Search results for: programmed rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 961

Search results for: programmed rehabilitation

421 Clinical Pathway for Postoperative Organ Transplantation

Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

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420 Identifying Future Helminth Zoonotic in Indonesian Slow Loris (Nycticebus coucang)

Authors: Nafisatul Ulfa, Elok Budi Retnani, R. P. Agus Lelana

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Emerging zoonotic parasite infection could originate in wildlife so its time very important to identify zoonotic agents in wild populations or maintained. According to the International Union Conservation of Nature (IUCN), Sumateran slow loris (Nycticebus coucang) was protected primate which have vulnerable status. Their population in wildlife decreased cause hunting for trade and destroy habitat. Helminthiasis can caused dead regularly and its so The study was conducted to know prevalence of gastrointestinal helminth infection of slow loris (Nycticebus coucang) in The Centre of Primate Rehabilitation of International Animal Rescue Indonesia (YIARI). Total of 13 fecal sampel from captive group of Nycticebus coucang were collected for 6 days and analysed from Februari-Mei 2014 by using McMaster, flotasion and Baermann technique. All fecal sampel was examined based on its fecal pool. Out of 13 fecal sampel examined, all of sampel (100%) was infected with five types of helminth Ascaris (84,61%), Hymenolepis (76,92%), Strongylid (61,54%), Oxyurid (15,38%) dan Trichuris (7,69%). The average number of egg per gram (EPG) was 11-1810.

Keywords: fecal, helminth, Nycticebus coucang, parasite, prevalence, slow loris

Procedia PDF Downloads 545
419 Effects of Renin Angiotensin Pathway Inhibition on Efficacy of Anti-PD-1/PD-L1 Treatment in Metastatic Cancer

Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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418 Geotechnical Challenges for the Use of Sand-sludge Mixtures in Covers for the Rehabilitation of Acid-Generating Mine Sites

Authors: Mamert Mbonimpa, Ousseynou Kanteye, Élysée Tshibangu Ngabu, Rachid Amrou, Abdelkabir Maqsoud, Tikou Belem

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The management of mine wastes (waste rocks and tailings) containing sulphide minerals such as pyrite and pyrrhotite represents the main environmental challenge for the mining industry. Indeed, acid mine drainage (AMD) can be generated when these wastes are exposed to water and air. AMD is characterized by low pH and high concentrations of heavy metals, which are toxic to plants, animals, and humans. It affects the quality of the ecosystem through water and soil pollution. Different techniques involving soil materials can be used to control AMD generation, including impermeable covers (compacted clays) and oxygen barriers. The latter group includes covers with capillary barrier effects (CCBE), a multilayered cover that include the moisture retention layer playing the role of an oxygen barrier. Once AMD is produced at a mine site, it must be treated so that the final effluent at the mine site complies with regulations and can be discharged into the environment. Active neutralization with lime is one of the treatment methods used. This treatment produces sludge that is usually stored in sedimentation ponds. Other sludge management alternatives have been examined in recent years, including sludge co-disposal with tailings or waste rocks, disposal in underground mine excavations, and storage in technical landfill sites. Considering the ability of AMD neutralization sludge to maintain an alkaline to neutral pH for decades or even centuries, due to the excess alkalinity induced by residual lime within the sludge, valorization of sludge in specific applications could be an interesting management option. If done efficiently, the reuse of sludge could free up storage ponds and thus reduce the environmental impact. It should be noted that mixtures of sludge and soils could potentially constitute usable materials in CCBE for the rehabilitation of acid-generating mine sites, while sludge alone is not suitable for this purpose. The high sludge water content (up to 300%), even after sedimentation, can, however, constitute a geotechnical challenge. Adding lime to the mixtures can reduce the water content and improve the geotechnical properties. The objective of this paper is to investigate the impact of the sludge content (30, 40 and 50%) in sand-sludge mixtures (SSM) on their hydrogeotechnical properties (compaction, shrinkage behaviour, saturated hydraulic conductivity, and water retention curve). The impact of lime addition (dosages from 2% to 6%) on the moisture content, dry density after compaction and saturated hydraulic conductivity of SSM was also investigated. Results showed that sludge adding to sand significantly improves the saturated hydraulic conductivity and water retention capacity, but the shrinkage increased with sludge content. The dry density after compaction of lime-treated SSM increases with the lime dosage but remains lower than the optimal dry density of the untreated mixtures. The saturated hydraulic conductivity of lime-treated SSM after 24 hours of cure decreases by 3 orders of magnitude. Considering the hydrogeotechnical properties obtained with these mixtures, it would be possible to design CCBE whose moisture retention layer is made of SSM. Physical laboratory models confirmed the performance of such CCBE.

Keywords: mine waste, AMD neutralization sludge, sand-sludge mixture, hydrogeotechnical properties, mine site reclamation, CCBE

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417 Impact of Culture and Religion on Disability and the Health Care Seeking Practices of the Shona People

Authors: Mafunda Esther

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The paper seeks to find out and document the impact of culture and religion on disability, specifically language impairment and health care seeking practices of the Shona people. Its main objectives are to explore the cultural and religious beliefs that affect the utilization of rehabilitation services in a rural community in Zimbabwe. The other objective of the paper is to describe how language impairment is presented and understood by people living in a Zimbabwean rural area. The research is qualitative interpretive phenomenological research, and it utilizes the case study approach using semi structured interviews and focus group discussions. Results from the research established that religious and cultural beliefs determine how the Shona people view disability, and this guides their health care seeking practices. The research is important since communication disorders occur in populations worldwide though they are not always recognized as such. The lack of recognition of and the attitudes toward speech and languages disorders, as well as the beliefs about the causes of such disorders, affect people's attitudes toward the treatment of the disorders.

Keywords: culture, religion, disability, language impairment

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416 Impact of Instrument Transformer Secondary Connections on Performance of Protection System: Experiences from Indian POWERGRID

Authors: Pankaj Kumar Jha, Mahendra Singh Hada, Brijendra Singh, Sandeep Yadav

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Protective relays are commonly connected to the secondary windings of instrument transformers, i.e., current transformers (CTs) and/or capacitive voltage transformers (CVTs). The purpose of CT and CVT is to provide galvanic isolation from high voltages and reduce primary currents and voltages to a nominal quantity recognized by the protective relays. Selecting the correct instrument transformers for an application is imperative: failing to do so may compromise the relay’s performance, as the output of the instrument transformer may no longer be an accurately scaled representation of the primary quantity. Having an accurately rated instrument transformer is of no use if these devices are not properly connected. The performance of the protective relay is reliant on its programmed settings and on the current and voltage inputs from the instrument transformers secondary. This paper will help in understanding the fundamental concepts of the connections of Instrument Transformers to the protection relays and the effect of incorrect connection on the performance of protective relays. Multiple case studies of protection system mal-operations due to incorrect connections of instrument transformers will be discussed in detail in this paper. Apart from the connection issue of instrument transformers to protective relays, this paper will also discuss the effect of multiple earthing of CTs and CVTs secondary on the performance of the protection system. Case studies presented in this paper will help the readers to analyse the problem through real-world challenges in complex power system networks. This paper will also help the protection engineer in better analysis of disturbance records. CT and CVT connection errors can lead to undesired operations of protection systems. However, many of these operations can be avoided by adhering to industry standards and implementing tried-and-true field testing and commissioning practices. Understanding the effect of missing neutral of CVT, multiple earthing of CVT secondary, and multiple grounding of CT star points on the performance of the protection system through real-world case studies will help the protection engineer in better commissioning the protection system and maintenance of the protection system.

Keywords: bus reactor, current transformer, capacitive voltage transformer, distance protection, differential protection, directional earth fault, disturbance report, instrument transformer, ICT, REF protection, shunt reactor, voltage selection relay, VT fuse failure

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415 Structural Health Monitoring of Buildings and Infrastructure

Authors: Mojtaba Valinejadshoubi, Ashutosh Bagchi, Osama Moselhi

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Structures such as buildings, bridges, dams, wind turbines etc. need to be maintained against various factors such as deterioration, excessive loads, environment, temperature, etc. Choosing an appropriate monitoring system is important for determining any critical damage to a structure and address that to avoid any adverse consequence. Structural Health Monitoring (SHM) has emerged as an effective technique to monitor the health of the structures. SHM refers to an ongoing structural performance assessment using different kinds of sensors attached to or embedded in the structures to evaluate their integrity and safety to help engineers decide on rehabilitation measures. Ability of SHM in identifying the location and severity of structural damages by considering any changes in characteristics of the structures such as their frequency, stiffness and mode shapes helps engineers to monitor the structures and take the most effective corrective actions to maintain their safety and extend their service life. The main objective of this study is to review the overall SHM process specifically determining the natural frequency of an instrumented simply-supported concrete beam using modal testing and finite element model updating.

Keywords: structural health monitoring, natural frequency, modal analysis, finite element model updating

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414 Proprioceptive Neuromuscular Facilitation Exercises of Upper Extremities Assessment Using Microsoft Kinect Sensor and Color Marker in a Virtual Reality Environment

Authors: M. Owlia, M. H. Azarsa, M. Khabbazan, A. Mirbagheri

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Proprioceptive neuromuscular facilitation exercises are a series of stretching techniques that are commonly used in rehabilitation and exercise therapy. Assessment of these exercises for true maneuvering requires extensive experience in this field and could not be down with patients themselves. In this paper, we developed software that uses Microsoft Kinect sensor, a spherical color marker, and real-time image processing methods to evaluate patient’s performance in generating true patterns of movements. The software also provides the patient with a visual feedback by showing his/her avatar in a Virtual Reality environment along with the correct path of moving hand, wrist and marker. Primary results during PNF exercise therapy of a patient in a room environment shows the ability of the system to identify any deviation of maneuvering path and direction of the hand from the one that has been performed by an expert physician.

Keywords: image processing, Microsoft Kinect, proprioceptive neuromuscular facilitation, upper extremities assessment, virtual reality

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413 Effect of Hand Grip Strength on Shoulder Muscles Activity in Patients with Subacromial Impingement

Authors: Mohamed E. Abdelrahamn, Mahmoud Aly Hassan, Mohamed Sarhan

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Subacromial impingement syndrome (SIS) is a common shoulder disorder. Patients often complain from a decrease in electromyography (EMG) activity of the rotator cuff muscles especially the supraspinatus muscle during glenohumeral elevation. Objective: The purpose of the study is to assess the effect of applying 50% of maximum voluntary contraction of hand grip strength on the EMG activity of the shoulder muscles in patients with SIS. Methods: Thirty male and female patients participated in this study. Their ages ranged from 25 to 40 years. EMG activity of supraspinatus muscle and middle deltoid muscle was assessed without and with applying 50% of maximum voluntary contraction (MVC). Results: A significant difference was found for both supraspinatus and middle deltoid muscles, indicating that the gripping resulted in increasing muscle activity. Conclusion: Applying 50% MVC of hand grip strength could increase the supraspinatus and middle deltoid muscles activity in patients of SIS. This might be useful in the development and monitoring of shoulder rehabilitation strategies.

Keywords: electromyography, supraspinatus muscle, deltoid muscle, subacromial impingement syndrome

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412 Dynamic Balance and Functional Performance in Total Hip Arthroplasty

Authors: Mahmoud Ghazy, Ahmed R. Z. Baghdadi

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Background: With the perceived pain and poor function experienced following total hip Arthroplasty (THA), patients usually feel un-satisfied. Methods: Thirty patients with THA (group I) and thirty indicated for arthroplasty but weren’t operated on yet (group II) participated in the study. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and III respectively. The Berg Balance Scale (BBS), Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively and three months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs. Results: group I had significantly lower TUG and SC time compared with group II four weeks and three months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly four weeks and three months post-operatively compared with four weeks pre- operatively in group. But no significant differences in BBS scores four weeks and three months post-operatively in group I compared with group II. Interpretation/Conclusion : Patients with THA still have defects in proprioception, so they needs more concentration on proprioception training.

Keywords: dynamic balance, functional performance, hip arthroplasty, total

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411 Evaluating and Reflecting on Virtual Exercise Programs during the COVID-19 Pandemic

Authors: Teng Minnie Y., Jarus Tal, Wong Anita

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Introduction: The COVID-19 pandemic has altered the lifestyle of all Canadians. While "stay-at-home" public health directives have been implemented to mitigate the spread of COVID-19, they may also lead to or worsen physical and social health challenges for older adults. In particular, older adults with disabilities are especially vulnerable. In response, we quickly adapted to virtual rehabilitation exercise intervention for older adults. Objectives: First, to identify the factors that influenced the acceptability and feasibility of virtual exercise implementation, and second, to evaluate whether the virtual delivery was effective for health promotion in older adults with disabilities. Methods: We carried out weekly virtual exercise programs from January 2021 to June 2021. We conducted semi-structured focus groups and interviews to explore the perspectives of participants who are older adults. The focus group and interview data are transcribed and coded thematically. Conclusions: The acceptability and feasibility of delivering exercises virtually were influenced by the provision of a safe and supportive environment for social connection, the availability of the necessary technology, and the role of the support system.

Keywords: physical activity, virtual exercises, older adults, people with disabilities

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410 Simultaneous Measurement of Wave Pressure and Wind Speed with the Specific Instrument and the Unit of Measurement Description

Authors: Branimir Jurun, Elza Jurun

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The focus of this paper is the description of an instrument called 'Quattuor 45' and defining of wave pressure measurement. Special attention is given to measurement of wave pressure created by the wind speed increasing obtained with the instrument 'Quattuor 45' in the investigated area. The study begins with respect to theoretical attitudes and numerous up to date investigations related to the waves approaching the coast. The detailed schematic view of the instrument is enriched with pictures from ground plan and side view. Horizontal stability of the instrument is achieved by mooring which relies on two concrete blocks. Vertical wave peak monitoring is ensured by one float above the instrument. The synthesis of horizontal stability and vertical wave peak monitoring allows to create a representative database for wave pressure measuring. Instrument ‘Quattuor 45' is named according to the way the database is received. Namely, the electronic part of the instrument consists of the main chip ‘Arduino', its memory, four load cells with the appropriate modules and the wind speed sensor 'Anemometers'. The 'Arduino' chip is programmed to store two data from each load cell and two data from the anemometer on SD card each second. The next part of the research is dedicated to data processing. All measured results are stored automatically in the database and after that detailed processing is carried out in the MS Excel. The result of the wave pressure measurement is synthesized by the unit of measurement kN/m². This paper also suggests a graphical presentation of the results by multi-line graph. The wave pressure is presented on the left vertical axis, while the wind speed is shown on the right vertical axis. The time of measurement is displayed on the horizontal axis. The paper proposes an algorithm for wind speed measurements showing the results for two characteristic winds in the Adriatic Sea, called 'Bura' and 'Jugo'. The first of them is the northern wind that reaches high speeds, causing low and extremely steep waves, where the pressure of the wave is relatively weak. On the other hand, the southern wind 'Jugo' has a lower speed than the northern wind, but due to its constant duration and constant speed maintenance, it causes extremely long and high waves that cause extremely high wave pressure.

Keywords: instrument, measuring unit, waves pressure metering, wind seed measurement

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409 Ethnographic Exploration of Elderly Residents' Perceptions and Utilization of Health Care to Improve Their Quality of Life

Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: ethnographic study, health care needs, Malay elderly people, Malaysia, Quality of life, Residential home

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408 A Real Time Ultra-Wideband Location System for Smart Healthcare

Authors: Mingyang Sun, Guozheng Yan, Dasheng Liu, Lei Yang

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Driven by the demand of intelligent monitoring in rehabilitation centers or hospitals, a high accuracy real-time location system based on UWB (ultra-wideband) technology was proposed. The system measures precise location of a specific person, traces his movement and visualizes his trajectory on the screen for doctors or administrators. Therefore, doctors could view the position of the patient at any time and find them immediately and exactly when something emergent happens. In our design process, different algorithms were discussed, and their errors were analyzed. In addition, we discussed about a , simple but effective way of correcting the antenna delay error, which turned out to be effective. By choosing the best algorithm and correcting errors with corresponding methods, the system attained a good accuracy. Experiments indicated that the ranging error of the system is lower than 7 cm, the locating error is lower than 20 cm, and the refresh rate exceeds 5 times per second. In future works, by embedding the system in wearable IoT (Internet of Things) devices, it could provide not only physical parameters, but also the activity status of the patient, which would help doctors a lot in performing healthcare.

Keywords: intelligent monitoring, ultra-wideband technology, real-time location, IoT devices, smart healthcare

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407 The Social Construction of the Family among the Survivors of Sex Trafficking

Authors: Nisha James, Shubha Ranganathan

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Sex trafficking is a traumatic ongoing process which includes human rights violations against the victims. Majority of the trafficked individuals in India are from families with low socioeconomic status, from rural areas, unmarried or married off at a very young age. Many of the sex trafficked feel that it is necessary to make sacrifices, for the benefit of their families. The combination of these cultural family values with the stigma of rape and prostitution are manipulated and used as a tool in the abuse of power against the sex trafficked. The rescue, rehabilitation and reintegration of these individuals are usually difficult due to the stigma and social exclusion that they face. In these circumstances, social support is very effective in social inclusion of these individuals. The present study was a qualitative one, using semi-structured interviews with 29 Indian survivors of sex trafficking and a few sex workers. Thematic analysis was done on the data derived from the semi-structured interviews. The major findings indicate that the family can be seen as both the ‘cause’ for being sex trafficked, and the factor in victim continuing to be sex trafficked. At the same time, it can also become a driver for getting rescued, rehabilitated and reintegrated. The study also explores the social construction about ‘family’ among the survivors of sex trafficking, reflecting on who they refer to as ‘family’, what they mean by the term ‘family’ and how these families emerge. Therefore the analytic concept of ‘family’ is a crucial element in sex trafficking and cannot be defined only in terms of its conventional definition of a basic unit of society.

Keywords: sex-trafficking, survivor, family, social construction

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406 Integrating Wearable-Textiles Sensors and IoT for Continuous Electromyography Monitoring

Authors: Bulcha Belay Etana, Benny Malengier, Debelo Oljira, Janarthanan Krishnamoorthy, Lieva Vanlangenhove

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Electromyography (EMG) is a technique used to measure the electrical activity of muscles. EMG can be used to assess muscle function in a variety of settings, including clinical, research, and sports medicine. The aim of this study was to develop a wearable textile sensor for EMG monitoring. The sensor was designed to be soft, stretchable, and washable, making it suitable for long-term use. The sensor was fabricated using a conductive thread material that was embroidered onto a fabric substrate. The sensor was then connected to a microcontroller unit (MCU) and a Wi-Fi-enabled module. The MCU was programmed to acquire the EMG signal and transmit it wirelessly to the Wi-Fi-enabled module. The Wi-Fi-enabled module then sent the signal to a server, where it could be accessed by a computer or smartphone. The sensor was able to successfully acquire and transmit EMG signals from a variety of muscles. The signal quality was comparable to that of commercial EMG sensors. The development of this sensor has the potential to improve the way EMG is used in a variety of settings. The sensor is soft, stretchable, and washable, making it suitable for long-term use. This makes it ideal for use in clinical settings, where patients may need to wear the sensor for extended periods of time. The sensor is also small and lightweight, making it ideal for use in sports medicine and research settings. The data for this study was collected from a group of healthy volunteers. The volunteers were asked to perform a series of muscle contractions while the EMG signal was recorded. The data was then analyzed to assess the performance of the sensor. The EMG signals were analyzed using a variety of methods, including time-domain analysis and frequency-domain analysis. The time-domain analysis was used to extract features such as the root mean square (RMS) and average rectified value (ARV). The frequency-domain analysis was used to extract features such as the power spectrum. The question addressed by this study was whether a wearable textile sensor could be developed that is soft, stretchable, and washable and that can successfully acquire and transmit EMG signals. The results of this study demonstrate that a wearable textile sensor can be developed that meets the requirements of being soft, stretchable, washable, and capable of acquiring and transmitting EMG signals. This sensor has the potential to improve the way EMG is used in a variety of settings.

Keywords: EMG, electrode position, smart wearable, textile sensor, IoT, IoT-integrated textile sensor

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405 A Brain Controlled Robotic Gait Trainer for Neurorehabilitation

Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

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This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: brain computer interface (BCI), gait trainer, spinal cord injury (SCI), neurorehabilitation

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404 Steps towards Changing Students' Attitudes to Disability

Authors: Farzaneh Yazdani, Nastaran Yazdani, Laya Nobakht

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The aim of this study was to explore the changes that may happen in students attitudes regarding disability after attending the module ‘Disability: theories, nature and experiences’ designed around reflective self-awareness exercises. Literature indicates enhanced knowledge does not automatically lead to changes in attitude. Health care professionals are the most significant people to instil hope in their clients to pursue a happy life. As an advocate for people with disability, health care professionals need to believe themselves in people with disability being able to pursue a happy life as an abled body does. Researchers aimed to explore the impact of the ‘Disability’ module using discussion and reflective exercises, on students’ way of thinking and possible changes in attitude towards disability. Students were asked to write stories from the beginning and after completing the module. A thematic analysis was applied to identify the students’ way of communicating their thoughts and feelings about disable-bodied /disability before and after the module. Three major themes were identified to represent the differences before and after attending the module as: problem /solution oriented approach towards perceived problems, separating/ integrating disable/able-bodied, passive/ active role of disable-bodied and society.

Keywords: qualitative study, reflection, rehabilitation, thematic analysis

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403 Investigation of Stress and Its Effects on Health Workers in Federal Medical Centres in Nigeria

Authors: Chisom N. Nwaigwe, Blessing N. Egbulefu, Angela Uwakwem

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A study on Stress and its’ effect on the health of workers in Federal Medical Centres in Nigeria is presented. The aim is to evaluate how much stress related hazards health workers in our tertiary health institutions are exposed to and to create awareness and reduce the rate at which stress affect the health of the working population in Nigeria, using workers in Federal Medical Centre, Umuahia as a case study. The descriptive survey design was adopted with the aid of 100 questionnaires delivered to the respondents in order to obtain first-hand information. From the findings, the major causes of stress were identified as inadequate staffing, unresolved family problems and psychological/cultural factors like the return of a lactating mother to work after three months post-delivery. The effects of stress on the workers were identified as hypertension, poor job performances, depression, asthma, and peptic ulcers. The study recommended instituting counseling units for stress management, holding seminars on stress management and increasing the salary scale (remuneration) and proper roster planning as solutions to stress reduction in our hospitals. This study is important to management in planning staffing, roaster, and a rehabilitation programme for her staff.

Keywords: stress, causes, effects, workers

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402 The Comparison of Backward and Forward Running Program on Balance Development and Plantar Flexion Force in Pre Seniors: Healthy Approach

Authors: Neda Dekamei, Mostafa Sarabzadeh, Masoumeh Bigdeli

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Backward running is commonly used in different sports conditioning, motor learning, and neurological purposes, and even more commonly in physical rehabilitation. The present study evaluated the effects of six weeks backward and forward running methods on balance promotion adaptation in students. 12 male and female preseniors with the age range of 45-60 years participated and were randomly classified into two groups of backward running (n: 6) and forward running (n: 6) training interventions. During six weeks, 3 sessions per week, all subjects underwent stated different models of backward and forward running training on treadmill (65-80 of HR max). Pre and post-tests were performed by force plate and electromyogram, two times before and after intervention. Data were analyzed using by T test. On the basis of obtained data, significant differences were recorded on balance and plantar flexion force in backward running (BR) and no difference for forward running (FR). It seems the training model of backward running can generate more stimulus to achieve better plantar flexion force and strengthening ankle protectors which leads to balance improvement in pre aging period. It can be recommended as an effective method to promote seniors life quality especially in balance neuromuscular parameters.

Keywords: backward running, balance, plantar flexion, pre seniors

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401 Does Mirror Therapy Improve Motor Recovery After Stroke? A Meta-Analysis of Randomized Controlled Trials

Authors: Hassan Abo Salem, Guo Feng, Xiaolin Huang

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The objective of this study is to determine the effectiveness of mirror therapy on motor recovery and functional abilities after stroke. The following databases were searched from inception to May 2014: Cochrane Stroke, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, and PEDro. Two reviewers independently screened and selected all randomized controlled trials that evaluate the effect of mirror therapy in stroke rehabilitation.12 randomized controlled trials studies met the inclusion criteria; 10 studies utilized the effect of mirror therapy for the upper limb and 2 studies for the lower limb. Mirror therapy had a positive effect on motor recover and function; however, we found no consistent influence on activity of daily living, Spasticity and balance. This meta-analysis suggests that, Mirror therapy has additional effect on motor recovery but has a small positive effect on functional abilities after stroke. Further high-quality studies with greater statistical power are required in order to accurately determine the effectiveness of mirror therapy following stroke.

Keywords: mirror therapy, motor recovery, stroke, balance

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400 Satellite Multispectral Remote Sensing of Ozone Pollution

Authors: Juan Cuesta

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Satellite observation is a fundamental component of air pollution monitoring systems, such as the large-scale Copernicus Programme. Next-generation satellite sensors, in orbit or programmed in the future, offer great potential to observe major air pollutants, such as tropospheric ozone, with unprecedented spatial and temporal coverage. However, satellite approaches developed for remote sensing of tropospheric ozone are based solely on measurements from a single instrument in a specific spectral range, either thermal infrared or ultraviolet. These methods offer sensitivity to tropospheric ozone located at the lowest at 3 or 4 km altitude above the surface, thus limiting their applications for ozone pollution analysis. Indeed, no current observation of a single spectral domain provides enough information to accurately measure ozone in the atmospheric boundary layer. To overcome this limitation, we have developed a multispectral synergism approach, called "IASI+GOME2", at the Laboratoire Interuniversitaire des Systèmes Atmosphériques (LISA) laboratory. This method is based on the synergy of thermal infrared and ultraviolet observations of respectively the Infrared Atmospheric Sounding Interferometer (IASI) and the Global Ozone Monitoring Experiment-2 (GOME-2) sensors embedded in MetOp satellites that have been in orbit since 2007. IASI+GOME2 allowed the first satellite observation of ozone plumes located between the surface and 3 km of altitude (what we call the lowermost troposphere), as it offers significant sensitivity in this layer. This represents a major advance for the observation of ozone in the lowermost troposphere and its application to air quality analysis. The ozone abundance derived by IASI+GOME2 shows a good agreement with respect to independent observations of ozone based on ozone sondes (a low mean bias, a linear correlation larger than 0.8 and a mean precision of about 16 %) around the world during all seasons. Using IASI+GOME2, lowermost tropospheric ozone pollution plumes are quantified both in terms of concentrations and also in the amounts of ozone photo-chemically produced along transport and also enabling the characterization of the ozone pollution, such as what occurred during the lockdowns linked to the COVID-19 pandemic. The current paper will show the IASI+GOME2 multispectral approach to observe the lowermost tropospheric ozone from space and an overview of several applications on different continents and at a global scale.

Keywords: ozone pollution, multispectral synergism, satellite, air quality

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399 Themes in Aesthetic Perceptions of Restorative Urban Landscapes

Authors: Rachel Bechtold, Catherine Shoulders, Donald Johnson, Jennie Popp, Elena Garcia, Lisa Wood

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Creating successfully restored urban landscapes involves both the sound design of natural resources and the incorporation of human perceptions of landscape. Moving forward with an invested interest from society is a challenge for the efficacy of reclaimed landscape design. In particular, urban areas present a dynamic environment wherein society and nature compete for resources and space. This review is meant to examine how perceptions of urban community members, the stakeholders for the plant species that share their environment, are reflected in aesthetic considerations. Findings from this literature review include themes of (1) aesthetic perceptions of stakeholders in rehabilitated landscapes and (2) the importance of organizing indicators of aesthetic perception for future design decisions. Recommendations include addressing the gap in research on aesthetic perceptions of reclaimed urban landscapes and addressing the lack of a consistent and widely accepted framework for these interdisciplinary studies. With knowledge of stakeholder perceptions, improved aesthetic and ecologic designs can more seamlessly merge into reclaimed urban landscapes.

Keywords: phytoremediation, urban landscape design, aesthetic perception, landscape ecology, phytorestoration, landscape reclamation, rehabilitation

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398 Psychological Security and Its Relationship with Self-Esteem among Adolescent with Mild Intellectual Disability

Authors: Muneera Abdul Haleem Bukhari, Maryam I. Alshirawi, Elsayed S. Elkhamisi

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This study aimed at understanding the relationship between psychological security and self-esteem among Adolescent with Mild Intellectual Disability, exploring the levels of psychological security and self-esteem, as well as determining the differences between genders in psychological security and self-esteem. The sample of the study contained (60) Adolescent with Mild Intellectual Disability, (34) males and (26) females who are enrolled in the Vocational and Social Rehabilitation Center and Hope Institute in the Kingdom of Bahrain. Their ages are between (15-23) years old. The Psychological Security Scale and self-Esteem Scale (prepared by James Battle) were used by the researcher. Results showed that levels of psychological security and self-esteem among Adolescents with Mild Intellectual Disability was above average; results also showed the order of the psychological security dimensions in the following manner (future outlook – mood - family security – social security) and the order of the dimensions of self-esteem in the following manner (social self-esteem – personal self-esteem – general self-esteem) among Adolescent with Mild Intellectual Disability; as for the differences between genders, the study showed that there was an increased level of psychological security among males. However, there was no difference in self-esteem between both sexes.

Keywords: psychological security, self-esteem, adolescent, intellectual disability, the Kingdom of Bahrain

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397 Numerical Modelling and Experiment of a Composite Single-Lap Joint Reinforced by Multifunctional Thermoplastic Composite Fastener

Authors: Wenhao Li, Shijun Guo

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Carbon fibre reinforced composites are progressively replacing metal structures in modern civil aircraft. This is because composite materials have large potential of weight saving compared with metal. However, the achievement to date of weight saving in composite structure is far less than the theoretical potential due to many uncertainties in structural integrity and safety concern. Unlike the conventional metallic structure, composite components are bonded together along the joints where structural integrity is a major concern. To ensure the safety, metal fasteners are used to reinforce the composite bonded joints. One of the solutions for a significant weight saving of composite structure is to develop an effective technology of on-board Structural Health Monitoring (SHM) System. By monitoring the real-life stress status of composite structures during service, the safety margin set in the structure design can be reduced with confidence. It provides a means of safeguard to minimize the need for programmed inspections and allow for maintenance to be need-driven, rather than usage-driven. The aim of this paper is to develop smart composite joint. The key technology is a multifunctional thermoplastic composite fastener (MTCF). The MTCF will replace some of the existing metallic fasteners in the most concerned locations distributed over the aircraft composite structures to reinforce the joints and form an on-board SHM network system. Each of the MTCFs will work as a unit of the AU and AE technology. The proposed MTCF technology has been patented and developed by Prof. Guo in Cranfield University, UK in the past a few years. The manufactured MTCF has been successfully employed in the composite SLJ (Single-Lap Joint). In terms of the structure integrity, the hybrid SLJ reinforced by MTCF achieves 19.1% improvement in the ultimate failure strength in comparison to the bonded SLJ. By increasing the diameter or rearranging the lay-up sequence of MTCF, the hybrid SLJ reinforced by MTCF is able to achieve the equivalent ultimate strength as that reinforced by titanium fastener. The predicted ultimate strength in simulation is in good agreement with the test results. In terms of the structural health monitoring, a signal from the MTCF was measured well before the load of mechanical failure. This signal provides a warning of initial crack in the joint which could not be detected by the strain gauge until the final failure.

Keywords: composite single-lap joint, crack propagation, multifunctional composite fastener, structural health monitoring

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396 Performance Based Road Asset Evaluation

Authors: Kidus Dawit Gedamu

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Addis Ababa City Road Authority is responsible for managing and setting performance evaluation of the city’s road network using the International Roughness Index (IRI). This helps the authority to conduct pavement condition assessments of asphalt roads each year to determine the health status or Level of service (LOS) of the roadway network and plan program improvements such as maintenance, resurfacing and rehabilitation. For a lower IRI limit economical and acceptable maintenance strategy may be selected among a number of maintenance alternatives. The Highway Development and Management (HDM-4) tool can do such measures to help decide which option is the best by evaluating the economic and structural conditions. This paper specifically addresses flexible pavement, including two principal arterial streets under the administration of the Addis Ababa City Roads Authority. The roads include the road from Megenagna Interchange to Ayat Square and from Ayat Square to Tafo RA. First, it was assessed the procedures followed by the city's road authority to develop the appropriate road maintenance strategies. Questionnaire surveys and interviews are used to collect information from the city's road maintenance departments. Second, the project analysis was performed for functional and economic comparison of different maintenance alternatives using HDM-4.

Keywords: appropriate maintenance strategy, cost stream, road deterioration, maintenance alternative

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395 Characteristics of Autism Spectrum Disorder Patient and Perception of Caregiver Regarding Speech and Language Therapy in Bangladesh

Authors: K. M. Saif Ur Rahman, Razib Mamun, Himica Arjuman, Fida Al Shams

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Introduction: Autism spectrum disorder (ASD) has become an emerging neurodevelopmental disorder with increasing prevalence. It has become an important public health issue globally. Many approaches including speech and language therapy (SLT), occupational therapy, behavioral therapy etc. are being applied for the betterment of the ASD patients. This study aims to describe the characteristics of ASD patients and perception of caregiver regarding SLT in Bangladesh. Methods: This cross-sectional study was conducted in a therapy and rehabilitation center at Dhaka city. Caregivers of 48 ASD patients responded regarding their perception of SLT and characteristics of patients. Results: Among 48 ASD patients, 56.3% were between 3 to 5 years age group with a male predominance (87.5%). More than half of the participants (56.3%) initiated SLT at the age of 1-3 years and the majority (43.8%) were taking SLT for less than 1 year. Majority of the patients (64.6%) were taken to a physician for healthcare as a first contact of which 29.2% were referred to SLT by physicians. More than half (56.3%) of the caregivers were moderately satisfied with SLT and most of them (62.5%) mentioned moderate improvement through SLT. Improvement rate was 10-15% in specific symptoms such as eye contact, complex mannerism, pointing, imitation etc. Conclusion: This study reveals the self-reported perception of caregivers on SLT. Despite reported improvements, more exploration of different approaches and intervention for management of ASD is recommended.

Keywords: ASD, characteristics, SLT, Bangladesh

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394 Liability of AI in Workplace: A Comparative Approach Between Shari’ah and Common Law

Authors: Barakat Adebisi Raji

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In the workplace, Artificial Intelligence has, in recent years, emerged as a transformative technology that revolutionizes how organizations operate and perform tasks. It is a technology that has a significant impact on transportation, manufacturing, education, cyber security, robotics, agriculture, healthcare, and so many other organizations. By harnessing AI technology, workplaces can enhance productivity, streamline processes, and make more informed decisions. Given the potential of AI to change the way we work and its impact on the labor market in years to come, employers understand that it entails legal challenges and risks despite the advantages inherent in it. Therefore, as AI continues to integrate into various aspects of the workplace, understanding the legal and ethical implications becomes paramount. Also central to this study is the question of who is held liable where AI makes any defaults; the person (company) who created the AI, the person who programmed the AI algorithm or the person who uses the AI? Thus, the aim of this paper is to provide a detailed overview of how AI-related liabilities are addressed under each legal tradition and shed light on potential areas of accord and divergence between the two legal cultures. The objectives of this paper are to (i) examine the ability of Common law and Islamic law to accommodate the issues and damage caused by AI in the workplace and the legality of compensation for such injury sustained; (ii) to discuss the extent to which AI can be described as a legal personality to bear responsibility: (iii) examine the similarities and disparities between Common Law and Islamic Jurisprudence on the liability of AI in the workplace. The methodology adopted in this work was qualitative, and the method was purely a doctrinal research method where information is gathered from the primary and secondary sources of law, such as comprehensive materials found in journal articles, expert-authored books and online news sources. Comparative legal method was also used to juxtapose the approach of Islam and Common Law. The paper concludes that since AI, in its current legal state, is not recognized as a legal entity, operators or manufacturers of AI should be held liable for any damage that arises, and the determination of who bears the responsibility should be dependent on the circumstances surrounding each scenario. The study recommends the granting of legal personality to AI systems, the establishment of legal rights and liabilities for AI, the establishment of a holistic Islamic virtue-based AI ethics framework, and the consideration of Islamic ethics.

Keywords: AI, health- care, agriculture, cyber security, common law, Shari'ah

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393 Neoliberal Settler City: Socio-Spatial Segregation, Livelihood of Artists/Craftsmen in Delhi

Authors: Sophy Joseph

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The study uses the concept of ‘Settler city’ to understand the nature of peripheralization that a neoliberal city initiates. The settler city designs powerless communities without inherent rights, title and sovereignty. Kathputli Colony, home to generations of artists/craftsmen, who have kept heritage of arts/crafts alive, has undergone eviction of its population from urban space. The proposed study, ‘Neoliberal Settler City: Socio-spatial segregation and livelihood of artists/craftsmen in Delhi’ would problematize the settler city as a colonial technology. The colonial regime has ‘erased’ the ‘unwanted’ as primitive and swept them to peripheries in the city. This study would also highlight how structural change in political economy has undermined their crafts/arts by depriving them from practicing/performing it with dignity in urban space. The interconnections between citizenship and In-Situ Private Public Partnership in Kathputli rehabilitation has become part of academic exercise. However, a comprehensive study connecting inherent characteristics of neoliberal settler city, trajectory of political economy of unorganized workers - artists/craftsmen and legal containment and exclusion leading to dispossession and marginalization of communities from the city site, is relevant to contextualize the trauma of spatial segregation. This study would deal with political, cultural, social and economic dominant behavior of the structure in the state formation, accumulation of property and design of urban space, fueled by segregation of marginalized/unorganized communities and disowning the ‘footloose proletariat’, the migrant workforce. The methodology of study involves qualitative research amongst communities and the field work-oral testimonies and personal accounts- becomes the primary material to theorize the realities. The secondary materials in the forms of archival materials about historical evolution of Delhi as a planned city from various archives, would be used. As the study also adopt ‘narrative approach’ in qualitative study, the life experiences of craftsmen/artists as performers and emotional trauma of losing their livelihood and space forms an important record to understand the instability and insecurity that marginalization and development attributes on urban poor. The study attempts to prove that though there was a change in political tradition from colonialism to constitutional democracy, new state still follows the policy of segregation and dispossession of the communities. It is this dispossession from the space, deprivation of livelihood and non-consultative process in rehabilitation that reflects the neoliberal approach of the state and also critical findings in the study. This study would entail critical spatial lens analyzing ethnographic and sociological data, representational practices and development debates to understand ‘urban otherization’ against craftsmen/artists. This seeks to develop a conceptual framework for understanding the resistance of communities against primitivity attached with them and to decolonize the city. This would help to contextualize the demand for declaring Kathputli Colony as ‘heritage artists village’. The conceptualization and contextualization would help to argue for right to city of the communities, collective rights to property, services and self-determination. The aspirations of the communities also help to draw normative orientation towards decolonization. It is important to study this site as part of the framework, ‘inclusive cities’ because cities are rarely noted as important sites of ‘community struggles’.

Keywords: neoliberal settler city, socio-spatial segregation, the livelihood of artists/craftsmen, dispossession of indigenous communities, urban planning and cultural uprooting

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392 The Plight of the Rohingyas: Design Guidelines to Accommodate Displaced People in Bangladesh

Authors: Nazia Roushan, Maria Kipti

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The sensitive issue of a large-scale entry of Rohingya refugees to Bangladesh has arisen again since August of 2017. Incited by ethnic and religious conflict, the Rohingyas—an ethnic group concentrated in the north-west state of Rakhine in Myanmar—have been fleeing to what is now Bangladesh from as early as the late 1700s in four main exoduses. This long-standing persecution has recently escalated, and accommodating the recent wave of exodus has been especially challenging due to the sheer volume of a million refugees concentrated in refugee camps in two small administrative units (upazilas) in the south-east of the country: the host area. This drastic change in the host area’s social fabric is putting a lot of strain on the country’s economic, demographic and environmental stability, and security. Although Bangladesh’s long-term experience with disaster management has enabled it to respond rapidly to the crisis, the government is failing to cope with this enormous problem and has taken insufficient steps towards improving the living conditions to inhibit the inflow of more refugees. On top of that, the absence of a comprehensive national refugee policy, and the density of the structures of the camps are constricting the upgrading of the shelters to international standards. As of December 2016, the combined number of internally displaced persons (IDPs) due to conflict and violence (stock), and new displacements due to disasters (flow) in Bangladesh had exceeded 1 million. These numbers have increased dramatically in the last few months. Moreover, by 2050, Bangladesh will have as much as 25 million climate refugees just from its coastal districts. To enhance the resilience of the vulnerable, it is crucial to methodically factorize further interventions between Disaster Risk Reduction for Resilience (DRR) and the concept of Building Back Better (BBB) in the rehabilitation-reconstruction period. Considering these points, this paper provides a palette of options for design guidelines related to the living spaces and infrastructures for refugees. This will encourage the development of national standards for refugee camps, and the national and local level rehabilitation-reconstruction practices. Unhygienic living conditions, vulnerability, and the general lack of control over life are pervasive throughout the camps. This paper, therefore, proposes site-specific strategic and physical planning and design for shelters for refugees in Bangladesh that will lead to sustainable living environments through the following: a) site survey of existing two registered and one makeshift unregistered refugee camps to document and study their physical conditions, b) questionnaires and semi-structured focus group discussions carried out among the refugees and stakeholders to understand what the lived experiences and needs are; and c) combining the findings with international minimum standards for shelter and settlement from International Federation of Red Cross and Red Crescent (IFRC), Médecins Sans Frontières (MSF), United Nations High Commissioner for Refugees (UNHCR). These proposals include temporary shelter solutions that balance between lived spaces and regimented, repetitive plans using readily available and cheap materials, erosion control and slope stabilization strategies, and most importantly, coping mechanisms for the refugees to be self-reliant and resilient.

Keywords: architecture, Bangladesh, refugee camp, resilience, Rohingya

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