Search results for: sustained%20release

Authors: Abdulwahhab Khedr, Tamer Shehata, Hanaa El-Ghamry

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Venlafaxine HCl is a novel antidepressant drug used in the treatment of major depressive disorder, generalized anxiety disorder, social anxiety disorder and panic disorder. Conventional therapeutic regimens with venlafaxine HCl immediate-release dosage forms require frequent dosing due to short elimination half-life of the drug and reduced bioavailability. Hence, this study was carried out to develop sustained-release dosage forms of venlafaxine HCl to reduce its dosing frequency, to improve patient compliance and to reduce side effects of the drug. The polymers used were hydroxypropylmethyl cellulose, xanthan gum, sodium alginate, sodium carboxymethyl cellulose, Carbopol 940 and ethyl cellulose. The physical properties of the prepared tablets including tablet thickness, diameter, weight uniformity, content uniformity, hardness and friability were evaluated. Also, the in-vitro release of venlafaxine HCl from different matrix tablets was studied. Based on physical characters and in-vitro release profiles, certain formulae showing promising sustained-release profiles were subjected to film coating with 15% w/v EC in dichloromethane/ethanol mixture (1:1 ratio) using 1% w/v HPMC as pore former and 30% w/w dibutyl phthalate as plasticizer. The optimized formulations were investigated for drug-excipient compatibility using FTIR and DSC studies. Physical evaluation of the prepared tablets fulfilled the pharmacopoeial requirements for tablet friability test, where the weight loss of the prepared formulae did not exceed 1% of the weight of the tested tablets. Moderate release was obtained from tablets containing HPMC. FTIR and DSC studies for such formulae revealed the absence of any type of chemical interaction between venlafaxine HCl and the used polymers or excipients. Forced swimming test in rats was used to evaluate the antidepressant activity of the selected matrix tablets of venlafaxine HCl. Results showed that formulations significantly decreased the duration of animals’ immobility during the 24 hr-period of the test compared to non-treated group.

Keywords: antidepressant, sustained-release, matrix tablet, venlafaxine hydrochloride

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Authors: Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng

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Postoperative implant-associated infections in soft tissues and bones remain a serious complication in orthopaedic surgery, which leads to impaired healing, re-implantation, prolong hospital stay and increase cost. Drug-loaded implants with sustained release of antibiotics at the local site are current research interest to reduce the risk of post-operative infections and osteomyelitis, thus, minimize the need for follow-up care and increase patient comfort. However, the improved drug release of the drug-loaded bone cements is usually accompanied by a loss in mechanical strength, which is critical for weight-bearing bone cement. Recently, more attempts have been undertaken to develop techniques to enhance the antibiotic elution as well as preserve the mechanical properties of the bone cements. The present study investigates the potential influence of addition of mesoporous silica nanoparticles (MSN) on the in vitro drug release kinetics of gentamicin (GTMC), along with the mechanical properties of bone cements. Simplex P was formulated with MSN and loaded with GTMC by direct impregnation. Meanwhile, Simplex P with water soluble poragen (xylitol) and high loading of GTMC as well as commercial bone cement CMW Smartset GHV were used as controls. MSN-formulated bone cements are able to increase the drug release of GTMC by 3-fold with a cumulative release of more than 46% as compared with other control groups. Furthermore, a sustained release could be achieved for two months. The loaded nano-sized MSN with uniform pore channels significantly build up an effective nano-network path in the bone cement facilitates the diffusion and extended release of GTMC. Compared with formulations using xylitol and high GTMC loading, incorporation of MSN shows no detrimental effect on biomechanical properties of the bone cements as no significant changes in the mechanical properties as compared with original bone cement. After drug release for two months, the bending modulus of MSN-formulated bone cements is 4.49 ± 0.75 GPa and the compression strength is 92.7 ± 2.1 MPa (similar to the compression strength of Simplex-P: 93.0 ± 1.2 MPa). The unaffected mechanical properties of MSN-formulated bone cements was due to the unchanged microstructures of bone cement, whereby more than 98% of MSN remains in the matrix and supports the bone cement structures. In contrast, the large portions of extra voids can be observed for the formulations using xylitol and high drug loading after the drug release study, thus caused compressive strength below the ASTM F541 and ISO 5833 minimum of 70 MPa. These results demonstrate the potential applicability of MSN-functionalized poly(methyl methacrylate)-based bone cement as a highly efficient, sustained and local drug delivery system with good mechanical properties.

Keywords: antibiotics, biomechanical properties, bone cement, sustained release

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Authors: Jung-Yoon Lee, Jongmun Kim, Hyo-Jun Chang, Jung-Min Kim

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People’s tendency towards living in apartment houses is increasing in a densely populated country. However, some residents living in apartment houses are bothered by noise coming from the houses above. In order to reduce noise pollution, the communities are increasingly imposing a bylaw, including the limitation of floor impact sound, minimum thickness of floors, and floor soundproofing solutions. This research effort focused on the specific long-time deflection of resilient materials in the floor sound insulation systems of apartment houses. The experimental program consisted of testing nine floor sound insulation specimens subjected to sustained load for 45 days. Two main parameters were considered in the experimental investigation: three types of resilient materials and magnitudes of loads. The test results indicated that the structural behavior of the floor sound insulation systems under long-time load was quite different from that the systems under short-time load. The loading period increased the deflection of floor sound insulation systems and the increasing rate of the long-time deflection of the systems with ethylene vinyl acetate was smaller than that of the systems with low density ethylene polystyrene.

Keywords: resilient materials, floor sound insulation systems, long-time deflection, sustained load, noise pollution

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Authors: Rongzhou Wang

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Research on designing nano-antibacterial agent with potent and long-lasting antibacterial property is demanding and provoking work. In this study, a core-shell AgBr/cationic polymer nanocomposite (AgBr/NPVP-H10) were synthesized and its structure confirmed by Fourier Transform Infrared Spectrometer (FT-IR), Nuclear Magnetic Resonance (1H NMR) and X-ray diffraction (XRD), and the cationic polymer contents were determined with Thermal Gravimetric Analyzer (TGA). The morphology was directly observed by Transmission Electron Microscope (TEM) which showed that the nanoparticle contains single core and organic shell and had an average diameter of 30.1 nm. The antibacterial test against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli illuminated that this nanocomposite had potent bactericidal activity, which can be attributed to the contact-killing of cationic polymers and releasing-killing of Ag+ ions. In addition, cationic polymer encapsulating AgBr cores gave the resin discs sustained release of Ag+ ions, which may result in long-lasting bactericidal activity. The AgBr/NPVP-H10 nanoparticle with the dual bactericidal capability and long term antimicrobial effect is a promising material aimed at preventing bacterial infection.

Keywords: core-shell nanocomposite, cationic polymer, dual antibacterial capability, long-lasting antibacterial activity

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Authors: Jamboor K. Vishwanatha

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Among the potent anti-cancer agents, curcumin has been found to be very efficacious against various cancer cells. Despite multiple medicinal benefits of curcumin, poor water solubility, poor physiochemical properties and low bioavailability continue to pose major challenges in developing a formulation for clinical efficacy. To improve its potential application in the clinical area, we formulated poly lactic-co-glycolic acid (PLGA) nanoparticles. The PLGA nanoparticles were formulated using solid-oil/water emulsion solvent evaporation method and then characterized for percent yield, encapsulation efficiency, surface morphology, particle size, drug distribution within nanoparticles and drug polymer interaction. Our studies showed the successful formation of smooth and spherical curcumin loaded PLGA nanoparticles with a high percent yield of about 92.01±0.13% and an encapsulation efficiency of 90.88±0.14%. The mean particle size of the nanoparticles was found to be 145nm. The in vitro drug release profile showed 55-60% drug release from the nanoparticles over a period of 24 hours with continued sustained release over a period of 8 days. Exposure to curcumin loaded nanoparticles resulted in reduced cell viability of cancer cells compared to normal cells. We used a novel non-covalent insertion of a homo-bifunctional spacer for targeted delivery of curcumin to various cancer cells. Functionalized nanoparticles for antibody/targeting agent conjugation was prepared using a cross-linking ligand, bis(sulfosuccinimidyl) suberate (BS3), which has reactive carboxyl group to conjugate efficiently to the primary amino groups of the targeting agents. In our studies, we demonstrated successful conjugation of antibodies, Annexin A2 or prostate specific membrane antigen (PSMA), to curcumin loaded PLGA nanoparticles for targeting to prostate and breast cancer cells. The percent antibody attachment to PLGA nanoparticles was found to be 92.8%. Efficient intra-cellular uptake of the targeted nanoparticles was observed in the cancer cells. These results have emphasized the potential of our multifunctional curcumin nanoparticles to improve the clinical efficacy of curcumin therapy in patients with cancer.

Keywords: polymeric nanoparticles, cancer therapy, sustained release, curcumin

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Authors: Farzad Doostishoar, Abbas Pardakhty, Abdolreza Hassanzadeh, Sudeh salarpour, Elham Sharif

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Background: Sericin is a protein extracted from silk and has antioxidant, antimicrobial, antineoplastic, wound healing and moisturizing properties. Different cosmetic formulation of sericin is available in different countries such as Japan and the other south-eastern Asian countries. We formulated and evaluated the sunscreen properties of topical formulations of sericin by an in vitro method. Method: Niosomes composed of sorbitan palmitate (Span 40), polysorbate 40 (Tween 40) and cholesterol (300 µmol, 3.5:3.5:3 molar ratio) were prepared by film hydration technique. Sericin was dissolved in normal saline and the lipid hydration was carried out at 60°C and the niosomes were incorporated in a Carbomer gel base. A W/O cream was also prepared and the release of sericin was evaluated by using Franz diffusion cell. Particle size analysis, sericin encapsulation efficiency measurement, morphological studies and stability evaluation were done in niosomal formulations. SPF was calculated by using Transpore tape in vitro method for both formulations. Results: Niosomes had high stability during 6 months storage at 4-8°C. The mean volume diameter of niosomes was less than 7 µm which is ideal for sustained release of drugs in topical formulations. The SPF of niosomal gel was 25 and higher than sericin cream with a diffusion based release pattern of active material. Conclusion: Sericin can be successfully entrapped in niosomes with sustained release pattern and relatively high SPF.

Keywords: sericin, niosomes, sun protection factor, cream, gel

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Authors: Mahitab A. A. Mahmoud

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Despite the international community’s galvanized efforts to achieve gender equality, the Arab world still lags behind for their sustained suppression of diversity and freedoms. In Egypt, homosexuals are defamed and hunted not only by authorities but also by politicized religious institutions and media platforms. The resultant state-sponsored homophobia is reflected in media. This paper offers a critical discourse analysis of the representation of LGBTQs in Egypt’s local news articles and movies in an attempt to investigate the underlying ideology. The results reveal a clichéd portrayal of homosexuals as a social parasite that requires cleansing by the government. LGBTQs are depicted as an outcome of debauchery, unhappy marriage, sexual deviancy, deficiency of masculinity/femininity, absence of the mother and/or father figure(s), abject poverty, excessive wealth, psychiatric disorder, debased instincts, childhood sexual molestation, immorality, deviation from religion, chaos, treason, conspiracy against the regime, to name only a few. This image, which is imposed and sustained by the state, exposes homosexuals to a violation of their human rights by both the police and the society, endangers their lives, breeds intolerance, social inequality and violence, prevents healthy coexistence; and deprives them of living a normal life.

Keywords: critical discourse analysis, gender studies, homophobia, homosexuality, ideology, media studies

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Authors: Janki Shankar, Shu Ping Chen

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Background: New immigrants are one of most vulnerable sections of the Canadian society. Unable to gain entry into Canada’s strictly regulated professions and trades, several skilled and qualified new immigrants take up precarious jobs without adequate occupational health and safety training, thereby increasing their risk of sustaining occupational injury and illness compared to Canadian born workers. Access to timely and appropriate support is critical for injured new immigrant workers who face additional challenges compared to Canadian born workers in accessing information and support post-injury. The purpose of our study was to explore the post-injury experiences and support needs of new immigrant workers who have sustained work-related injuries. Methods: Using an interpretive research approach and semi structured face to face qualitative interviews, 27 new immigrant workers from a range of industries operating in two cities in a province in Canada were interviewed. All had sustained work-related injuries and reported these to their work supervisors. A constant comparative approach was used to identify key themes across the worker experiences. Results: Findings reveal several factors that can shape the experiences of new immigrant workers and influence their return-to-work outcomes. Conclusion: Based on the insights of study participants, policies, practices, and potential interventions informed by their needs and preferences are proposed that can improve return to work outcomes for these workers.

Keywords: new immigrant workers, post-injury experiences, return to work outcomes, qualified

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Authors: Kristy Howells, Catherine Meehan

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This position paper presents current research findings into the proposed gap between teachers’ and practitioners’ thinking and acting about physical activity health and well-being in childhood. Within the new Primary curriculum, there is a focus on sustained physical activity within a Physical Education and healthy lifestyles in Personal, Health, Social and Emotional lessons, but there is no curriculum guidance about what sustained physical activity is and how it is defined. The current health guidance on birth to five suggests that children should not be inactive for long periods and specify light and energetic activities, however there is the a suggested period of time per day for young children to achieve, but the guidance does not specify how this should be measured. The challenge therefore for teachers and practitioners is their own confidence and understanding of what “good / moderate intensity” physical activity and healthy living looks like for children and the children understanding what they are doing. There is limited research about children from birth to eight years and also the perceptions and attitudes of those who work with this age group of children, however it was found that children at times can identify different levels of activity and it has been found that children can identify healthy foods and good choices for healthy living at a basic level. Authors have also explored teachers’ beliefs about teaching and learning and found that teachers could act in accordance to their beliefs about their subject area only when their subject knowledge, understanding and confidence of that area is high. It has been proposed that confidence and competence of practitioners and teachers to integrate ‘well-being’ within the learning settings has been reported as being low. This may be due to them not having high subject knowledge. It has been suggested that children’s life chances are improved by focusing on well-being in their earliest years. This includes working with parents and families, and being aware of the environmental contexts that may impact on children’s wellbeing. The key is for practitioners and teachers to know how to implement these ideas effectively as these key workers have a profound effect on young children as role models and due to the time of waking hours spent with them. The position paper is part of a longitudinal study at Canterbury Christ Church University and currently we will share the research findings from the initial questionnaire (online, postal, and in person) that explored and evaluated the knowledge, competence and confidence levels of practitioners and teachers as to the structure and planning of sustained physical activity and healthy lifestyles and how this progresses with the children’s age.

Keywords: health, perceptions, physical activity, well-being

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Authors: J. Herrero, D. Puigserver, I. Nijenhuis, K. Kuntze, J. M. Carmona

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In the transition zone between aquifers and basal aquitards, the perchloroethene (PCE)-pools are more recalcitrant than those elsewhere in the aquifer. Although biodegradation of chloroethenes occur in this zone, it is a slow process and a remediation strategy is needed. The aim of this study is to demonstrate that combined strategy of biostimulation and in situ chemical reduction (ISCR) is more efficient than the two separated strategies. Four different microcosm experiments with sediment and groundwater of a selected field site where an aged pool exists at the bottom of a transition zone were designed under i) natural conditions, ii) biostimulation with lactic acid, iii) ISCR with zero-value iron (ZVI) and under iv) a combined strategy with lactic acid and ZVI. Biotic and abiotic dehalogenation, terminal electron acceptor processes and evolution of microbial communities were determined for each experiment. The main results were: i) reductive dehalogenation of PCE-pools occurs under sulfate-reducing conditions; ii) biostimulation with lactic acid supports more pronounced reductive dehalogenation of PCE and trichloroethene (TCE), but results in an accumulation of 1,2-cis-dichloroethene (cDCE); iii) ISCR with ZVI produces a sustained dehalogenation of PCE and its metabolites iv) combined strategy of biostimulation and ISCR results in a fast dehalogenation of PCE and TCE and a sustained dehalogenation of cisDCE. These findings suggest that biostimulation and ISCR with ZVI are the most suitable strategies for a complete reductive dehalogenation of PCE-pools in the transition zone and further to enable the dissolution of dense non-aqueous phase liquids.

Keywords: aged PCE-pool, anaerobic microcosm experiment, biostimulation, in situ chemical reduction, natural attenuation

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Authors: Manoj Gupta Charan Pushparaj

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Tourism related activities are getting popular day by day and tourism has become an integral part of everyone’s life. Ecotourism initiatives have grown enormously in the past decade, and the concept of ecotourism has shown to bring great benefits in terms of environment conservation and to improve the livelihood of local people. However, the potential of ecotourism to sustain improving the livelihood of the local population in the remote future is a topic of active debate. A primary challenge that exists in this regard is the enormous costs of limiting the impacts of tourism related activities on the environment. Here we employed systems modeling approach using computer simulations to determine if ecotourism activities in the small hill town of Yercaud (Tamil Nadu, India) can be sustained over years in improving the livelihood of the local population. Increasing damage to the natural environment as a result of tourism-related activities have plagued the pristine hill station of Yercaud. Though ecotourism efforts can help conserve the environment and enrich local population, questions remain if this can be sustained in the distant future. The vital state variables in the model are the existing tourism foundation (labor, services available to tourists, etc.,) in the town of Yercaud and its natural environment (water, flora and fauna). Another state variable is the textile industry that drives the local economy. Our results would help to understand if environment conservation efforts are sustainable in Yercaud and would also offer suggestions to make it sustainable over the course of several years.

Keywords: ecotourism, simulations, modeling, Yercaud

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Authors: Mohammed Sherzad

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The Sahara desert covers third of the total surface of Africa with a quarter of this area within the national boundaries of Algeria. Sand drift and deposition is considered one of the major factors of the desertification process in the area. It is estimated that a third of the world's hot arid lands are covered by aeolian sand deposits, forming extensive sand bedforms. The Gourrara region in the Grand Erg Occidental (west of Algerian Sahara) and the region of Souf in the Grand Erg Oriental (east of Algerian Sahara) have been chosen as case studies. These were significant cultural and trading centers for many centuries despite their remote location and their harsh desert environment particularly solar radiation and sand drift and deposition. The architecture of the sustained vernacular settlements in each of the two regions has unique design features for this environment. So do the irrigation systems used - palm groves and the foggara system for capturing and distributing groundwater. However, the ecological balance which enabled the Saharans to live with the desert has been upset. New buildings often use technology based on models imported or imposed from areas that climatically have little in common. These make the inhabitants live ‘in the desert’ rather than ‘with the desert’. This paper will describe the qualities of the vernacular architecture and demonstrate its effectiveness and adaptability to the region’s harsh desert environment in comparison with contemporary buildings. Developing design guides and approaches based on lessons from the traditional architecture is important to ensure sustained livelihoods of the inhabitants in these areas.

Keywords: vernacular architecture, desert architecture, hot climate, aeolian sand deposition

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Authors: Camille Charlebois-Plante, Marie-Ève Bourassa, Gaelle Dumel, Meriem Sabir, Louis De Beaumont

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To the extent of our knowledge, there has been little interest in the chronic effects of mild traumatic brain injury (mTBI) on cognition during normal aging. This is rather surprising considering the impacts on daily and social functioning. In addition, sustaining a mTBI during late adulthood may increase the effect of normal biological aging in individuals who consider themselves normal and healthy. The objective of this study was to characterize the persistent neuropsychological repercussions of mTBI sustained during late adulthood, on average 12 months prior to testing. To this end, 35 mTBI patients and 42 controls between the ages of 50 and 69 completed an exhaustive neuropsychological assessment lasting three hours. All mTBI patients were asymptomatic and all participants had a score ≥ 27 at the MoCA. The evaluation consisted of 20 standardized neuropsychological tests measuring memory, attention, executive and language functions, as well as information processing speed. Performance on tests of visual (Brief Visuospatial Memory Test Revised) and verbal memory (Rey Auditory Verbal Learning Test and WMS-IV Logical Memory subtest), lexical access (Boston Naming Test) and response inhibition (Stroop) revealed to be significantly lower in the mTBI group. These findings suggest that a mTBI sustained during late adulthood induces lasting effects on cognitive function. Episodic memory and executive functions seem to be particularly vulnerable to enduring mTBI effects.

Keywords: cognitive function, late adulthood, mild traumatic brain injury, neuropsychology

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Authors: Siziwe Monica Zuma

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The Expanded Public Works Program (EPWP) is an instrument that the South African Government uses to reduce unemployment and poverty and also stimulate economic growth. However, due to the limited budget and programs in the EPWP, the program has had challenges in reducing unemployment, poverty and stimulating economic growth. The EPWP Vuk’uphile program had positive outcomes in developing Black emerging contractors, in order for them to participate in the main stream economy far better than when the EPWP program was not introduced. The Skills component of the program particularly the EPWP Infrastructure, which is the most funded program under EPWP has had limited success in transferring appropriate skills to ensure labour participants can penetrate the labour market after participating in the EPWP. Education and skills are important attributes that can contribute to labour absorption, however, the EPWP particularly the infrastructure program needs to strengthen skills development over a longer period of time suggested a year with multi skills relevant to the labour market. Longer and more sustained employment provides a safety net and reduces poverty better that short term employment. The EPWP program can be expanded in the infrastructure sector, focusing on rural infrastructure, agricultural infrastructure, infrastructure related components like property, ownership, management, and other services. These can stimulate the Economic sector Infrastructure of EPWP, offer longer term and more sustained employment and rural enterprise development and further employment. The Expanded Public Works Program (EPWP) is an instrument that the South African Government uses to reduce unemployment and poverty and also stimulate economic growth. However, due to the limited budget and programs in the EPWP, the program has had challenges in reducing unemployment, poverty and stimulating economic growth. The EPWP Vuk’uphile program has had positive outcomes in developing Black emerging contractors, in order for them to participate in the main stream economy far better than when the EPWP program was not introduced. The Skills component of the program particularly the EPWP Infrastructure, which is the most funded program under EPWP has had limited success in transferring appropriate skills to ensure labour participants are able to penetrate the labour market after participating in the EPWP. Education and skills are important attributes that can contribute to labour absorption, however, the EPWP particularly the infrastructure program needs to strengthen skills development over a longer period of time suggested a year with multi skills relevant to the labour market. Longer and more sustained employment provides a safety net and reduces poverty better that short term employment. The EPWP program can be expanded in the infrastructure sector, focusing on rural infrastructure, agricultural infrastructure, infrastructure related components like property, ownership, management, and other services. These can stimulate the Economic sector Infrastructure of EPWP, offer longer term and more sustained employment and rural enterprise development and further employment.

Keywords: Expanded Public Works Program (EPWP), VUKÚPHILE, youth, Public Works Programs (PWP), Infrastructure Sector of EPWP (EPWP Infrastructure)

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Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior

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There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.

Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy

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Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

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Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

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Authors: Rajni Kant Panik

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The aim of the present study was to develop and evaluate mupirocin loaded nanoparticle incorporated into hydrogel as an infected wound healer. Incorporated Nanoparticle in hydrogel provides a barrier that effectively prevents the contamination of the wound and further progression of infection to deeper tissues. Hydrogel creates moist healing environment on wound space with good fluid absorbance. Nanoparticles were prepared by double emulsion solvent evaporation method using different ratios of PLGA polymer and the hydrogels was developed using sodium alginate and gelatin. Further prepared nanoparticles were then incorporated into the hydrogels. The formulations were characterized by FT-IR and DSC for drug and polymer compatibility and surface morphology was studied by TEM. Nanoparticle hydrogel were evaluated for their size, shape, encapsulation efficiency and for in vitro studies. The FT-IR and DSC confirmed the absence of any drug polymer interaction. The average size of Nanoparticle was found to be in range of 208.21-412.33 nm and shape was found to be spherical. The maximum encapsulation efficiency was found to be 69.03%. The in vitro release profile of Nanoparticle incorporated hydrogel formulation was found to give sustained release of drug. Antimicrobial activity testing confirmed that encapsulated drug preserve its effectiveness. The stability study confirmed that the formulation prepared were stable. Present study complements our finding that mupirocin loaded Nanoparticle incorporated into hydrogel has the potential to be an effective and safe novel addition for the release of mupirocin in sustained manner, which may be a better option for the management of wound. These finding also supports the progression of antibiotic via hydrogel delivery system is a novel topical dosage form for the management of wound.

Keywords: hydrogel, nanoparticle, PLGA, wound healing

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Authors: Esther O. Adebitan, Florence Oyelade

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The Millennium Development Goals (MDGs) was initiated by the UN member nations’ aspiration for the betterment of human life. It is expressed in a set of numerical ‎and time-bound targets. In more recent time, the aspiration is shifting away from just the achievement to the sustainability of achieved MDGs beyond the 2015 target. The main objective of this study was assessing how much the hotel industry within the Nigerian Federal Capital Territory (FCT) as a member of the global community is involved in the achievement of sustainable MDGs within the FCT. The study had two population groups consisting of 160 hotels and the communities where these are located. Stratified random sampling technique was adopted in selecting 60 hotels based on large, medium ‎and small hotels categorisation, while simple random sampling technique was used to elicit information from 30 residents of three of the hotels host communities. The study was guided by tree research questions and two hypotheses aimed to ascertain if hotels see the need to be involved in, and have policies in pursuit of achieving sustained MDGs, and to determine public opinion regarding hotels contribution towards the achievement of the MDGs in their communities. A 22 item questionnaire was designed ‎and administered to hotel managers while 11 item questionnaire was designed ‎and administered to hotels’ host communities. Frequency distribution and percentage as well as Chi-square were used to analyse data. Results showed no significant involvement of the hotel industry in achieving sustained MDGs in the FCT and that there was disconnect between the hotels and their immediate communities. The study recommended that hotels should, as part of their Corporate Social Responsibility pick at least one of the goals to work on in order to be involved in the attainment of enduring Millennium Development Goals.

Keywords: MDGs, hotels, FCT, host communities, corporate social responsibility

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Authors: Mohammad S. Islam

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Elections in Bangladesh are always controversial, and sometimes it becomes a violent affair when state power is combined with politics. Despite the commitment of the ruling party- the polling government to ensure free, fair, and credible elections, the participants of opposition parties and the general voters became very disappointed, terribly frustrated, and severely shocked. It happened when numerous claims of serious irregularities of vote rigging and violence came out in broad daylight during the election. This paper addresses the issues of how the ruling party created frightening and a horror situation to make people silent over electoral fraud and violent incidents, including gang rape. It also seeks to demonstrate that election-2018 was simply the deceptive action of the ruling party to legitimate their power, but not to provide a minimum opportunity for voters to exercise their fundamental right to vote. The fundamental freedom and the rule of law seemed to be ignored completely in this election process and afterwards. With the help of state machinery, the government of the ruling party violated human rights, restricted fundamental freedoms, and humiliated social protection & dignity. The contestant’s views as witnessed and relevant literatures are cited first for conceptual understanding. Then, the paper will examine how a new dimension of circumstantial social measures related to sustained protection can reduce all kinds of violence against humanity towards establishing a peaceful democratic society. Finally, this paper interprets the key findings and considers wider implications.

Keywords: electoral fraud, human rights, sustained protection, social measures, vote rigging

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Authors: S. Bouameur, S. Chirani

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The aim of this study was to evaluate the potential use of EthylCellulose in the preparation of microspheres as a Drug Delivery System for sustained release of phenobarbital. The microspheres were prepared by solvent evaporation technique using ethylcellulose as polymer matrix with a ratio 1:2, dichloromethane as solvent and Polyvinyl alcohol 1% as processing medium to solidify the microspheres. Size, shape, drug loading capacity and entrapement efficiency were studied.

Keywords: phenobarbital, microspheres, ethylcellulose, polyvinylacohol

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Authors: John E. Muñoz, Jose F. Lopez, David S. Lopez

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Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects 1 out of 5 Colombian children, converting into a real public health problem in the country. Conventional treatments such as medication and neuropsychological therapy have been proved to be insufficient in order to decrease high incidence levels of ADHD in the principal Colombian cities. This work demonstrates a design and development of a videogame that uses a brain computer interface not only to serve as an input device but also as a tool to monitor neurophysiologic signal. The video game named “The Harvest Challenge” puts a cultural scene of a Colombian coffee grower in its context, where a player can use his/her avatar in three mini games created in order to reinforce four fundamental aspects: i) waiting ability, ii) planning ability, iii) ability to follow instructions and iv) ability to achieve objectives. The details of this collaborative designing process of the multimedia tool according to the exact clinic necessities and the description of interaction proposals are presented through the mental stages of attention and relaxation. The final videogame is presented as a tool for sustained attention training in children with ADHD using as an action mechanism the neuromodulation of Beta and Theta waves through an electrode located in the central part of the front lobe of the brain. The processing of an electroencephalographic signal is produced automatically inside the videogame allowing to generate a report of the theta/beta ratio evolution - a biological marker, which has been demonstrated to be a sufficient measure to discriminate of children with deficit and without.

Keywords: BCI, neuromodulation, ADHD, videogame, neurofeedback, theta/beta ratio

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Authors: Tabassum Yasmin, Hamid Pahlevan

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HIV/Hepatitis C co-infection treatments have evolved substantially and they have similar sustained virologic response rates as those of Hepatitis C monoinfected population. There are a few studies on therapy of patients with dual genotypes, especially in HIV/Hepatic C coinfected group. Most studies portrayed case reports of dual genotype chronic Hepatitis C coinfection treatment with Sofosbuvir/Ledipasvir and Ribavirin. A 79-year-old male with a history of HIV on Truvada and Isentress had chronic Hepatitis C with 1a and 2 genotypes. The patient has a history of alcohol intake for 40 years but recently stopped drinking alcohol. He has a history of intravenous drug use in the past and currently is not using any recreational drugs. Patient has Fibro score of 0.7 with Metavir score F2 to F4. AFP is 3.2. The HCV RNA is 493,034 IU/ML. The HBV viral DNA is < 1.30 (not detected). The CD4 is 687CU/MM. The FIB 4 is 3.34 with APRI index 0.717. The HIV viral load is 101 copies/ML. MRI abdomen did not show any liver abnormality. Fixed dose Sofosbuvir/Ledipasvir was used for therapy without Ribavirin. He tolerated medication except for some minor gastrointestinal side effects like abdominal bloating. He demonstrated 100% adherence rate. Patient completed 12 weeks of therapy. HCV RNA was undetectable at 4 and 12 weeks. He achieved SVR at week 12 and subsequently had undetectable RNA for 2 years. Dual genotype prevalence in chronic hepatitis C population is rare, especially in HIV/hepatic coinfection. Our case demonstrates that dual genotypic cases can still be successfully treated with Direct Acting Antiviral agents. The newer agents for therapy for pan genotypes were not available at the time the patient was being treated. We demonstrated that dual agent therapy was still able to maintain SVR in our patient.

Keywords: HIV/Hepatitis C, SVR (sustained virologic response), DAA (direct active antiviral agents, dual genotype

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Authors: Odeyemi Ifeoluwayemi, Maha Joushua, Fulani Omoyeni

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In the search for sustainability, over time, architectural approaches to design have moved from just nature inspired design to the study of nature’s principles to produce effective designs that solve the issue of sustainability. Nature has established materials, shapes and processes that are effective right from a minor scale to an enormous scale. A branch of human knowledge that studies nature is called biology. Biology helps us to grasp and understand nature. Biomimicry is a new way of viewing and valuing nature, based not on what we can extract from the natural world but on what we can learn from it. Life has sustained on the earth for the last 3.85 billion years, and it is necessary for us to find out how life has been able to stay sustained for that long. The building must teach the society new ecological morals, thus, a better understanding of how nature works can usefully inspire architectural designs to resolve issues that have already been resolved by nature. This will not only help in creating a healthy environment but will also produce positive environmental impacts. Biomimetic Architecture connects and reproduces the ideologies found in nature in order to create built environment which benefit people and other living creatures as well as preserving it for the future. Understanding the bioprocess would lead to the establishment of ecological approaches that serve as a platform for creating a built environment that goes beyond sustaining current settings but also mimic nature’s regenerative ecosystem. This paper aims to explain these design methods under the name of biomimicry and biomimetic architecture by reviewing literature and research works done by examining these approaches classified as forms, processes and ecosystems. It is expected that this research will provide information that would, therefore, lead to the creation of buildings that are eco-friendly and provide greater comfort to the populaces.

Keywords: biomimetic architecture, biomimicry, ecological design, nature

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Authors: Chee Wee Gan, Anthony Herr Cheun Ng, Yee Shan Wong, Subbu Venkatraman, Lynne Hsueh Yee Lim

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Otitis media with effusion (OME) is the leading cause of hearing loss in children worldwide. Surgery to insert grommet tube into the eardrum is usually indicated for OME unresponsive to antimicrobial therapy. It is the most common surgery for children. However, current commercially available grommet tubes are non-bioresorbable, not drug-treated, with unpredictable duration of retention on the eardrum to ventilate middle ear. Their functionality is impaired when clogged or chronically infected, requiring additional surgery to remove/reinsert grommet tubes. We envisaged that a novel fully bioresorbable grommet tube with sustained antibiotic release technology could address these drawbacks. In this study, drug-loaded bioresorbable poly(L-lactide-co-ε-caprolactone)(PLC) copolymer grommet tubes were fabricated by microinjection moulding technique. In vitro drug release and degradation model of PLC tubes were studied. Antibacterial property was evaluated by incubating PLC tubes with P. aeruginosa broth. Surface morphology was analyzed using scanning electron microscopy. A preliminary animal study was conducted using guinea pigs as an in vivo model to evaluate PLC tubes with and without drug, with commercial Mini Shah grommet tube as comparison. Our in vitro data showed sustained drug release over 3 months. All PLC tubes revealed exponential degradation profiles over time. Modeling predicted loss of tube functionality in water to be approximately 14 weeks and 17 weeks for PLC with and without drug, respectively. Generally, PLC tubes had less bacteria adherence, which were attributed to the much smoother tube surfaces compared to Mini Shah. Antibiotic from PLC tube further made bacteria adherence on surface negligible. They showed neither inflammation nor otorrhea after 18 weeks post-insertion in the eardrums of guinea pigs, but had demonstrated severe degree of bioresorption. Histology confirmed the new PLC tubes were biocompatible. Analyses on the PLC tubes in the eardrums showed bioresorption profiles close to our in vitro degradation models. The bioresorbable antibiotic-loaded grommet tubes showed good predictability in functionality. The smooth surface and sustained release technology reduced the risk of tube infection. Tube functional duration of 18 weeks allowed sufficient ventilation period to treat OME. Our ongoing studies include modifying the surface properties with protein coating, optimizing the drug dosage in the tubes to enhance their performances, evaluating their functional outcome on hearing after full resoption of grommet tube and healing of eardrums, and developing animal model with OME to further validate our in vitro models.

Keywords: bioresorbable polymer, drug release, grommet tube, guinea pigs, otitis media with effusion

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Authors: Sinead Morrison, Ann Swillen, Therese Van Amelsvoort, Samuel Chawner, Elfi Vergaelen, Michael Owen, Marianne Van Den Bree

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22q11.2 Deletion Syndrome (22q11.2DS) is caused by the deletion of approximately 60 genes on chromosome 22 and is associated with high rates of neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). The presentation of these disorders in 22q11.2DS is reported to be comparable to idiopathic forms and therefore presents a valuable model for understanding mechanisms of neurodevelopmental disorders. Cognitive deficits are thought to be a core feature of neurodevelopmental disorders, and possibly manifest in behavioural and emotional problems. There have been mixed findings in 22q11.2DS on whether the presence of ADHD or ASD is associated with greater cognitive deficits. Furthermore, the influence of developmental stage has never been taken into account. The aim was therefore to examine whether the presence of ADHD or ASD was associated with cognitive deficits in childhood and/or adolescence in 22q11.2DS. We conducted the largest study to date of this kind in 22q11.2DS. The same battery of tasks measuring processing speed, attention and spatial working memory were completed by 135 participants with 22q11.2DS. Wechsler IQ tests were completed, yielding Full Scale (FSIQ), Verbal (VIQ) and Performance IQ (PIQ). Age-standardised difference scores were produced for each participant. Developmental stages were defined as children (6-10 years) and adolescents (10-18 years). ADHD diagnosis was ascertained from a semi-structured interview with a parent. ASD status was ascertained from a questionnaire completed by a parent. Interaction and main effects of cognitive performance of those with or without a diagnosis of ADHD or ASD in childhood or adolescence were conducted with 2x2 ANOVA. Significant interactions were followed up with t-tests of simple effects. Adolescents with ASD displayed greater deficits in all measures (processing speed, p = 0.022; sustained attention, p = 0.016; working memory, p = 0.006) than adolescents without ASD; there was no difference between children with and without ASD. There were no significant differences on IQ measures. Both children and adolescents with ADHD displayed greater deficits on sustained attention (p = 0.002) than those without ADHD. There were no significant differences on any other measures for ADHD. Magnitude of cognitive deficit in individuals with 22q11.2DS varied by cognitive domain, developmental stage and presence of neurodevelopmental disorder. Adolescents with 22q11.2DS and ASD showed greater deficits on all measures, which suggests there may be a sensitive period in childhood to acquire these domains, or reflect increasing social and academic demands in adolescence. The finding of poorer sustained attention in children and adolescents with ADHD supports previous research and suggests a specific deficit which can be separated from processing speed and working memory. This research provides unique insights into the association of ASD and ADHD with cognitive deficits in a group at high genomic risk of neurodevelopmental disorders.

Keywords: 22q11.2 deletion syndrome, attention deficit hyperactivity disorder, autism spectrum disorder, cognitive development

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Authors: Rajendra Jangde, Deependra Singh

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Present work was based with objective to release of the antimicrobial and debriding agent in sustained manner at the wound surface. In order to provide a long-lasting antimicrobial action and moist environment on wound space, Biocompatible moist system was developed for complete healing. In the present study, a biocompatible moist system of PVA-gelatin hydrogel was developed capable of carrying multiple drugs- Quercetin and Cabopol in controlled manner for effective and complete wound healing. Carbopol and Quercetin were prepared by thin film hydration techniques and optimized system was incorporated in PVA-Gelatin slurry. PVA-Gelatin hydrogels were prepared by freeze thaw method. The prepared dispersion was casted into films to prepare multiphase hydrogel system and characterized by in vitro and in vivo studies. Results revealed the uniform dispersion of microspheres in a three-dimensional matrix of the PVA-Gelatin hydrogel observed at different magnifications. The in vitro release data showed typical biphasic release pattern, i.e., a burst release followed by a slower sustained release for 5 days. Prepared system was found to be stable under both normal and accelerated conditions. Histopathological study showed significant (p<0.05) increase in fibroblast cells, collagen fibres and blood vessels formation. All parameters such as wound contraction, tensile strength, histopathological and biochemical parameters- hydroxyproline content, protein level, etc. were observed significant (p<0.05) in comparison to control group. Present results suggest an accelerated re-epithelialization under moist wound environment with delivery of multiple drugs effective at different stages of wound healing cascade with minimum disturbance of wound bed.

Keywords: multiphase hydrogel, optimization quercetin, wound healing

Procedia PDF Downloads 238

Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

Abstract:

The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

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Authors: Ali Kassem, Ehab Fawzy, Mahmoud Sef el-eslam, Fatma Salah- Eldeen, El zahraa Mohamed

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Introduction: The combination of interferon (INF) and ribavirin is the preferred treatment for chronic hepatitis C viral (HCV) infection. However, nonresponse to this therapy remains common and is associated with several factors such as HCV genotype and HCV viral load in addition to host factors such as sex, HLA type and cytokine polymorphisms. Aim of the work: The aim of this study was to determine predictors of response to (INF) therapy in chronic HCV infected patients treated with INF alpha and ribavirin combination therapy. Patients and Methods: The present study included 110 patients (62 males, 48 females) with chronic HCV infection. Their ages ranged from 20-59 years. Inclusion criteria were organized according to the protocol of the Egyptian National Committee for control of viral hepatitis. Patients included in this study were recruited to receive INF ribavirin combination therapy; 54 patients received pegylated NF α-2a (180 μg) and weight based ribavirin therapy (1000 mg if < 75 kg, 1200 mg if > 75 kg) for 48 weeks and 53 patients received pegylated INF α-2b (1.5 ug/kg/week) and weight based ribavirin therapy (800 mg if < 65 kg, 1000 mg if 65-75 kg and 1200 mg if > 75kg). One hundred and seven liver biopsies were included in the study and submitted to histopathological examination. Hematoxylin and eosin (H&E) stained sections were done to assess both the grade and the stage of chronic viral hepatitis, in addition to the degree of steatosis. Modified hepatic activity index (HAI) grading, modified Ishak staging and Metavir grading and staging systems were used. Laboratory follow up including: HCV PCR at the 12th week to assess the early virologic response (EVR) and at the 24th week were done. At the end of the course: HCV PCR was done at the end of the course and tested 6 months later to document end virologic response (ETR) and sustained virologic response (SVR) respectively. Results One hundred seven patients; 62 males (57.9 %) and 45 females (42.1%) completed the course and included in this study. The age of patients ranged from 20-59 years with a mean of 40.39±10.03 years. Six months after the end of treatment patients were categorized into two groups: Group (1): patients who achieved sustained virological response (SVR). Group (2): patients who didn't achieve sustained virological response (non SVR) including non-responders, breakthrough and relapsers. In our study, 58 (54.2%) patients showed SVR, 18 (16.8%) patients were non-responders, 15 (14%) patients showed break-through and 16 (15 %) patients were relapsers. Univariate binary regression analysis of the possible risk factors of non SVR showed that the significant factors were higher age, higher fasting insulin level, higher Metavir stage and higher grade of hepatic steatosis. Multivariate binary regression analysis showed that the only independent risk factor for non SVR was high fasting insulin level. Conclusion: Younger age, lower Metavir stage, lower steatosis grade and lower fasting insulin level are good predictors of SVR and could be used in predicting the treatment response of pegylated interferon/ribavirin therapy.

Keywords: chronic HCV infection, interferon ribavirin combination therapy, predictors to antiviral therapy, treatment response

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Authors: Damilola Mofikoya

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Developed countries account for a large proportion of greenhouse gas emissions. In the last decade, countries including the United States and China have made a commitment to cut down carbon emissions by signing the Paris Climate Agreement. However, carbon neutrality is a challenging issue to tackle at the country level because of the scale of the problem. To overcome this challenge, cities are at the forefront of these efforts. Many cities in the United States are taking strategic actions and proposing programs and initiatives focused on renewable energy, green transportation, less use of fossil fuel vehicles, etc. There have been concerns about the implications of those strategies and a lack of community engagement. This paper is focused on community-based efforts that help actualize the reduction of carbon footprint through sustained and inclusive action. Existing zero-carbon assessment tools are examined to understand variables and indicators associated with the zero-carbon goals. Based on a broad, systematic review of literature on community strategies, and existing zero-carbon assessment tools, a dashboard was developed to help simplify and demystify carbon neutrality goals at a community level. The literature was able to shed light on the key contributing factors responsible for the success of community efforts in carbon neutrality. Stakeholder education is discussed as one of the strategies to help communities take action and generate momentum. The community-based efforts involving individuals and residents, such as reduction of food wastages, shopping preferences, transit mode choices, and healthy diets, play an important role in the context of zero-carbon initiatives. The proposed community-based dashboard will emphasize the importance of sustained, structured, and collective efforts at a communal scale. Finally, the present study discusses the relationship between life expectancy and quality of life and how it affects carbon neutrality in communities.

Keywords: carbon footprint, communities, life expectancy, quality of life

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Authors: Mulligan T., Barker-Collo S., Gobson K., Jones K.

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There is a relatively scarce body of literature regarding adolescent experiences of traumatic brain injury (TBI). This qualitative study explored how sustaining a TBI at this unique stage of development might impact a young person as they navigate the challenges of adolescence and transition to adulthood, and what might support recovery. Thirteen young adults who sustained a mild-moderate TBI as an adolescent (aged 13 – 17 years), approximately 7.7 years (range = 6.7 – 8.0 years) prior, participated in the research. Semi-structured individual interviews were conducted to explore participants’ experiences surrounding and following their TBIs. Thematic analysis of interview data produced five key categories of findings: (1) Following their TBIs, many participants experienced problems with cognitive (e.g., forgetfulness, concentration difficulties), physical (e.g., migraines, fatigue) and emotional (e.g., depression, anxiety) functioning, which were often endured into adulthood. (2) TBI-related problems often adversely affected important areas of life for the participant, including school, work and friendships. (3) Changes following TBI commonly impacted identity formation. (4) Recovery processes evolved over time as the participants coped initially by just ‘getting on with it’, before learning to accept new limitations and, ultimately, growing from their TBI experiences. (5) While the presence of friends and family assisted recovery, struggles were often exacerbated by a lack of emotional support from others, in addition to the absence of any assistance or information-provision from professionals regarding what to expect following TBI. The findings suggest that even mild TBI sustained during adolescence can have consequences for an individual’s functioning, engagement in life and identity development, whilst also giving rise to post-traumatic growth. Recovery following adolescent TBI might be maximised by facilitating greater understanding of the injury and acknowledging its impacts on important areas of life, as well as the provision of emotional support and facilitating self-reflection and meaning-making.

Keywords: adolescent, brain Injury, qualitative, post-traumatic growth

Procedia PDF Downloads 51