Search results for: personalized health care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10603

Search results for: personalized health care

5173 Data Calibration of the Actual versus the Theoretical Micro Electro Mechanical Systems (MEMS) Based Accelerometer Reading through Remote Monitoring of Padre Jacinto Zamora Flyover

Authors: John Mark Payawal, Francis Aldrine Uy, John Paul Carreon

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This paper shows the application of Structural Health Monitoring, SHM into bridges. Bridges are structures built to provide passage over a physical obstruction such as rivers, chasms or roads. The Philippines has a total of 8,166 national bridges as published on the 2015 atlas of the Department of Public Works and Highways (DPWH) and only 2,924 or 35.81% of these bridges are in good condition. As a result, PHP 30.464 billion of the 2016 budget of DPWH is allocated on roads and/or bridges maintenance alone. Intensive spending is owed to the present practice of outdated manual inspection and assessment, and poor structural health monitoring of Philippine infrastructures. As the School of Civil, Environmental, & Geological Engineering of Mapua Institute of Technology (MIT) continuous its well driven passion in research based projects, a partnership with the Department of Science and Technology (DOST) and the DPWH launched the application of Structural Health Monitoring, (SHM) in Padre Jacinto Zamora Flyover. The flyover is located along Nagtahan Boulevard in Sta. Mesa, Manila that connects Brgy. 411 and Brgy. 635. It gives service to vehicles going from Lacson Avenue to Mabini Bridge passing over Legarda Flyover. The flyover is chosen among the many located bridges in Metro Manila as the focus of the pilot testing due to its site accessibility, and complete structural built plans and specifications necessary for SHM as provided by the Bureau of Design, BOD department of DPWH. This paper focuses on providing a method to calibrate theoretical readings from STAAD Vi8 Pro and sync the data to actual MEMS accelerometer readings. It is observed that while the design standards used in constructing the flyover was reflected on the model, actual readings of MEMS accelerometer display a large difference compared to the theoretical data ran and taken from STAAD Vi8 Pro. In achieving a true seismic response of the modeled bridge or hence syncing the theoretical data to the actual sensor reading also called as the independent variable of this paper, analysis using single degree of freedom (SDOF) of the flyover under free vibration without damping using STAAD Vi8 Pro is done. The earthquake excitation and bridge responses are subjected to earthquake ground motion in the form of ground acceleration or Peak Ground Acceleration, PGA. Translational acceleration load is used to simulate the ground motion of the time history analysis acceleration record in STAAD Vi8 Pro.

Keywords: accelerometer, analysis using single degree of freedom, micro electro mechanical system, peak ground acceleration, structural health monitoring

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5172 The Estimation Method of Inter-Story Drift for Buildings Based on Evolutionary Learning

Authors: Kyu Jin Kim, Byung Kwan Oh, Hyo Seon Park

Abstract:

The seismic responses-based structural health monitoring system has been performed to reduce seismic damage. The inter-story drift ratio which is the major index of the seismic capacity assessment is employed for estimating the seismic damage of buildings. Meanwhile, seismic response analysis to estimate the structural responses of building demands significantly high computational cost due to increasing number of high-rise and large buildings. To estimate the inter-story drift ratio of buildings from the earthquake efficiently, this paper suggests the estimation method of inter-story drift for buildings using an artificial neural network (ANN). In the method, the radial basis function neural network (RBFNN) is integrated with optimization algorithm to optimize the variable through evolutionary learning that refers to evolutionary radial basis function neural network (ERBFNN). The estimation method estimates the inter-story drift without seismic response analysis when the new earthquakes are subjected to buildings. The effectiveness of the estimation method is verified through a simulation using multi-degree of freedom system.

Keywords: structural health monitoring, inter-story drift ratio, artificial neural network, radial basis function neural network, genetic algorithm

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5171 Psychosocial Experience of Parents of Children with Conduct Disorder in Thulamela, South Africa

Authors: Constance Singo, Choja Oduaran

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Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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5170 The Efficacy of Albendazole against Soil-Transmitted Helminths and the Impact of Mass Drug Administration of Albendazole and Ivermectin on Health Status

Authors: Mike Yaw Osei-Atweneboana, John Asiedu Larbi, Edward Jenner Tettevi

Abstract:

Background: The lymphatic filariasis (LF) control programme has been on-going in Ghana since 2000. This community-wide approach involves the use of ivermectin (IVM) and albendazole (ALB). Soil-transmitted helminth (STH) infections control is augmented within this programme; however, in areas where LF is not prevalent, albendazole alone is administered to school children. The purpose of this study was therefore, to determine the efficacy of albendazole against soils transmitted helminths and the impact of mass drug administration of albendazole and ivermectin on the health status of children of school going age and pregnant women. Material/Methods: This was a twelve months longitudinal study. A total of 412 subjects including school children (between the ages of 2-17 years) and pregnant women were randomly selected from four endemic communities in Kpandai district of the Northern region. Coprological assessment for parasites was based on the Kato–Katz technique in both dry and rainy seasons at baseline, 21 days and 3 months post-treatment. Single-dose albendazole treatment was administered to all patients at baseline. Preserved samples are currently under molecular studies to identify possible single nucleotide polymorphism (SNP) within the beta tubulin gene which is associated with benzimidazole resistance. Results: Of all the parasites found (hookworm, Trichuris trichiura, Hymenolepis nana, and Taenia sp.); hookworm was the most prevalent. In the dry season, the overall STHs prevalence at pre-treatment was 29%, while 9% and 13% prevalence was recorded at 21 days, and three months after treatment respectively. However, in the rainy season, the overall STHs prevalence was 8%, while 4% and 12% was recorded at 21 days and three months respectively after ALB treatment. In general, ALB treatment resulted in an overall hookworm egg count reduction rate of 89% in the dry season and 93% in the rainy season, while the T. trichiura egg count reduction rate was 100% in both seasons. Conclusions: STH infections still remains a significant public health burden in Ghana. Hookworm infection seems to respond poorly or sub-optimally to ALB, raising concerns of possible emergence of resistance which may lead to a major setback for the control and elimination of STH infections, especially hookworm infections.

Keywords: hookworm, sub-optimal response, albendazole, trichuriasis, soil-transmitted helminths

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5169 Oral Versus Iontophoresis Nonsteroidal Anti-Inflammatory Drugs in Tennis Elbow

Authors: Moustafa Ali Elwan, Ibrahim Salem Abdelrafa, Ashraf Moharm

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed oral and topical drugs worldwide. Moreover, NSAIDs are responsible for most of all adverse drug reactions. For several decades, there are numerous attempts to use the cutaneous layers as a gate into the body for the local delivery of the therapeutic agent. Transdermal drug delivery is a validated technology contributing significantly to global pharmaceutical care. Transdermal Drug Delivery systems can be improved by using therapeutic agents. Moreover, Transdermal Drug Delivery systems can be improved by using chemical enhancers like ultrasound or iontophoresis. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. Objective: to compare the drug administration by ‘iontophoresis’ versus the oral rule. Methods: This study was conducted at the Faculty of Physical Therapy, Modern University for technology and information, Cairo, Egypt, on 20 participants (8 female & 12 male) who complained of tennis elbow. Their mean age was (25.45 ± 3.98) years, and all participants were assessed in many aspects: Pain threshold was assessed by algometer. Range of motion was assessed by electro goniometer, and isometric strength was assessed by a portable hand-held dynamometer. Then Participants were randomly assigned into two groups: group A was treated with oral NSAID (diclofenac) while group B was treated via administration of NSAIDs (diclofenac) via an iontophoresis device. All the participants were subjected to blood samples analysis in both pre-administration of the drug and post-administration of the drug for 24 hours (sample/every 6 hours). Results: The results demonstrated that there was a significant improvement in group b, “iontophoresis NSAIDs group,” more than in group B,” oral NSAIDs group,” in all measurements ‘ pain threshold, strength, and range of motion. Also, the iontophoresis method shows higher maximum plasma concentrations (Cmax) and concentration-time curves than the oral method.

Keywords: diclofenac, iontophoresis, NSAIDs, oral, tennis elbow

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5168 Benefits and Drawbacks of Robotic Firefighting

Authors: Mukhtar Ibrahim Bello, Ibrahim U. Aikawa, Abubakar Sadiq Muhammad, Muhammad Baballe Ahmad

Abstract:

These vital signs can be tracked by wearable sensors, which can also be used to assess patients' health. As a result, they can be very beneficial to patients and healthcare professionals in the diagnosis of diseases, particularly when it comes to taking a patient's body temperature in infectious disorders.

Keywords: fire out-break, robots, saving, dangerous environments, impacts

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5167 Embracing Our Scars: Self-Harm 101

Authors: Bree Wiles

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Self-harm is still a topic that is not talked about enough, especially with the growing concern for the safety of LGBTQIA+ youth. LGBTQIA+ youth are coming out at earlier ages, thus bringing to attention the added risks for this population. Many LGBTQIA+ youth end up engaging in some form of self-destructive behavior from dealing with the stigma and negative socialization around them. Within the LGBTQIA+ youth population, self-harm alongside depression and suicide is especially common. This disparity shows the importance of providing LGBTQIA+ youth with resources that affirm their identities. As professionals and parents, it is important to understand the types of self-harm, the average age range when it can occur, causes, populations, risk factors, and self-harm in connection with mental health and suicide. It is imperative to provide protective factors for LGBTQIA+ youth in helping to replace self-harming behaviors with positive coping strategies. Helping LGBTQIA+ youth in different contexts, including from a professional, parent, and educator perspective, allows unique ways in which each can assist an LGBTQIA+ youth who is self-harming. The stigma, shame, and many misconceptions about self-harming behaviors are discussed in depth including from the lived experience of this author and professional experiences working with queer youth. Most importantly, it is imperative to know how to approach LGBTQIA+ youth who are self-harming, including how to speak in a compassionate and empathy-based framework. Clear interventions and therapeutic techniques based on evidence-based practices on alternatives to self-harm, lived experience, and previous practices with queer youth who are self-harming are provided and discussed.

Keywords: LGBTQ+, mental health, self-harm, depression

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5166 A Study of the Prevalence of Hypertension and Pre Hypertension in Adolescence Age between 10-17 in Ahvaz (2008-2009)

Authors: Armaghan Moravej Aleali, Seyed Mahmoud Latifi, Homeira Rashidi

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Objective: High blood pressure in a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. The aim of this present was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. Material & Methods: This descriptive-analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran). A questionnaire include: height, weight, and body mass index, systolic and diastolic blood pressures filled for each participant. Blood pressure was measured twice for each person. For the diagnosis of hypertension, the fourth report of the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Health Institute of United States was used. Results: The subject participants of the study were 1707children and adolescents including 922 boys (54%) and 785 girls 46%). The prevalence of high blood pressure was 1.7% (boys 2.5% girls 0.8%). The prevalence of pre-hypertension was 9 % (7.6% in boys, 10.6% in girls). The mean systolic and diastolic blood pressures increased with increasing body mass index. Conclusion: In this study, the prevalence of high blood pressure was found to be lower than other studies in our country. The prevalence of the high blood pressure in boys was significantly higher than girls. This study, like other studies, showed a high correlation between being overweight and an increase in systolic and diastolic blood pressure.

Keywords: hypertension, pre-hypertension, childhood, adolescence

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5165 Innovative Practices That Have Significantly Scaled up Depot Medroxy Progesterone Acetate-SC Self-Inject Services

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background The Delivering Innovations in Selfcare (DISC) project promotes universal access to quality selfcare services beginning with subcutaneous depot medroxy progesterone acetate (DMPA-SC) contraceptive self-injection (SI) option. Self-inject (SI) offers women a highly effective and convenient option that saves them frequent trips to providers. Its increased use has the potential to improve the efficiency of an overstretched healthcare system by reducing provider workloads. State Social and Behavioral Change Communications (SBCC) Officers lead project demand creation and service delivery innovations that have resulted in significant increases in SI uptake among women who opt for injectables. Strategies Service Delivery Innovations The implementation of the "Moment of Truth (MoT)" innovation helped providers overcome biases and address client fear and reluctance to self-inject. Bi-annual program audits and supportive mentoring visits helped providers retain their competence and motivation. Proper documentation, tracking, and replenishment of commodities were ensured through effective engagement with State Logistics Units. The project supported existing state monitoring and evaluation structures to effectively record and report subcutaneous depot medroxy progesterone acetate (DMPA-SC) service utilization. Demand creation Innovations SBCC Officers provide oversight, routinely evaluate performance, trains, and provides feedback for the demand creation activities implemented by community mobilizers (CMs). The scope and intensity of training given to CMs affect the outcome of their work. The project operates a demand creation model that uses a schedule to inform the conduct of interpersonal and group events. Health education sessions are specifically designed to counter misinformation, address questions and concerns, and educate target audience in an informed choice context. The project mapped facilities and their catchment areas and enlisted the support of identified influencers and gatekeepers to enlist their buy-in prior to entry. Each mobilization event began with pre-mobilization sensitization activities, particularly targeting male groups. Context-specific interventions were informed by the religious, traditional, and cultural peculiarities of target communities. Mobilizers also support clients to engage with and navigate online digital Family Planning (FP) online portals such as DiscoverYourPower website, Facebook page, digital companion (chat bot), interactive voice response (IVR), radio and television (TV) messaging. This improves compliance and provides linkages to nearby facilities. Results The project recorded 136,950 self-injection (SI) visits and a self-injection (SI) proportion rate that increased from 13 percent before the implementation of interventions in 2021 to 62 percent currently. The project cost-effectively demonstrated catalytic impact by leveraging state and partner resources, institutional platforms, and geographic scope to scale up interventions. The project also cost effectively demonstrated catalytic impact by leveraging on the state and partner resources, institutional platforms, and geographic scope to sustainably scale-up these strategies. Conclusion Using evidence-informed iterations of service delivery and demand creation models have been useful to significantly drive self-injection (SI) uptake. It will be useful to consider this implementation model during program design. Contemplation should also be given to systematic and strategic execution of strategies to optimize impact.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, innovation, service delivery, demand creation.

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5164 Saliva Cortisol and Yawning as a Predictor of Neurological Disease

Authors: Simon B. N. Thompson

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Cortisol is important to our immune system, regulates our stress response, and is a factor in maintaining brain temperature. Saliva cortisol is a practical and useful non-invasive measurement that signifies the presence of the important hormone. Electrical activity in the jaw muscles typically rises when the muscles are moved during yawning and the electrical level is found to be correlated with the cortisol level. In two studies using identical paradigms, a total of 108 healthy subjects were exposed to yawning-provoking stimuli so that their cortisol levels and electrical nerve impulses from their jaw muscles was recorded. Electrical activity is highly correlated with cortisol levels in healthy people. The Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details were collected and exclusion criteria applied for voluntary recruitment: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners as compared with the non-yawners between rest and post-stimuli. Significant evidence supports the Thompson Cortisol Hypothesis that suggests rises in cortisol levels are associated with yawning. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, diagnosis, neurological disease, thompson cortisol hypothesis, yawning

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5163 Ethyl Carbamate in Korean Total Diet Study: Level, Dietary Intake, and Risk Assessment

Authors: Eunmi Koh, Bogyoung Choi, Dayeon Ryu, Jee-Yeon Lee, Sungok Kwon, Cho-Il Kim

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Ethyl carbamate(EC) is a probable human carcinogen (Group 2A) found in alcoholic beverages and fermented foods. A total of 351 samples including fermented foods and alcoholic beverages were chosen from 734 foods appeared in the pooled intake data of 2008, 2009, 2010, and 2011 Korea National Health & Nutrition Examination Survey (KNHANES). Sampling was carried out from September 2013 to July 2016 in 18 supermarkets of 9 metropolitan cities in Korea. The samples were pooled, prepared according to various cooking methods, and analyzed. A total of 1245 samples were analyzed using gas chromatograph-mass spectrometer. EC was detected in 13 items (1.0%), which ranged from not-detected to 151 g/kg. Alcoholic beverages (maesilju, whisky, and bokbunjaju) and fermented soy products (soy sauce and soybean paste) were the food items with relatively higher EC levels. Dietary intake of EC in the Korean population was estimated to be 2.11 ng/kg body weight (bw) per day for average population and 8.42 ng/kg bw per day for high consumers (the 97.5th percentile). When the estimated average dietary exposure to EC was compared with the Benchmark Dose Lower Confidence Limit 10% (BMDL10) of 0.3 mg/kg bw per day, margin of exposure (MOE) values of 1420000 to 28000000 were observed. This indicates that there is no health concern for the Korean population.

Keywords: ethyl carbamate, total diet study, dietary exposure, margin of exposure

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5162 Lifetime Attachment: Adult Daughters Attachment to Their Old Mothers

Authors: Meltem Anafarta Şendağ, Funda Kutlu

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Attachment theory has some major postulates that direct attention of psychologists from many different domains. First, the theory suggests that attachment is a lifetime process. This means that every human being from cradle to grave needs someone stronger to depend on in times of stress. Second, the attachment is a dynamic process and as one goes through developmental stages it is being transferred from one figure to another (friends, romantic partners). Third, the quality of attachment relationships later in time directly affected by the earliest attachment relationship established between the mother and the infant. Depending on these postulates, attachment literature focuses mostly on mother – child attachment during childhood and romantic relationship during adulthood. However, although romantic partners are important attachment figures in adults’ life, parents are not dropped out from the attachment hierarchy but they keep being important attachment figures. Despite the fact that parents could still be an important figure in adults’ life, adult – parent attachment is overlooked in the literature. Accordingly, this study focuses on adult daughters’ current attachment to their old mothers in relation with early parental bonding and current attachment to husbands. Participants of the study were 383 adult women (Average age = 40, ranging between 23 and 70) whose mothers were still alive and who were married at the time of the study. Participants were completed Adult Attachment Scale, Parental Bonding Instrument, and Experiences in Close Relationship – II together with demographic questionnaire. Results revealed that daughters’ attachment to their mothers weakens as they get older, have more children, and have longer marriages. Stronger attachment to mothers was found positively correlated with current satisfaction with the relationship, perception of maternal care before the age of 12 and negatively correlated with perception of controlling behavior before the age 12. Considering the relationship between current parental attachment and romantic attachment, it was found that as the current attachment to mother strengthens attachment avoidance towards husband decreases. Results revealed that although attachment between the adult daughters and old mothers weakens, the relationship is still critical in daughters’ lives. The strength of current attachment with the mother is related both with the early relationship with the mother and current attachment with the husband. The current study is thought to contribute to attachment theory emphasizing the attachment as a lifetime construct.

Keywords: adult daughter, attachment, old mothers, parental bonding

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5161 Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis

Authors: kamran Bhatti

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Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathogens); none for macrolides against atypical pathogens, but 20% and 27% for fluoroquinolones and tetracyclines. In West Africa, the resistance rates were generally higher, although the highest rates for ampicillin, cephalosporins, and fluoroquinolones were observed in the Gulf area. Lower rates were observed in Southeastern Europe. Conclusions: Resistance to antibiotics is a health problem requiring local health authorities to combat this phenomenon. Knowledge of the spectrum of pathogens and antibiotic resistance rates is crucial to assess local guidelines for the treatment of prostatitis.

Keywords: enterobacteriacae; escherichia coli, gram-positive pathogens, antibiotic, bacterial prostatitis, resistance

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5160 Determinants of Poverty: A Logit Regression Analysis of Zakat Applicants

Authors: Zunaidah Ab Hasan, Azhana Othman, Abd Halim Mohd Noor, Nor Shahrina Mohd Rafien

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Zakat is a portion of wealth contributed from financially able Muslims to be distributed to predetermine recipients; main among them are the poor and the needy. Distribution of the zakat fund is given with the objective to lift the recipients from poverty. Due to the multidimensional and multifaceted nature of poverty, it is imperative that the causes of poverty are properly identified for assistance given by zakat authorities reached the intended target. Despite, various studies undertaken to identify the poor correctly, there are reports of the poor not receiving the adequate assistance required from zakat. Thus, this study examines the determinants of poverty among applicants for zakat assistance distributed by the State Islamic Religious Council in Malacca (SIRCM). Malacca is a state in Malaysia. The respondents were based on the list of names of new zakat applicants for the month of April and May 2014 provided by SIRCM. A binary logistic regression was estimated based on this data with either zakat applications is rejected or accepted as the dependent variable and set of demographic variables and health as the explanatory variables. Overall, the logistic model successfully predicted factors of acceptance of zakat applications. Three independent variables namely gender, age; size of households and health significantly explain the likelihood of a successful zakat application. Among others, the finding suggests the importance of focusing on providing education opportunity in helping the poor.

Keywords: logistic regression, zakat distribution, status of zakat applications, poverty, education

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5159 The Practice of Low Flow Anesthesia to Reduce Carbon Footprints Sustainability Project

Authors: Ahmed Eid, Amita Gupta

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Abstract: Background: Background Medical gases are estimated to contribute to 5% of the carbon footprints produced by hospitals, Desflurane has the largest impact, but all increase significantly when used with N2O admixture. Climate Change Act 2008, we must reduce our carbon emission by 80% of the 1990 baseline by 2050.NHS carbon emissions have reduced by 18.5% (2007-2017). The NHS Long Term Plan has outlined measures to achieve this objective, including a 2% reduction by transforming anaesthetic practices. FGF is an important variable that determines the utilization of inhalational agents and can be tightly controlled by the anaesthetist. Aims and Objectives Environmental safety, Identification of areas of high N20 and different anaesthetic agents used across the St Helier operating theatres and consider improvising on the current practice. Methods: Data was collected from St Helier operating theatres and retrieved daily from Care Station 650 anaesthetic machines. 60 cases were included in the sample. Collected data (average flow rate, amount and type of agent used, duration of surgery, type of surgery, duration, and the total amount of Air, O2 and N2O used. AAGBI impact anaesthesia calculator was used to identify the amount of CO2 produced and also the cost per hour for every pt. Communication via reminder emails to staff emphasized the significance of low-flow anaesthesia and departmental meeting presentations aimed at heightening awareness of LFA, Distribution of AAGBI calculator QR codes in all theatres enables the calculation of volatile anaesthetic consumption and CO2e post each case, facilitating informed environmental impact assessment. Results: A significant reduction in the flow rate use in the 2nd sample was observed, flow rate usage between 0-1L was 60% which means a great reduction of the consumption of volatile anaesthetics and also Co2e. By using LFA we can save money but most importantly we can make our lives much greener and save the planet.

Keywords: low flow anesthesia, sustainability project, N₂0, Co2e

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5158 Workplace Risk Assessment in a Paint Factory

Authors: Rula D. Alshareef, Safa S. Alqathmi, Ghadah K. Alkhouldi, Reem O. Bagabas, Farheen B. Hasan

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Safety engineering is among the most crucial considerations in any work environment. Providing mentally, physically, and environmentally safe work conditions must be the top priority of any successful organization. Company X is a local paint production company in Saudi Arabia; in a month, the factory experienced two significant accidents, which indicates that workers’ safety is overlooked. The aim of the research is to examine the risks, assess the root causes and recommend control measures that will eventually contribute to providing a safe workplace. The methodology used is sectioned into three phases, risk identification, assessment, and finally, mitigation. In the identification phase, the team used Rapid Entire Body Assessment (REBA) and National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) tools to holistically establish knowledge about the current risk posed to the factory. The physical hazards in the factory were assessed in two different operations, which are mixing and filling/packaging. For the risk assessment phase, the hazards were deeply analyzed through their severity and impact. Additionally, through risk mitigation, the Rapid Entire Body Assessment (REBA) score decreased from 11 to 7, and the National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) has been reduced from 5.27 to 1.85.

Keywords: ergonomics, safety, workplace risks, hazards, awkward posture, fatigue, work environment

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5157 Evaluation of the Notifiable Diseases Surveillance System, South, Haiti, 2022

Authors: Djeamsly Salomon

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Background: Epidemiological surveillance is a dynamic national system used to observe all aspects of the evolution of priority health problems, through: collection, analysis, systematic interpretation of information, and dissemination of results with necessary recommendations. The study was conducted to assess the mandatory disease surveillance system in the Sud Department. Methods: A study was conducted from March to May 2021 with key players involved in surveillance at the level of health institutions in the department . The CDC's 2021 updated guideline was used to evaluate the system. We collected information about the operation, attributes, and usefulness of the surveillance system using interviewer-administered questionnaires. Epi-Info7.2 and Excel 2016 were used to generate the mean, frequencies and proportions. Results: Of 30 participants, 23 (77%) were women. The average age was 39 years[30-56]. 25 (83%) had training in epidemiological surveillance. (50%) of the forms checked were signed by the supervisor. Collection tools were available at (80%). Knowledge of at least 7 notifiable diseases was high (100%). Among the respondents, 29 declared that the collection tools were simple, 27 had already filled in a notification form. The maximum time taken to fill out a form was 10 minutes. The feedback between the different levels was done at (60%). Conclusion: The surveillance system is useful, simple, acceptable, representative, flexible, stable and responsive. The data generated was of high quality. However, it is threatened by the lack of supervision of sentinel sites, lack of investigation and weak feedback. This evaluation demonstrated the urgent need to improve supervision in the sites and to feedback information. Strengthen epidemiological surveillance.

Keywords: evaluation, notifiable diseases, surveillance, system

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5156 Healthcare Waste Management Practices in Bangladesh: A Case Study in Dhaka City, Bangladesh

Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan

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Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Keywords: awareness, disposal, Dhaka city, healthcare waste management, waste generation

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5155 Factors Associated with Hand Functional Disability in People with Rheumatoid Arthritis: A Systematic Review and Best-Evidence Synthesis

Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

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Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

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5154 The Dual Catastrophe of Behçet’s Disease Visual Loss Followed by Acute Spinal Shock After Lumbar Drain Removal

Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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5153 O2 Saturation Comparison Between Breast Milk Feeding and Tube Feeding in Very Low Birth Weight Neonates

Authors: Ashraf Mohammadzadeh, Ahmad Shah Farhat, Azin Vaezi, Aradokht Vaezi

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Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen saturation in very low birth weight infant (<1500gm). Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receivinge only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia(less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS. Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia. Conclusion: There was no significant statistical difference between the two methods in arterial oxygen saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.

Keywords: Very low birth weight (V.L.B.W), O2 Saturation, Breast Feeding, Tube Feeding

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5152 Long-Term Monitoring and Seasonal Analysis of PM10-Bound Benzo(a)pyrene in the Ambient Air of Northwestern Hungary

Authors: Zs. Csanádi, A. Szabó Nagy, J. Szabó, J. Erdős

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Atmospheric aerosols have several important environmental impacts and health effects in point of air quality. Monitoring the PM10-bound polycyclic aromatic hydrocarbons (PAHs) could have important environmental significance and health protection aspects. Benzo(a)pyrene (BaP) is the most relevant indicator of these PAH compounds. In Hungary, the Hungarian Air Quality Network provides air quality monitoring data for several air pollutants including BaP, but these data show only the annual mean concentrations and maximum values. Seasonal variation of BaP concentrations comparing the heating and non-heating periods could have important role and difference as well. For this reason, the main objective of this study was to assess the annual concentration and seasonal variation of BaP associated with PM10 in the ambient air of Northwestern Hungary seven different sampling sites (six urban and one rural) in the sampling period of 2008–2013. A total of 1475 PM10 aerosol samples were collected in the different sampling sites and analyzed for BaP by gas chromatography method. The BaP concentrations ranged from undetected to 8 ng/m3 with the mean value range of 0.50-0.96 ng/m3 referring to all sampling sites. Relatively higher concentrations of BaP were detected in samples collected in each sampling site in the heating seasons compared with non-heating periods. The annual mean BaP concentrations were comparable with the published data of the other Hungarian sites.

Keywords: air quality, benzo(a)pyrene, PAHs, polycyclic aromatic hydrocarbons

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5151 Rheumatoid Arthritis, Periodontitis and the Subgingival Microbiome: A Circular Relationship

Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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5150 Obese and Overweight Women and Public Health Issues in Hillah City, Iraq

Authors: Amean A. Yasir, Zainab Kh. A. Al-Mahdi Al-Amean

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In both developed and developing countries, obesity among women is increasing, but in different patterns and at very different speeds. It may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. This research studied the age distribution among obese women, the types of overweight and obesity, and the extent of the problem of overweight/obesity and the obesity etiological factors among women in Hillah city in central Iraq. A total of 322 overweight and obese women were included in the study, those women were randomly selected. The Body Mass Index was used as indicator for overweight/ obesity. The incidence of overweight/obesity among age groups were estimated, the etiology factors included genetic, environmental, genetic/environmental and endocrine disease. The overweight and obese women were screened for incidence of infection and/or diseases. The study found that the prevalence of 322 overweight and obese women in Hillah city in central Iraq was 19.25% and 80.78%, respectively. The obese women types were recorded based on BMI and WHO classification as class-1 obesity (29.81%), class-2 obesity (24.22%) and class-3 obesity (26.70%), the result was discrepancy non-significant, P value < 0.05. The incidence of overweight in women was high among those aged 20-29 years (90.32%), 6.45% aged 30-39 years old and 3.22% among ≥ 60 years old, while the incidence of obesity was 20.38% for those in the age group 20-29 years, 17.30% were 30-39 years, 23.84% were 40-49 years, 16.92% were 50-59 years group and 21.53% were ≥ 60 years age group. These results confirm that the age can be considered as a significant factor for obesity types (P value < 0.0001). The result also showed that the both genetic factors and environmental factors were responsible for incidents of overweight or obesity (84.78%) p value < 0.0001. The results also recorded cases of different repeated infections (skin infection, recurrent UTI and influenza), cancer, gallstones, high blood pressure, type 2 diabetes, and infertility. Weight stigma and bias generally refers to negative attitudes; Obesity can affect quality of life, and the results of this study recorded depression among overweight or obese women. This can lead to sexual problems, shame and guilt, social isolation and reduced work performance. Overweight and Obesity are real problems among women of all age groups and is associated with the risk of diseases and infection and negatively affects quality of life. This result warrants further studies into the prevalence of obesity among women in Hillah City in central Iraq and the immune response of obese women.

Keywords: obesity, overweight, Iraq, body mass index

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5149 The Effect of Reminiscence Therapy with Ethernet-Based Videos on Cognition and Apathy in Elderly with Mild Dementia

Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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5148 Mitigating Biofouling on Reverse Osmosis Membranes: Applying Greener Preservatives to Biofilm Treatment

Authors: Anna Curtin, Matthew Thibodeau, Heather Buckley

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Water scarcity is characterized by a lack of access to clean and affordable drinking water, as well as water for hygienic and economic needs. The amount of people effected by water scarcity is expected to increase in the coming years due to climate change, population growth, and pollution, amongst other things. In response, scientists are pursuing cost effective drinking water treatment methods, often with a focus on alternative water sources. Desalination of seawater via reverse osmosis is one promising alternative method. Desalination of seawater via reverse osmosis, however, is limited significantly by biofouling of the filtration membrane. Biofouling is the buildup of microorganisms in a biofilm at the water-membrane interface. It clogs the membrane, decreasing the efficiency of filtration, consequently increasing operational and maintenance costs. Although effective, existing chemical treatment methods can damage the membrane, decreasing the lifespan of the membrane; create antibiotic resistance; and cause harm to humans and the environment if they pass through the membrane into the permeate. The current project focuses on applying safer preservatives used in home and personal care products to RO membranes to investigate the biofouling treatment efficacy. Currently, many of these safer preservatives have only been tested on cells in planktonic phase in suspension cultures, not on cells in biofilms. The results of suspension culture tests are not applicable to biofouling scenarios because organisms in planktonic phase in suspension cultures exhibit different morphological, chemical, and metabolic characteristics than those in a biofilm. Testing antifoulant efficacy of safer preservatives on biofilms will provide more applicable results to biofouling on RO membranes. To do this, biofilms will be grown on 96-well-plates and minimum inhibitory concentrations (MIC90) and log-reductions will be calculated for various safer preservatives. Results from these tests will be used to guide doses for tests of safer preservatives in a bench-scale RO system.

Keywords: reverse osmosis, biofouling, preservatives, antimicrobial, safer alternative, green chemistry

Procedia PDF Downloads 133
5147 Fathers and Daughters: Their Relationship and Its Impact on Body Image and Mental Health

Authors: John Toussaint

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Objective: Our society is suffering from an epidemic of body image dissatisfaction, and related disorders appear to be increasing globally for children. There is much to indicate that children's body image and eating attitudes are being affected negatively by socio-cultural factors such as parents, peers and media. Most studies and theories, however, have focused extensively on the daughter-mother relationship. Very few studies have investigated the role of attachment to the father as an important factor in the development of girls’ and women’s attitudes towards themselves and their bodies. Recently, data have shown that the father’s parenting style, as well as the quality of the relationship with him is crucial for the understanding of the development and persistence of body image disorders. This presentation is based on samples of participants with self-defined body image dissatisfaction, and the self-reported measures of their fathers’ parental behaviours, emotional warmth, support, or protection. Attachment theory does offer support in exploring these relationships and it is used in this presentation to assist in understanding the relationship between the father and his daughter in relation to body image and mental health. Clinical implications are also offered in respect to work with body image, eating disorders and relational therapy. Methods: As awareness of the increasing frequency of body image concerns in children grows, so too does the need for a simple, valid and reliable measure of body image. The Children's Body Image Scale (CBIS) designed in Australia, depicts seven male and females figures from which children are to choose their perceived body type and ideal body type. This was compared with a range of international body mass index (BMI) reference standards. These measures together with individual one-on-one interviews were completed by 158 children aged 7-12 years. Results: A high frequency of body image dissatisfaction was indicated in the children's responses. 55% of girls and 41% of boys said they would like to be thinner, and wished for an ideal BMI figure below the 10th percentile. This is an unhealthy and unattainable level of body fatness for the majority of children when considered in relation to the reported secular trend of their increasing average body size. Thin children were generally ranked as best and perceived as kind, happy, academically skilled, and socially successful. Fat children were perceived as unintelligent, lazy, greedy, unpopular, and unable to play physical games. Conclusions: Body image ideals and fat stereotypes are well entrenched among children. There is much to indicate that children's body image and eating attitudes are being affected negatively by sociocultural factors such as parents, peers and media. Teachers and health professionals could promote intervention programs for children involving knowledge and acceptance of genetic influences on body type; the dangerous effects of weight loss dieting; the importance of physical activity and eating healthy; and scepticism and critical analysis of mass media messages.

Keywords: body image, father attachment, mental health, eating disorders

Procedia PDF Downloads 247
5146 Assessment of Intern Students' Attitudes towards Medical Errors

Authors: Nilgün Katrancı, Pınar Göv

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With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

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5145 Hepatological Alterations in Market Gardeners Occupationally Exposed to Pesticides in the Western Highlands of Cameroon

Authors: M. G. Tanga, P. B. Telefo, D. N. Tarla

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Even though the WHO, the EPA and other regulatory bodies have recognized the effects of acute pesticide poisoning little data exists on health effects after long-term low-dose exposures especially in Africa and Cameroon. The aim of this study was to evaluate the impact of pesticides on the hepatic functions of market gardeners in the Western Region of Cameroon by studying some biochemical parameters. Sixty six male market gardeners in Foumbot, Massangam, and Bantoum were interviewed on their health status, habits and pesticide use in agriculture, including the spray frequency, application method, and pesticide dosage. Thirty men with no history of pesticide exposure were recruited as control group. Thereafter, their blood samples were collected for assessment of hepatic function biomarkers (ALT, AST, and albumin). The results showed that 56 pesticides containing 25 active ingredients were currently used by market gardeners enrolled in our study and most of their symptoms (headache, fatigue, skin rashes, eye irritation, and nausea) were related to the use of these chemicals. Compared to the control subjects market gardeners’ ALT levels (32.9 ± 7.19 UL-1 vs. 82.11 ± 35.40 UL-1; P < 0.001) and, AST levels (40.63 ± 6.52 UL-1 vs. 112.11 UL-1 ± 47.15 UL-1; P < 0.001) were significantly increased. These results suggest that liver function tests can be used as biomarkers to indicate toxicity before overt clinical signs occur. The market gardeners’ chronic exposure to pesticides due to poor application measures could lead to hepatic function impairment. Further research on larger scale is needed to confirm these findings and to establish a mechanism of toxicity.

Keywords: biomarkers, liver, pesticides, occupational exposure

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5144 Psychosocial Support in Disaster Situations in the Philippines and Indonesia: A Critical Literature Review

Authors: Fuad Hamsyah

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Since last two decades, major disasters have happened in the Philippines and Indonesia as two countries that are located in the pacific ring of fire territory. While in Southeast Asian countries, the process of psychosocial support provision is facing various constraints such as limited number of mental health professionals and the limited knowledge about the provision of psychosocial support for disaster survivors. Yet after the tsunami disaster in 2004, many Asian countries begin to develop policies about the provision of psychosocial interventions as an effort for future disasters preparedness. In addition, mental health professionals have to consider the local cultural values and beliefs in order to provide people with effective psychosocial support since cultural values and beliefs play a significant role in the diversity of psychological distress that forms symptoms formation, and people’s way to seek for psychological assistance. This study is a critical literature review on 130 relevant selected documents and literatures. IASC MHPSS guideline is used as the research framework in doing critical analysis. The purpose of this study is to conduct a critical analysis on the mental health and psychosocial support provision in the Philippines and Indonesia with three main objectives: 1) To describe strengths, weaknesses, and challenges in the process of psychosocial supports given by public and private organizations in emergency settings of disaster in the Philippines and Indonesia, 2) To compare psychosocial support practices between the Philippines and Indonesia, and to identify the good practices among these countries, 3) To learn how cultural values influence the implementation of psychosocial supports in emergency settings of disaster. This research indicated that almost every function from IASC MHPSS guidelines has been implemented effectively in the Philippines and Indonesia, yet not in every detail of IASC MHPSS guidelines. Several similarities and differences are indicated in this study also based on the IASC MHPSS guidelines as the analysis framework. Further, both countries have some good practices that can be useful as an example of a comprehensive psychosocial support implementation. Apart from the IASC MHPSS guideline, cultural values and beliefs in the Philippines such as kanya-kanya syndrome, pakikipakapwa, utang na loob, bahala na, pagkaya are indicated as several cultural values that have strong influences towards people’s attitude and behavior in disaster situations. While in Indonesia, several cultural values such as sabar and nrimo become two important attitudes to cope disaster situations.

Keywords: disaster, Indonesia, psychosocial support, Philippines

Procedia PDF Downloads 375