Search results for: behaviour therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3807

Search results for: behaviour therapy

3237 Information Needs and Seeking Behaviour of Postgraduate Students of Kohat University of Science and Technology, Khyber Pakhtunkhwa, Pakistan

Authors: Saeed Ullah Jan, Muhammad Ali, Misbah Ullah Awan

Abstract:

Purpose: This study investigated the information needs and seeking behaviour, and hurdles to information seeking of Post Graduate students of Kohat University of Science and Technology (KUST), Khyber Pakhtunkhwa. It focused on the information requirements of the post-graduate students of the university, the pattern they use for seeking information, and the difficulties they face while seeking information. Design/Methodology/approach: This study used a quantitative approach, adapting a survey questionnaire method for data collection. The population of this study was composed of M.Phil. and Ph.D. students of 2019 and 2020 in the faculties of Physical and Numerical Sciences, Chemical and Pharmaceutical Sciences, Biological Sciences, and Social Sciences of KUST. The sample size was 260. Students were selected randomly. The study response rate was 77%, and data were analyzed through SPSS (22 versions). Key findings: The study revealed that Most students' information needs were for study and research activities, new knowledge, and career development. To fulfill these needs, the scholars use various sources and resources. The sources they used for information needs were journal articles, textbooks, and research projects commonly. For the information-seeking purpose, often, students prefer books that have some importance. The other factors that played an essential role in selecting material were topical relevance, Novelty, Recommended by colleagues, and publisher's reputation. Most of the students thought that Book Exhibitions, Open Access systems in the Library, and the Display of new arrivals could enhance the students' information-seeking. The main problem seeking information was faced by them was a shortage of printed information resources. Overall they wanted more facilities, enhancement in the library collection, and better services. Delimitations of the study: This study has not included 1) BS and M.Sc. Students of KUST; 2) The colleges and institutions affiliated with KUST; 3) This study was delimited only to the Post Graduate students of KUST. Practical implication(s): The findings of the study motivate the policymakers and authorities of KUST to restructure the information literacy programs to fulfill the scholars' information needs. It may inform the policymakers to know the difficulties faced by scholars during information seeking. Contribution to the knowledge: No significant work has been done on the students' information needs and seeking behaviour at KUST. The study analyzed the information needs and seeking behaviour of post graduate students. It brought a clear picture of information needs and seeking behaviour of scholars and addressed the problems faced by them during the seeking process.

Keywords: information needs of Pakistan, information-seeking behaviors, postgraduate students, university libraries, Kohat university of science and technology, Khyber Pakhtunkhwa, Pakistan

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3236 A Collaborative Approach to Improving Mental and Physical Health-Related Outcomes for a Heart Transplant Patient Through Music and Art Therapy Treatment

Authors: Elizabeth Laguaite, Alexandria Purdy

Abstract:

Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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3235 Sustainable Design for Building Envelope in Hot Climates: A Case Study for the Role of the Dome as a Component of an Envelope in Heat Exchange

Authors: Akeel Noori Almulla Hwaish

Abstract:

Architectural design is influenced by the actual thermal behaviour of building components, and this in turn depends not only on their steady and periodic thermal characteristics, but also on exposure effects, orientation, surface colour, and climatic fluctuations at the given location. Design data and environmental parameters should be produced in an accurate way for specified locations, so that architects and engineers can confidently apply them in their design calculations that enable precise evaluation of the influence of various parameters relating to each component of the envelope, which indicates overall thermal performance of building. The present paper will be carried out with an objective of thermal behaviour assessment and characteristics of the opaque and transparent parts of one of the very unique components used as a symbolic distinguished element of building envelope, its thermal behaviour under the impact of solar temperatures, and its role in heat exchange related to a specific U-value of specified construction materials alternatives. The research method will consider the specified Hot-Dry weather and new mosque in Baghdad, Iraq as a case study. Also, data will be presented in light of the criteria of indoor thermal comfort in terms of design parameters and thermal assessment for a“model dome”. Design alternatives and considerations of energy conservation, will be discussed as well using comparative computer simulations. Findings will be incorporated to outline the conclusions clarifying the important role of the dome in heat exchange of the whole building envelope for approaching an indoor thermal comfort level and further research in the future.

Keywords: building envelope, sustainable design, dome impact, hot-climates, heat exchange

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3234 Fracture Behaviour of Functionally Graded Materials Using Graded Finite Elements

Authors: Mohamad Molavi Nojumi, Xiaodong Wang

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In this research fracture behaviour of linear elastic isotropic functionally graded materials (FGMs) are investigated using modified finite element method (FEM). FGMs are advantageous because they enhance the bonding strength of two incompatible materials, and reduce the residual stress and thermal stress. Ceramic/metals are a main type of FGMs. Ceramic materials are brittle. So, there is high possibility of crack existence during fabrication or in-service loading. In addition, damage analysis is necessary for a safe and efficient design. FEM is a strong numerical tool for analyzing complicated problems. Thus, FEM is used to investigate the fracture behaviour of FGMs. Here an accurate 9-node biquadratic quadrilateral graded element is proposed in which the influence of the variation of material properties is considered at the element level. The stiffness matrix of graded elements is obtained using the principle of minimum potential energy. The implementation of graded elements prevents the forced sudden jump of material properties in traditional finite elements for modelling FGMs. Numerical results are verified with existing solutions. Different numerical simulations are carried out to model stationary crack problems in nonhomogeneous plates. In these simulations, material variation is supposed to happen in directions perpendicular and parallel to the crack line. Two special linear and exponential functions have been utilized to model the material gradient as they are mostly discussed in literature. Also, various sizes of the crack length are considered. A major difference in the fracture behaviour of FGMs and homogeneous materials is related to the break of material symmetry. For example, when the material gradation direction is normal to the crack line, even under applying the mode I loading there exists coupled modes I and II of fracture which originates from the induced shear in the model. Therefore, the necessity of the proper modelling of the material variation should be considered in capturing the fracture behaviour of FGMs specially, when the material gradient index is high. Fracture properties such as mode I and mode II stress intensity factors (SIFs), energy release rates, and field variables near the crack tip are investigated and compared with results obtained using conventional homogeneous elements. It is revealed that graded elements provide higher accuracy with less effort in comparison with conventional homogeneous elements.

Keywords: finite element, fracture mechanics, functionally graded materials, graded element

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3233 Factors Relating to Motivation to Change Behaviors in Individuals Who Are Overweight

Authors: Teresa Wills, Geraldine Mccarthy, Nicola Cornally

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Background: Obesity is an emerging healthcare epidemic affecting virtually all age and socio-economic groups and is one of the most serious and prevalent diseases of the 21st century. It is a public health challenge because of its prevalence, associated costs and health effects. The increasing prevalence of obesity has created a social perception that overweight body sizes are healthy and normal. This normalization of obesity within our society and the acceptance of higher body weights have led to individuals being unaware of the reality of their weight status and gravity of this situation thus impeding recognition of obesity. Given the escalating global health problem of obesity and its co-morbidities, the need to re-appraise its management is more compelling than ever. It is widely accepted that the causes of obesity are complex and multi-factorial. Engagement of individuals in weight management programmes is difficult if they do not perceive they have a problem with their weight. Recognition of the problem is a key component of obesity management and identifying the main predictors of behaviour is key to designing health behaviour interventions. Aim: The aim of the research was to determine factors relating to motivation to change behaviours in individuals who perceive themselves to be overweight. Method: The research design was quantitative, correlational and cross-sectional. The design was guided by the Health Belief Model. Data were collected online using a multi-section and multi-item questionnaire, developed from a review of the theoretical and empirical research. A sample of 202 men and women who perceived themselves to be overweight participated in the research. Descriptive and inferential statistical analyses were employed to describe relationships between variables. Findings: Following multivariate regression analysis, perceived barriers to weight loss and perceived benefits of weight loss were significant predictors of motivation to change behaviour. The perceived barriers to weight loss which were significant were psychological barriers to weight loss (p = < 0.019) and environmental barriers to physical activity (p= < 0.032).The greatest predictor of motivation to change behaviour was the perceived benefits of weight loss (p < 0.001). Perceived susceptibility to obesity and perceived severity of obesity did not emerge as significant predictors in this model. Total variance explained by the model was 33.5%. Conclusion: Perceived barriers to weight loss and perceived benefits of weight loss are important determinants of motivation to change behaviour. These findings have important implications for health professionals to help inform their practice and for the development of intervention programmes to prevent and control obesity.

Keywords: motivation to change behaviours, obesity, predictors of behavior, interventions, overweight

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3232 A Systematic Review of Patient-Reported Outcomes and Return to Work after Surgical vs. Non-surgical Midshaft Humerus Fracture

Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

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Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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3231 Targeted Nano Anti-Cancer Drugs for Curing Cancers

Authors: Imran Ali

Abstract:

General chemotherapy for cancer treatment has many side and toxic effects. A new approach of targeting nano anti-cancer drug is under development stage and only few drugs are available in the market today. The unique features of these drugs are targeted action on cancer cells only without any side effect. Sometimes, these are called magic drugs. The important molecules used for nano anti-cancer drugs are cisplatin, carboplatin, bleomycin, 5-fluorouracil, doxorubicin, dactinomycin, 6-mercaptopurine, paclitaxel, topotecan, vinblastin and etoposide etc. The most commonly used materials for preparing nano particles carriers are dendrimers, polymeric, liposomal, micelles inorganic, organic etc. The proposed lecture will comprise the-of-art of nano drugs in cancer chemo-therapy including preparation, types of drugs, mechanism, future perspectives etc.

Keywords: cancer, nano-anti-cancer drugs, chemo-therapy, mechanism of action, future perspectives

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3230 Influence of Yield Stress and Compressive Strength on Direct Shear Behaviour of Steel Fibre-Reinforced Concrete

Authors: Bensaid Boulekbache, Mostefa Hamrat, Mohamed Chemrouk, Sofiane Amziane

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This study aims in examining the influence of the paste yield stress and compressive strength on the behaviour of fibre-reinforced concrete (FRC) versus direct shear. The parameters studied are the steel fibre contents, the aspect ratio of fibres and the concrete strength. Prismatic specimens of dimensions 10x10x35cm made of concrete of various yield stress reinforced with steel fibres hooked at the ends with three fibre volume fractions (i.e. 0, 0.5, and 1%) and two aspects ratio (65 and 80) were tested to direct shear. Three types of concretes with various compressive strength and yield stress were tested, an ordinary concrete (OC), a self-compacting concrete (SCC) and a high strength concrete (HSC). The concrete strengths investigated include 30 MPa for OC, 60 MPa for SCC and 80 MPa for HSC. The results show that the shear strength and ductility are affected and have been improved very significantly by the fibre contents, fibre aspect ratio and concrete strength. As the compressive strength and the volume fraction of fibres increase, the shear strength increases. However, yield stress of concrete has an important influence on the orientation and distribution of the fibres in the matrix. The ductility was much higher for ordinary and self-compacting concretes (concrete with good workability). The ductility in direct shear depends on the fibre orientation and is significantly improved when the fibres are perpendicular to the shear plane. On the contrary, for concrete with poor workability, an inadequate distribution and orientation of fibres occurred, leading to a weak contribution of the fibres to the direct shear behaviour.

Keywords: concrete, fibre, direct shear, yield stress, orientation, strength

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3229 A Comparison of Dietary Quality and Nutritional Adequacy of Meal Plans of a Diet Prescription Generator Web App against the Australian Guidelines to Healthy Eating

Authors: Ananda Perera

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Diet therapy has a positive impact on many diseases in General Practice. If a meal plan can be generated as easily as writing a drug prescription for dyspepsia, then the evidence and practice gap in nutrition therapy can be narrowed. Meal plans of 50 diet prescriptions were compared with the criteria for a healthy diet given by Australian authorities. The energy value of each meal plan was compared with the recommended daily energy requirements of the authorities for Diet Prescription Generator (DPG) accuracy. Meal plans generated were within the criteria laid down by the Australian authorities for a healthy diet.

Keywords: dieting, obesity, diabetes, weight loss, computerized decision support systems, dieting software, CDSS, meal plans

Procedia PDF Downloads 142
3228 Threading Professionalism Through Occupational Therapy Curriculum: A Framework and Resources

Authors: Ashley Hobson, Ashley Efaw

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Professionalism is an essential skill for clinicians, particularly for Occupational Therapy Providers (OTPs). The World Federation of Occupational Therapy (WFOT) Guiding Principles for Ethical Occupational Therapy and American Occupational Therapy Association (AOTA) Code of Ethics establishes expectations for professionalism among OTPs, emphasizing its importance in the field. However, the teaching and assessment of professionalism vary across OTP programs. The flexibility provided by the country standards allows programs to determine their own approaches to meeting these standards, resulting in inconsistency. Educators in both academic and fieldwork settings face challenges in objectively assessing and providing feedback on student professionalism. Although they observe instances of unprofessional behavior, there is no standardized assessment measure to evaluate professionalism in OTP students. While most students are committed to learning and applying professionalism skills, they enter OTP programs with varying levels of proficiency in this area. Consequently, they lack a uniform understanding of professionalism and lack an objective means to self-assess their current skills and identify areas for growth. It is crucial to explicitly teach professionalism, have students to self-assess their professionalism skills, and have OTP educators assess student professionalism. This approach is necessary for fostering students' professionalism journeys. Traditionally, there has been no objective way for students to self-assess their professionalism or for educators to provide objective assessments and feedback. To establish a uniform approach to professionalism, the authors incorporated professionalism content into our curriculum. Utilizing an operational definition of professionalism, the authors integrated professionalism into didactic, fieldwork, and capstone courses. The complexity of the content and the professionalism skills expected of students increase each year to ensure students graduate with the skills to practice in accordance with the WFOT Guiding Principles for Ethical Occupational Therapy Practice and AOTA Code of Ethics. Two professionalism assessments were developed based on the expectations outlined in the both documents. The Professionalism Self-Assessment allows students to evaluate their professionalism, reflect on their performance, and set goals. The Professionalism Assessment for Educators is a modified version of the same tool designed for educators. The purpose of this workshop is to provide educators with a framework and tools for assessing student professionalism. The authors discuss how to integrate professionalism content into OTP curriculum and utilize professionalism assessments to provide constructive feedback and equitable learning opportunities for OTP students in academic, fieldwork, and capstone settings. By adopting these strategies, educators can enhance the development of professionalism among OTP students, ensuring they are well-prepared to meet the demands of the profession.

Keywords: professionalism, assessments, student learning, student preparedness, ethical practice

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3227 Quality of Life and Self-Assessed Health of Buprenorphine–Maintained Opiate Addicts

Authors: Igna Brajević Gizdić, Gorka Vuletić

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Introduction: Addiction is a chronic brain relapsing disorder. Opioid Substitution Therapy (OST) using buprenorphine as a medical treatment option shows as a promising option for achieving and maintaining abstinence in opioid-addicted patients. This research aimed to determine and evaluate the quality of life (QoL) in opiate-addicted patients after five years of buprenorphine therapy. Method: The total sample included 44 buprenorphine-maintained opiate addicts in outpatient treatment. The participants were administered the QoL questionnaire (WHOQOL-BREF) at two-time points (T1 and T2) with an interval of at least five years. WHOQOL-BREF contains a total of 26 questions. The first two questions, related to overall QoL and general health status, and the remaining questions (3–26), which represented four domains—physical, psychological, social, and environmental health—were evaluated separately. Results: The results indicated no significant differences in overall self-assessed QoL nor in individual domains after five years (T2) of abstinence with OST buprenorphine- maintenance. Conclusion: These findings indicated no improvement in QoL of buprenorphine-maintenance opiate addicts in outpatient treatment. However, this might be due to the smaller sample size and participants' overall high scores in QoL at T1. This study suggests the importance of expectations when considering the QoL and general health of buprenorphine-maintenance opiate addicts in outpatient treatment.

Keywords: abstinence, addicts, buprenorphine, opioid substitution therapy, quality of life

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3226 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

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3225 Impact of Motor Behaviour Aspects of Autism on Cognitive Ability in Children with Autism Spectrum Disorder

Authors: Rana Zeina

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Cognitive and behavioral symptoms may, in fact, overlap and be related to the level of the general cognitive function. We measured the behavioral aspects of autism and its correlation to the cognitive ability in 30 children with ASD. We used a neuropsychological battery CANTAB eclipse to evaluate the ASD children's cognitive ability. Individuals with ASDs and challenging behaviors showed significant correlation between some cognitive abilities and motor behavior aspects. Based on these findings we can conclude that the motor behavioral problems in autism affect specific cognitive abilities in ASDs such as comprehension, learning, reversal, acquisition, attention set shifting, and speed of reaction to one stimulus. Future research should also focus on the relationship between motor stereotypes and other subtypes of repetitive behaviors, such as verbal stereotypes, and ritual and routine adherence and use different types of CANTAB tests.

Keywords: cognitive ability, CANTAB test, behaviour motor aspects, autism spectrum disorders

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3224 The Influence of Leader’s Sources of Power on Organizational Citizenship Behaviour

Authors: Noor Azlina Mohamed Yunus, Noorlaila Yunus, Kadulliah Ghazali

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In this an era of intense competition, Malaysia aspires to be a fully developed country by 2020 and desires its citizens to perform and execute excellent work behaviors. For that reason, organizations are focusing on employees’ positive and constructive behaviors such as organizational citizenship behavior (OCB). They expect employees to not only complete their required duties by providing excellent performance but also keenly go beyond their roles that are not specifying in their formal job descriptions to ensure organizational success. The role and duty to acquire employees to engage and connect in OCB is the responsibility of a leader. Thus, leaders can utilize their sources of power to enable subordinates to accomplish organizational objective including OCB. Therefore, this paper formulates a framework postulating leader’s sources of power as an antecedent of organizational citizenship behavior (OCB). The discussion on implications for future theory development is discussed.

Keywords: organizational citizenship behaviour (OCB), leader’s sources of power, call centre industry, conceptual paper

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3223 Providing Additional Advantages for STATCOM in Power Systems by Integration of Energy Storage Device

Authors: Reza Sedaghati

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The use of Flexible AC Transmission System (FACTS) devices in a power system can potentially overcome limitations of the present mechanically controlled transmission system. Also, the advance of technology makes possible to include new energy storage devices in the electrical power system. The integration of Superconducting Magnetic Energy Storage (SMES) into Static Synchronous Compensator (STATCOM) can lead to increase their flexibility in improvement of power system dynamic behaviour by exchanging both active and reactive powers with power grids. This paper describes structure and behaviour of SMES, specifications and performance principles of the STATCOM/SMES compensator. Moreover, the benefits and effectiveness of integrated SMES with STATCOM in power systems is presented. Also, the performance of the STATCOM/SMES compensator is evaluated using an IEEE 3-bus system through the dynamic simulation by PSCAD/EMTDC software.

Keywords: STATCOM/SMES compensator, chopper, converter, energy storage system, power systems

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3222 Dorsal Root Ganglion Neuromodulation as an Alternative to Opioids in the Evolving Healthcare Crisis

Authors: Adam J. Carinci

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Background: The opioid epidemic is the most pressing healthcare crisis of our time. There is increasing recognition that opioids have limited long-term efficacy and are associated with hyperalgesia, addiction, and increased morbidity and mortality. Therefore, alternative strategies to combat chronic pain are paramount. We initiated a multicenter retrospective case series to review the efficacy of DRG stimulation in facilitating opioid tapering, opioid discontinuation and as a viable alternative to chronic opioid therapy. Purpose: The dorsal root ganglion (DRG) plays a key role in the development and maintenance of pain. Recent innovations in neuromodulation, specifically, dorsal root ganglion stimulation, offers an effective alternative to opioids in the treatment of chronic pain. This retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy. Procedure: This small multicenter retrospective case series provides preliminary evidence that DRG stimulation facilitates opioid weaning, opioid tapering and is a viable option to opioid therapy in the treatment of chronic pain. A retrospective analysis was completed. Visual analog scale pain scores and pain medication usage were collected at the baseline visit and after four weeks, 3 months and 6 months of treatment. Ten consecutive patients across two study centers were included. The pain was rated 7.38 at baseline and decreased to 1.50 at the 4-week follow-up, a reduction of 79.5%. All patients significantly decreased their opioid pain medication use with an average > 30% reduction in morphine equivalents and four were able to discontinue their medications entirely. Conclusion: This Retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy.

Keywords: dorsal root ganglion, neuromodulation, opioid sparing, stimulation

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3221 Effect of Magnetic Field in Treatment of Lower Back Myofascial Pain Syndrome: A Randomized Controlled Trial

Authors: Ahmed M. F. El Shiwi

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Background: Low back pain affects about 60% to 90% of the working-age population in modern industrial society. Myofascial pain syndrome is a condition characterized by muscles shortening with increased tone and associated with trigger points that aggravated with the activity of daily living. Purpose: To examine the effects of magnetic field therapy in patients with lower back myofascial pain syndrome. Methods: Thirty patients were assigned randomly into two groups. Subjects in the experimental group (n=15) with main age of 36.73 (2.52) received traditional physical therapy program (Infrared radiation, ultrasonic, stretching and strengthening exercises for back muscles) as well as magnetic field, and control group (n=15) with main age of 37.27 (2.52) received traditional physical therapy only. The following parameters including pain severity, functional disability and lumbar range of motion (flexion, extension, right side bending, and left side bending) were measured before and after four weeks of treatment. Results: The results showed significant improvement in all parameters in the experimental group compared with those in the control group. Interpretation/Conclusion: By the present date, it is possible to conclude that a magnetic field is effective as a method of treatment for lower back myofascial pain syndrome patients with the parameters used in the present study.

Keywords: magnetic field, lower back pain, myofascial pain syndrome, biological systems engineering

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3220 The Mechanical Behavior of a Cement-Fiber Composite Material

Authors: K. Harrat, M. Hidjeb, M. T’kint

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The aim of the present research work is to characterize a cement palm date fiber composite in order to be used in isolation and in the manufacture of new structural materials. This technique may possibly participate seriously in the preservation of the environment and develop a growing need for plant products. On one hand, It has been shown that the presence of natural fiber in the composite materials manufacture, based on hydraulic binder, has improved the mechanical behaviour of the material. On the Other hand, It has been proven that the durability of composite materials reinforced with untreated fibers was largely affected by the presence of organic matter. In order to extract the organic material, the fibers were treated with boiling water and then coated with different types of products. A considerable improvement in the sensitivity to water of the fibers, as well as in the mechanical strength and in the ductility of the composite material was observed. The fiber being sensitive to water, the study put the emphasis on its dimensional stability.

Keywords: cement composite, durability, heat treatment, mechanical behaviour, vegetal fiber

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3219 Modelling the Effect of Alcohol Consumption on the Accelerating and Braking Behaviour of Drivers

Authors: Ankit Kumar Yadav, Nagendra R. Velaga

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Driving under the influence of alcohol impairs the driving performance and increases the crash risks worldwide. The present study investigated the effect of different Blood Alcohol Concentrations (BAC) on the accelerating and braking behaviour of drivers with the help of driving simulator experiments. Eighty-two licensed Indian drivers drove on the rural road environment designed in the driving simulator at BAC levels of 0.00%, 0.03%, 0.05%, and 0.08% respectively. Driving performance was analysed with the help of vehicle control performance indicators such as mean acceleration and mean brake pedal force of the participants. Preliminary analysis reported an increase in mean acceleration and mean brake pedal force with increasing BAC levels. Generalized linear mixed models were developed to quantify the effect of different alcohol levels and explanatory variables such as driver’s age, gender and other driver characteristic variables on the driving performance indicators. Alcohol use was reported as a significant factor affecting the accelerating and braking performance of the drivers. The acceleration model results indicated that mean acceleration of the drivers increased by 0.013 m/s², 0.026 m/s² and 0.027 m/s² for the BAC levels of 0.03%, 0.05% and 0.08% respectively. Results of the brake pedal force model reported that mean brake pedal force of the drivers increased by 1.09 N, 1.32 N and 1.44 N for the BAC levels of 0.03%, 0.05% and 0.08% respectively. Age was a significant factor in both the models where one year increase in drivers’ age resulted in 0.2% reduction in mean acceleration and 19% reduction in mean brake pedal force of the drivers. It shows that driving experience could compensate for the negative effects of alcohol to some extent while driving. Female drivers were found to accelerate slower and brake harder as compared to the male drivers which confirmed that female drivers are more conscious about their safety while driving. It was observed that drivers who were regular exercisers had better control on their accelerator pedal as compared to the non-regular exercisers during drunken driving. The findings of the present study revealed that drivers tend to be more aggressive and impulsive under the influence of alcohol which deteriorates their driving performance. Drunk driving state can be differentiated from sober driving state by observing the accelerating and braking behaviour of the drivers. The conclusions may provide reference in making countermeasures against drinking and driving and contribute to traffic safety.

Keywords: alcohol, acceleration, braking behaviour, driving simulator

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3218 Characterization of Bovine SERPIN- Alpha-1 Antitrypsin (AAT)

Authors: Sharique Ahmed, Khushtar Anwar Salman

Abstract:

Alpha-1-antitrypsin (AAT) is a major plasma serine protease inhibitor (SERPIN). Hereditary AAT deficiency is one of the common diseases in some part of the world. AAT is mainly produced in the liver and functions to protect the lung against proteolytic damage (e.g., from neutrophil elastase) acting as the major inhibitor for neutrophil elastase. α (1)-Antitrypsin (AAT) deficiency is an under recognized genetic condition that affects approximately 1 in 2,000 to 1 in 5,000 individuals and predisposes to liver disease and early-onset emphysema. Not only does α-1-antitrypsin deficiency lead to disabling syndrome of pulmonary emphysema, there are other disorders too which include ANCA (antineutrophilic cytoplasmic antibody) positive Wegener's granulomatosis, diffuse bronchiectasis, necrotizing panniculitis in α-1-antitrypsin phenotype (S), idiopathic pulmonary fibrosis and steroid dependent asthma. Augmentation therapy with alpha-1 antitrypsin (AAT) from human plasma has been available for specific treatment of emphysema due to AAT deficiency. Apart from this several observations have also suggested a role for endogenous suppressors of HIV-1, alpha-1 antitrypsin (AAT) has been identified to be one of those. In view of its varied important role in humans, serum from a mammalian source was chosen for the isolation and purification. Studies were performed on the homogeneous fraction. This study suggests that the buffalo serum α-1-antritrypsin has characteristics close to ovine, dog, horse and more importantly to human α-1-antritrypsin in terms of its hydrodynamic properties such as molecular weight, carbohydrate content, etc. The similarities in the hydrodynamic properties of buffalo serum α-1-antitrypsin with other sources of mammalian α-1-antitrypsin mean that it can be further studied and be a potential source for "augmentation therapy", as well as a source of AAT replacement therapy to raise serum levels above the protective threshold. Other parameters like the amino acid sequence, the effect of denaturants, and the thermolability or thermostability of the inhibitor will be the interesting basis of future studies on buffalo serum alpha-1 antitrypsin (AAT).

Keywords: α-1-antitrypsin, augmentation therapy , hydrodynamic properties, serine protease inhibitor

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3217 Physiopathology of Osteitis in the Diabetic Foot

Authors: Mohamed Amine Adaour, Mohamed Sadek Bachene, Mosaab Fortassi, Wafaa Siouda

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73%, and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 82
3216 The Arts in Medicine and Health: A Necessity for Evidence-Based Health Systems

Authors: Alan S. Weber

Abstract:

This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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3215 Students’ and Clinical Supervisors’ Experiences of Occupational Therapy Practice Education: A Structured Critical Review

Authors: Hamad Alhamad, Catriona Khamisha, Emma Green, Yvonne Robb

Abstract:

Introduction: Practice education is a key component of occupational therapy education. This critical review aimed to explore students’ and clinical supervisors’ experiences of practice education, and to make recommendations for research. Method: The literature was systematically searched using five databases. Qualitative, quantitative and mixed methods studies were included. Critical Appraisal Skills Programme checklist for qualitative studies and Mixed Methods Assessment Tool for quantitative and mixed methods studies were used to assess study quality. Findings: Twenty-two studies with high quality scores were included: 16 qualitative, 3 quantitative and 3 mixed methods. Studies were conducted in Australia, Canada, USA and UK. During practice education, students learned professional skills, practical skills, clinical skills and problem-solving skills, and improved confidence and creativity. Supervisors had an opportunity to reflect on their practice and get experience of supervising students. However, clear objectives and expectations for students, and sufficient theoretical knowledge, preparation and resources for supervisors were required. Conclusion: Practice education provides different skills and experiences, necessary to become competent professionals; but some areas of practice education need to improve. Studies in non-western countries are needed to explore the perspectives of students and clinical supervisors in different cultures, to ensure the practice education models adopted are relevant.

Keywords: occupational therapy, practice education, fieldwork, students, clinical supervisors

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3214 A TiO₂-Based Memristor Reliable for Neuromorphic Computing

Authors: X. S. Wu, H. Jia, P. H. Qian, Z. Zhang, H. L. Cai, F. M. Zhang

Abstract:

A bipolar resistance switching behaviour is detected for a Ti/TiO2-x/Au memristor device, which is fabricated by a masked designed magnetic sputtering. The current dependence of voltage indicates the curve changes slowly and continuously. When voltage pulses are applied to the device, the set and reset processes maintains linearity, which is used to simulate the synapses. We argue that the conduction mechanism of the device is from the oxygen vacancy channel model, and the resistance of the device change slowly due to the reaction between the titanium electrode and the intermediate layer and the existence of a large number of oxygen vacancies in the intermediate layer. Then, Hopfield neural network is constructed to simulate the behaviour of neural network in image processing, and the accuracy rate is more than 98%. This shows that titanium dioxide memristor has a broad application prospect in high performance neural network simulation.

Keywords: memristor fabrication, neuromorphic computing, bionic synaptic application, TiO₂-based

Procedia PDF Downloads 90
3213 Evaluation of Neighbourhood Characteristics and Active Transport Mode Choice

Authors: Tayebeh Saghapour, Sara Moridpour, Russell George Thompson

Abstract:

One of the common aims of transport policy makers is to switch people’s travel to active transport. For this purpose, a variety of transport goals and investments should be programmed to increase the propensity towards active transport mode choice. This paper aims to investigate whether built environment features in neighbourhoods could enhance the odds of active transportation. The present study introduces an index measuring public transport accessibility (PTAI), and a walkability index along with socioeconomic variables to investigate mode choice behaviour. Using travel behaviour data, an ordered logit regression model is applied to examine the impacts of explanatory variables on walking trips. The findings indicated that high rates of active travel are consistently associated with higher levels of walking and public transport accessibility.

Keywords: active transport, public transport accessibility, walkability, ordered logit model

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3212 Effect of Early Therapeutic Intervention for the Children With Autism Spectrum Disorders: A Quasi Experimental Design

Authors: Sultana Razia

Abstract:

The number of children whose social, communication and behavior pattern is affected due to mental and developmental conditions is on the rise. Most of these conditions develop to uncontrollable levels because of ignorance and unaware about their child’s condition. The many myths surrounding mental or developmental conditions are a major cause of families of affected children to develop bitterness and to shy off from seeking appropriate help in time. Several early intervention programs have been put in place, and the number of beneficiaries of these programs is increasing by the day. This research seeks to look into early intervention programs and their effectiveness. The purpose of this study was to investigate the effect of early therapeutic intervention for the children with autism spectrum disorder. Participants were 140 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. This study included children who are at age of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disability or medical conditions excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy were provided. The results indicated that early intensive therapeutic intervention improve understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention a positive effect on diminishing symptoms of Autism Spectrum Disorder.

Keywords: M-CHAT, ASD, sensory cheeklist, OT

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3211 Clinical Efficacy of Localized Salvage Prostate Cancer Reirradiation with Proton Scanning Beam Therapy

Authors: Charles Shang, Salina Ramirez, Stephen Shang, Maria Estrada, Timothy R. Williams

Abstract:

Purpose: Over the past decade, proton therapy utilizing pencil beam scanning has emerged as a preferred treatment modality in radiation oncology, particularly for prostate cancer. This retrospective study aims to assess the clinical and radiobiological efficacy of proton scanning beam therapy in the treatment of localized salvage prostate cancer, following initial radiation therapy with a different modality. Despite the previously delivered high radiation doses, this investigation explores the potential of proton reirradiation in controlling recurrent prostate cancer and detrimental quality of life side effects. Methods and Materials: A retrospective analysis was conducted on 45 cases of locally recurrent prostate cancer that underwent salvage proton reirradiation. Patients were followed for 24.6 ± 13.1 months post-treatment. These patients had experienced an average remission of 8.5 ± 7.9 years after definitive radiotherapy for localized prostate cancer (n=41) or post-prostatectomy (n=4), followed by rising PSA levels. Recurrent disease was confirmed by FDG-PET (n=31), PSMA-PET (n=10), or positive local biopsy (n=4). Gross tumor volume (GTV) was delineated based on PET and MR imaging, with the planning target volume (PTV) expanding to an average of 10.9 cm³. Patients received proton reirradiation using two oblique coplanar beams, delivering total doses ranging from 30.06 to 60.00 GyE in 17–30 fractions. All treatments were administered using the ProBeam Compact system with CT image guidance. The International Prostate Symptom Scores (IPSS) and prostate-specific antigen (PSA) levels were evaluated to assess treatment-related toxicity and tumor control. Results and Discussions: In this cohort (mean age: 76.7 ± 7.3 years), 60% (27/45) of patients showed sustained reductions in PSA levels post-treatment, while 36% (16/45) experienced a PSA decline of more than 0.8 ng/mL. Additionally, 73% (33/45) of patients exhibited an initial PSA reduction, though some showed later PSA increases, indicating the potential presence of undetected metastatic lesions. The median post-retreatment IPSS score was 4, significantly lower than scores reported in other treatment studies. Overall, 69% of patients reported mild urinary symptoms, with 96% (43/45) experiencing mild to moderate symptoms. Three patients experienced grade I or II proctitis, while one patient reported grade III proctitis. These findings suggest that regional organs, including the urethra, bladder, and rectum, demonstrate significant radiobiological recovery from prior radiation exposure, enabling tolerance to additional proton scanning beam therapy. Conclusions: This retrospective analysis of 45 patients with recurrent localized prostate cancer treated with salvage proton reirradiation demonstrates favorable outcomes, with a median follow-up of two years. The post-retreatment IPSS scores were comparable to those reported in follow-up studies of initial radiation therapy treatments, indicating stable or improved urinary symptoms compared to the end of initial treatment. These results highlight the efficacy of proton scanning beam therapy in providing effective salvage treatment while minimizing adverse effects on critical organs. The findings also enhance the understanding of radiobiological responses to reirradiation and support proton therapy as a viable option for patients with recurrent localized prostate cancer following previous definitive radiation therapy.

Keywords: prostate salvage radiotherapy, proton therapy, biological radiation tolerance, radiobiology of organs

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3210 The Effect of Drug Prevention Programme Based On Cognitive-Behavioral Therapy (CBT) and Multidimensional Self Concept Module Towards Resiliency and Aggression Among At-Risk Youth in Malaysia

Authors: Mohammad Aziz Shah Mohamed Arip, Aslina Ahmad, Fauziah Mohd Sa'ad, Samsiah Mohd Jais, Syed Sofian Syed Salim

Abstract:

This experimental study evaluates the effect of using Cognitive-Behavioral Therapy (CBT) and Multidimensional Self-Concept Model (MSCM) in a drug prevention programme to increase resiliency and reduce aggression among at-risk youth in Malaysia. A number of 60 (N=60) university students who were at-risk of taking drugs were involved in this study. Participants were identified with self-rating scales, Adolescent Resilience Attitude Scale (ARAS) and Aggression Questionnaire. Based on the mean score of these instruments, the participants were divided into the treatment group, and the control group. Data were analyzed using t-test. The finding showed that the mean score of resiliency was increased in the treatment group compared to the control group. It also shows that the mean score of aggression was reduced in the treatment group compared to the control group. Drug Prevention Programme was found to help in enhancing resiliency and reducing aggression among participants in the treatment group compared to the controlled group. Implications were given regarding the preventive actions on drug abuse among youth in Malaysia.

Keywords: drug prevention programme, cognitive-behavioral therapy (CBT), multidimensional self concept model (MSCM), resiliency, aggression, at-risk youth

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3209 Diagnostic Physiopathology of Osteitis in the Diabetic Foot

Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

Abstract:

Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 104
3208 Gall Bladder Polyp Identified as Solitary RCC Metastasis 4 Years after Nephrectomy: An Unusual Case Report

Authors: Gerard Bray, Arya Bahadori, Sachinka Ranasinghe

Abstract:

Renal cell carcinoma (RCC) is among the top 10 most common cancers worldwide, where metastatic disease carries a poor prognosis. Herein, we present a 74-year-old male presenting with asymptomatic solitary metachronous metastasis to the gall bladder 4 years following nephrectomy for clear cell RCC. Solitary RCC metastasis to the gall bladder following nephrectomy is rarely reported in the literature and brings with it a clinical conundrum of whether surgical resection or systemic therapy should be utilized. In this case, surgical excision with cholecystectomy was employed without systemic therapy. We, therefore, contribute a rare and interesting case that highlights that metastasectomy of a solitary metastasis can improve survival according to current literature.

Keywords: renal cell carcinoma, gall bladder metastasis, solitary metastasectomy, metachronous

Procedia PDF Downloads 173