “FA”) and other methods such as through Informant’s Consensus Factor (ICF) and Use Value (UV). Our results indicate that, more than 60% of the population in these regions relies on medicinal plants for the treatment of different ailments with predominance of women consumers. 135 plant species belonging to 61 families were documented. These plants were used by the population for the treatment of a group of illness (about 14 principal ailments). We conclude that, in oriental Morocco, till now, the population has some traditional knowledge commonly used as medical tradition. These wealthy heritage needs conservation and evaluation.

Keywords: Morocco, medicinal plants, traditional knowledge, wealthy heritage

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1058 Retrospective Study for Elective Medical Patients Evacuation of Different Diagnoses Requiring Different Approach in Oxygen Usage

Authors: Branimir Skoric

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Over the past two decades, number of international travels rose significantly in the United Kingdom and Worldwide in the shape of business travels and holiday travels as well. The fact that elderly people travel a lot, more than ever before increased the needs for medical evacuations (repatriations) back home if they fell ill abroad or had any kind of accident. This paper concerns medical evacuations of patients on the way back home to the United Kingdom (United Kingdom Residents) and their specific medical needs during short-haul or long-haul commercial scheduled flight and ground transportation to the final destination regardless whether it was hospital or usual place of residence. Particular medical need during medical evacuations is oxygen supply and it can be supplied via portable oxygen concentrator, pulse flow oxygenator or continuous free flow oxygenator depending on the main diagnosis and patient’s comorbidities. In this retrospective study, patients were divided into two groups. One group was consisted of patients suffering from cardio-respiratory diagnoses as primary illness. Another Group consisted of patients suffering from noncardiac illnesses who have other problems including any kind of physical injury. Needs for oxygen and type of supply were carefully considered in regards of duration of the flight, standard airline cabin pressure and results described in this retrospective study.

Keywords: commercial flight, elderly travellers, medical evacuations, oxygen

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1057 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study

Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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