Search results for: long term care facility

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

Procedia PDF Downloads 141

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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Authors: O. Behar, A. Khellaf, K. Mohammedi, S. Ait Kaci

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Up to now, most validation studies have been based on the MBE and RMSE, and therefore, focused only on long and short terms performance to test and classify solar radiation models. This traditional analysis does not take into account the quality of modeling and linearity. In our analysis we have tested 22 solar radiation models that are capable to provide instantaneous direct and global radiation at any given location Worldwide. We introduce a new indicator, which we named Global Accuracy Indicator (GAI) to examine the linear relationship between the measured and predicted values and the quality of modeling in addition to long and short terms performance. Note that the quality of model has been represented by the T-Statistical test, the model linearity has been given by the correlation coefficient and the long and short term performance have been respectively known by the MBE and RMSE. An important founding of this research is that the use GAI allows avoiding default validation when using traditional methodology that might results in erroneous prediction of solar power conversion systems performances.

Keywords: solar radiation model, parametric model, performance analysis, Global Accuracy Indicator (GAI)

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Authors: Kiomars Sefidi

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Dead and habitat tree such as fallen logs, snags, stumps and cracks and loos bark etc. is regarded as an important ecological component of forests on which many forest dwelling species depend, yet its relation to management history in Caspian forest has gone unreported. The aim of research was to compare the amounts of dead tree and habitat in the forests with historically different intensities of management, including: forests with the long term implication of management (PS), the short-term implication of management (NS) which were compared with semi virgin forest (GS). The number of 405 individual dead and habitat trees were recorded and measured at 109 sampling locations. ANOVA revealed volume of the dead tree in the form and decay classes significantly differ within sites and dead volume in the semi virgin forest significantly higher than managed sites. Comparing the amount of dead and habitat tree in three sites showed that dead tree volume related with management history and significantly differ in three study sites. Also, the numbers of habitat trees including cavities, Cracks and loose bark and Fork split trees significantly vary among sites. Reaching their highest in virgin site and their lowest in the site with the long term implication of management, it was concluded that forest management cause reduction of the amount of dead and habitat tree. Forest management history affect the forest's ability to generate dead tree especially in a large size, thus managing this forest according to ecological sustainable principles require a commitment to maintaining stand structure that allow, continued generation of dead tree in a full range of size.

Keywords: forest biodiversity, cracks trees, fork split trees, sustainable management, Fagus orientalis, Iran

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: cardiopulmonary disease, bipolar disorder, SJS, therapy

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Authors: Haoyi Sheng

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China's aging tendency is becoming increasingly severe, which leads to the embarrassing situation of "getting old before getting wealthy". The traditional pension model does not comply with the need of today. Relying on "Internet Plus", it can efficiently integrate information and resources and meet the personalized needs of elderly care. It can reduce the operating cost of community elderly care facilities and lay a technical foundation for providing better services for the elderly. The key for providing help for the elderly in the future is to effectively integrate technology, make good use of technology, and improve the efficiency of elderly care services. The effective integration of traditional home care, community care, intelligent elderly care equipment and medical resources to create the "Internet Plus" community intelligent pension service mode has become the future development trend of aging care. The research method of this paper is to collect literature and conduct theoretical research on community pension firstly. Secondly, the combination of suitable aging design and "Internet Plus" is elaborated through research. Finally, this paper states the current level of intelligent technology in old-age care and looks into the future by understanding multiple levels of "Internet Plus". The development of community intelligent pension mode and content under "Internet Plus" has enormous development potential. In addition to the characteristics and functions of ordinary houses, residential design of endowment housing has higher requirements for comfort and personalization, and the people-oriented is the principle of design.

Keywords: ageing tendency, 'Internet Plus', community intelligent elderly care, elderly care service model, technology

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Authors: Paul Kenneth D. Luzon, Maria Antonia N. Tanchuling

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The Quezon City Controlled Dumping facility also known as Payatas produces leachate which can contaminate soil and water environment in the area. The goal of this study is to quantify the leachate produced by the QCCDF using the Hydrologic Evaluation of Landfill Performance (HELP) model. Results could be used as input for groundwater contaminant transport studies. The HELP model is based on a simple water budget and is an essential “model requirement” used by the US Environmental Protection Agency (EPA). Annual waste profile of the QCCDF was calculated. Based on topographical maps and estimation of settlement due to overburden pressure and degradation, a total of 10M m^3 of waste is contained in the landfill. The input necessary for the HELP model are weather data, soil properties, and landfill design. Results showed that from 1988 to 2011, an average of 50% of the total precipitation percolates through the bottom layer. Validation of the results is still needed due to the assumptions made in the study. The decrease in porosity of the top soil cover showed the best mitigation for minimizing percolation rate. This study concludes that there is a need for better leachate management system in the QCCDF.

Keywords: help model, landfill, payatas trash slide, quezon city controlled dumping facility

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Authors: Saeid Doaei

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The various studies have examined the relationship between FTO gene expression and macronutrients levels. In order to obtain better viewpoint from this interactions, all of the existing studies were reviewed systematically. All published papers have been obtained and reviewed using standard and sensitive keywords from databases such as CINAHL, Embase, PubMed, PsycInfo, and the Cochrane, from 1990 to 2016. The results indicated that all of 6 studies that met the inclusion criteria (from a total of 428 published article) found FTO gene expression changes at short-term follow-ups. Four of six studies found an increased FTO gene expression after calorie restriction, while two of them indicated decreased FTO gene expression. The effect of protein, carbohydrate and fat were separately assessed and suggested by all of six studies. In conclusion, the level of FTO gene expression in hypothalamus is related to macronutrients levels. Future research should evaluate the long-term impact of dietary interventions.

Keywords: obesity, gene expression, FTO, macronutrients

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Authors: Raptis Sotirios

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Health and social care (HSc) services planning and scheduling are facing unprecedented challenges due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven can help to improve policies, plan and design services provision schedules using algorithms assist healthcare managers’ to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as CART, random forests (RF), and logistic regression (LGR). The significance tests Chi-Squared test and Student test are used on data over a 39 years span for which HSc services data exist for services delivered in Scotland. The demands are probabilistically associated through statistical hypotheses that assume that the target service’s demands are statistically dependent on other demands as a NULL hypothesis. This linkage can be confirmed or not by the data. Complementarily, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus groups of services. Statistical tests confirm ML couplings making the prediction also statistically meaningful and prove that a target service can be matched reliably to other services, and ML shows these indicated relationships can also be linear ones. Zero paddings were used for missing years records and illustrated better such relationships both for limited years and in the entire span offering long term data visualizations while limited years groups explained how well patients numbers can be related in short periods or can change over time as opposed to behaviors across more years. The prediction performance of the associations is measured using Receiver Operating Characteristic(ROC) AUC and ACC metrics as well as the statistical tests, Chi-Squared and Student. Co-plots and comparison tables for RF, CART, and LGR as well as p-values and Information Exchange(IE), are provided showing the specific behavior of the ML and of the statistical tests and the behavior using different learning ratios. The impact of k-NN and cross-correlation and C-Means first groupings is also studied over limited years and the entire span. It was found that CART was generally behind RF and LGR, but in some interesting cases, LGR reached an AUC=0 falling below CART, while the ACC was as high as 0.912, showing that ML methods can be confused padding or by data irregularities or outliers. On average, 3 linear predictors were sufficient, LGR was found competing RF well, and CART followed with the same performance at higher learning ratios. Services were packed only if when significance level(p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, birth weights, alcoholism, drug abuse, and emergency admissions. The work found that different HSc services can be well packed as plans of limited years, across various services sectors, learning configurations, as confirmed using statistical hypotheses.

Keywords: class, cohorts, data frames, grouping, prediction, prob-ability, services

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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

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

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

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Authors: Ningombam Linthoingambi Devi, Amrendra Kumar

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The long term sampling at one of the most populated city in Indo-Gangetic region shows higher mass concentration of atmospheric aerosol (PM₂.₅) during spring season (144.70µg/m³), summer season (91.96 µg/m³), the autumn season (266.48µg/m³) and winter season (367.09 µg/m³) respectively. The concentration of PM₂.₅ in Patna across the year shows much higher than the limit fixed by the national ambient air quality level fixed by central pollution control board India (CPCB, India) and World Health Organization (WHO). Different water-soluble cation (Na⁺, K⁺, Ca²⁺, NH₄⁺ , and Mg²⁺) and anion (Cl⁻, NO₃⁻ , and SO₄²⁻) species were detected in PM₂.₅. Results show the significantly higher loaded of water-soluble ions during winter and spring seasons. The acidity of the atmosphere was revealed and calculated using selected major cations (K⁺, Ca²⁺ , and NH₄⁺) and anions (SO₄²⁻, and NO₃⁻). A regression correlation was analyzed to check the significant linkage between the acidity and alkalinity ions. During the winter season (r² = 0.79) and spring season (r² = 0.64) shows good significant correlation between the cations and anions. The ratio of NO₃⁻/SO₄²⁻ indicates the sources of secondary pollutants were mainly influenced by industrial and vehicular emission however SO₄²⁻ mostly emitted from industries during the winter season.

Keywords: aerosols, inorganic species, source apportionment, Indo-Gangetic region

Procedia PDF Downloads 133

Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

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Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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Authors: Michael D. Vinod, Hadi Khabbaz

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Construction of infrastructure above or adjacent to landfills is becoming more common to capitalize on the limited space available within urban areas. However, development above landfills is a challenging task due to large voids, the presence of organic matter, heterogeneous nature of waste and ambiguity surrounding landfill settlement prediction. Prior to construction of infrastructure above landfills, ground improvement techniques are being employed to improve the geotechnical properties of landfill material. Although the ground improvement techniques have little impact on long term biodegradation and creep related landfill settlement, they have shown some notable short term success with a variety of techniques, including methods for verifying the level of effectiveness of ground improvement techniques. This paper provides geotechnical and landfill engineers a guideline for selection of landfill ground improvement techniques and their suitability to project-specific sites. Ground improvement methods assessed and compared in this paper include concrete injected columns (CIC), dynamic compaction, rapid impact compaction (RIC), preloading, high energy impact compaction (HEIC), vibro compaction, vibro replacement, chemical stabilization and the inclusion of geosynthetics such as geocells. For each ground improvement technique a summary of the existing theory, benefits, limitations, suitable modern ground improvement monitoring methods, the applicability of ground improvement techniques for landfills and supporting case studies are provided. The authors highlight the importance of implementing cost-effective monitoring techniques to allow observation and necessary remediation of the subsidence effects associated with long term landfill settlement. These ground improvement techniques are primarily for the purpose of construction above closed landfills to cater for transport infrastructure loading.

Keywords: closed landfills, ground improvement, monitoring, settlement, transport infrastructure

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Authors: Huei-Fu Lu

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Hosting international major sports events (MSEs) has become a globalized strategy for many countries. Most modern countries believe that MSEs can bring the hosting countries with substantial and considerable economic and non-economic benefits; so many cities also input a huge of resources to bid for hosting MSEs. Despite the growing importance of MSEs, limited longitudinal analysis has been carried out to understand and explain the long term economic effects of such events. This paper is to continue the focus of previous literature on the economic effects of hosting MSEs. The study periods are from 1950 to 2014 and the secondary macro-economic data are selected from the countries that have hosted the Asian Games and the Olympic Games (including summer and winter) to precede a longitudinal analysis. A comparison of the real economic growth rate, investment, employment and international trade of hosting countries and the duration of these economic effects are also explored and discussed. Based on the countries’ attributes and locating area, aiming to ascertain whether hosting MSEs is economically worthwhile and whether the economic effects from MSEs are realized as anticipated. The results indicate that hosting MSEs to create positive economic effects like GDP growth or long-term employment may be a myth even for developing countries. However, the empirical findings can provide the sport management or authority with longitudinal and comprehensive elaboration for biding or hosting MSEs in the future.

Keywords: Asian Games, economic effects, major sports events (MSEs), olympic games

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Authors: Ezzati Givi M., Ezzatigivi N., Eimani H.

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Trigeminal Neuralgia (TN) consists of painful attacks often triggered with general activities, which cause impairment and disability. The first line of treatment consists of pharmacotherapy. However, the occurrence of many side-effects limits its application. Acute pain relief is crucial for titrating oral drugs and making time for neurosurgical intervention. This study aimed to examine the long-term anesthetic effect of QX-314 and capsaicin in trigeminal neuralgia using an animal model. TN was stimulated by surgical constriction of the infraorbital nerve in rats. After seven days, anesthesia infiltration was done, and the duration of mechanical allodynia was compared. Thirty-five male Wistar rats were randomly divided into seven groups as follows: control (normal saline); lidocaine (2%); QX314 (30 mM); lidocaine (2%)+QX314 (15 mM); lidocaine (2%)+QX314 (22 mM); lidocaine (2%)+QX314 (30 mM); and lidocaine (2%)+QX314 (30 mM) +capsaicin (1μg). QX314 in combination with lidocaine significantly increased the duration of anesthesia, which was dose-dependent. The combination of lidocaine+QX314+capsaicin could significantly increase the duration of anesthesia in trigeminal neuralgia. In the present study, we demonstrated that the combination of QX-314 with lidocaine and capsaicin produced a long-lasting, reversible local anesthesia and was superior to lidocaine alone in the fields of the duration of trigeminal neuropathic pain blockage.

Keywords: trigeminal neuralgia, capsaicin, lidocaine, long-lasting

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Razia Sultana, Md. Faroque Miah

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Mental health remains a significant global public health challenge, profoundly affecting millions worldwide. In Bangladesh, the situation is dire, with the National Mental Health Survey 2018-19 indicating that 19% of adults suffer from any kind of mental disorders, including severe mental disorder of around 2%. Despite these high prevalence rates, there is a substantial treatment gap in low- and middle-income countries, including Bangladesh, where up to 92% of individuals with mental illnesses do not receive adequate care. This gap is exacerbated by social barriers such as stigma, discrimination, social exclusion, poverty, homelessness, and human rights violations. To address these challenges, the SAJIDA Foundation launched the Proshanti in November 2022. Proshanti is a community based supportive housing intervention designed to provide cost-effective, sustainable, long-term care for individuals with chronic mental illnesses. It aims to rehabilitate participants by improving their mental health, quality of life, and equipping them with skills necessary for independent living and social mobility. Currently, Proshanti operates seven houses in Manikganj and Habiganj districts of Bangladesh, accommodating up to 40 individuals. Over a two-year period, individuals have received personalized support from trained personal assistants and care coordinators, regular health checkups, and opportunities for vocational training and community engagement. In this presentation, we will present the outcome of such intervention on individual’s functionality, quality of life and psychological health generated from 24 months of journey. Additionally, a qualitative approach will be employed to understand the facilitators and barriers of program implementation. The Proshanti program represents a promising model for addressing the significant mental health treatment gap in Bangladesh at the community level. Our findings will provide crucial insights into the program's feasibility, effectiveness, and the factors influencing its implementation, potentially guiding future mental health interventions in similar contexts.

Keywords: mental health, community based supportive housing, treatment gap, bangladesh

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Authors: Renjith George, Preethy Mary Donald

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Use of internet sources to retrieve health care related information among health care professionals has increased tremendously as the accessibility to internet is made easier through smart phones and tablets. Though there are huge data available at a finger touch, it is doubtful whether all the sources providing health care information adhere to evidence based practice. The objective of this survey was to study the prevalence of use of internet sources to get health care information, to assess the mind-set towards the authenticity of health care information available via internet sources and to study the awareness about evidence based practice in health care among medical and dental students in Melaka-Manipal Medical College. The survey was proposed as there is limited number of studies reported in the literature and this is the first of its kind in Malaysia. A cross sectional survey was conducted among the medical and dental students of Melaka-Manipal Medical College. A total of 521 students including medical and dental students in their clinical years of undergraduate study participated in the survey. A questionnaire consisting of 14 questions were constructed based on data available from the published literature and focused group discussion and was pre-tested for validation. Data analysis was done using SPSS. The statistical analysis of the results of the survey proved that the use of internet resources for health care information are equally preferred over the conventional resources among health care students. Though majority of the participants verify the authenticity of information from internet sources, there was considerable percentage of candidates who feels that all the information from the internet can be utilised for clinical decision making or were not aware about the need of verification of authenticity of such information. 63.7 % of the participants rely on evidence based practice in health care for clinical decision making while 34.2 % were not aware about it. A minority of 2.1% did not agree with the concept of evidence based practice. The observations of the survey reveals the increasing use of internet resources for health care information among health care students. The results warrants the need to move towards evidence based practice in health care as all health care information available online may not be reliable. The health care person should be judicious while utilising the information from such resources for clinical decision making.

Keywords: authenticity, evidence based practice, health care information, internet

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Authors: Musa D. Aliyu, Ouahid Harireche, Colin D. Hills

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The incapability of supercritical C02 to transport and dissolve mineral species from the geothermal reservoir to the fracture apertures and other important parameters in heat mining makes it an attractive substance for Heat extraction from hot dry rock. In other words, the thermodynamic efficiency of hot dry rock (HDR) reservoirs also increases if supercritical C02 is circulated at excess temperatures of 3740C without the drawbacks connected with silica dissolution. Studies have shown that circulation of supercritical C02 in homogenous geothermal reservoirs is quite encouraging; in comparison to that of the water. This paper aims at investigating the aforementioned processes in the case of the heterogeneous geothermal reservoir located at the Soultz site (France). The MultiPhysics finite element package COMSOL with an interface of coupling different processes encountered in the geothermal reservoir stimulation is used. A fully coupled numerical model is developed to study the thermal and hydraulic processes in order to predict the long-term operation of the basic reservoir parameters that give optimum energy production. The results reveal that the temperature of the SCC02 at the production outlet is higher than that of water in long-term stimulation; as the temperature is an essential ingredient in rating the energy production. It is also observed that the mass flow rate of the SCC02 is far more favourable compared to that of water.

Keywords: FEM, HDR, heterogeneous reservoir, stimulation, supercritical C02

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Authors: Nizar Ibnus

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The term 'pribumi' or indigenous people was originally coined in the colonisation era to differentiate between Dutch colonials and native Indonesian people. The term was also used to trigger nationalism among Indonesian people to liberate their country from any kind of colonialism which had seized their freedom for ages. However, after the war was over and the colonials had fled from the country, the usage began to be altered. It changed from nationalist propaganda term to somewhat racist term. Immigrants and half-blooded people were massively victimized. Then, in 1998 the government forbade the use of this term for public use. Apparently, this racial issue happens again. On 16th October 2017, Anies Baswedan as the new government of DKI Jakarta province mentioned this term in his inauguration speech. This indeed raises controversy among Indonesian people. Using critical discourse analysis, this paper examines how Indonesian media portray the figure of Anies Baswedan regarding the issue. The findings reveal that Indonesian media depict Anies Baswedan differently. Some view him guilty as he mentioned the controversial and forbidden term in public. While, the other media consider him as innocent as he used the term in different contexts. This various media point of view and framing is presumably emerged from their different ideologies.

Keywords: critical discourse analysis, media framing, racism, pribumi

Procedia PDF Downloads 189

Authors: Zhihui Liu, Dongmei Hao, Qian Qiu, Yang An, Lin Yang, Song Zhang, Yimin Yang, Xuwen Li, Dingchang Zheng

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Premature birth, defined as birth before 37 completed weeks of gestation is a leading cause of neonatal morbidity and mortality and has long-term adverse consequences for health. It has recently been reported that the worldwide preterm birth rate is around 10%. The existing measurement techniques for diagnosing preterm delivery include tocodynamometer, ultrasound and fetal fibronectin. However, they are subjective, or suffer from high measurement variability and inaccurate diagnosis and prediction of preterm labor. Electrohysterography (EHG) method based on recording of uterine electrical activity by electrodes attached to maternal abdomen, is a promising method to assess uterine activity and diagnose preterm labor. The purpose of this study is to analyze the difference of EHG signal features between term labor and preterm labor. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Among them, EHG signals from 38 term labor and 38 preterm labor were preprocessed with band-pass Butterworth filters of 0.08–4Hz. Then, EHG signal features were extracted, which comprised classical time domain description including root mean square and zero-crossing number, spectral parameters including peak frequency, mean frequency and median frequency, wavelet packet coefficients, autoregression (AR) model coefficients, and nonlinear measures including maximal Lyapunov exponent, sample entropy and correlation dimension. Their statistical significance for recognition of two groups of recordings was provided. The results showed that mean frequency of preterm labor was significantly smaller than term labor (p < 0.05). 5 coefficients of AR model showed significant difference between term labor and preterm labor. The maximal Lyapunov exponent of early preterm (time of recording < the 26th week of gestation) was significantly smaller than early term. The sample entropy of late preterm (time of recording > the 26th week of gestation) was significantly smaller than late term. There was no significant difference for other features between the term labor and preterm labor groups. Any future work regarding classification should therefore focus on using multiple techniques, with the mean frequency, AR coefficients, maximal Lyapunov exponent and the sample entropy being among the prime candidates. Even if these methods are not yet useful for clinical practice, they do bring the most promising indicators for the preterm labor.

Keywords: electrohysterogram, feature, preterm labor, term labor

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Authors: Seyed Kian Haji Seyed Javadi, Aisan Nouri

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Patient satisfaction in dental care is shaped by experiences throughout the treatment journey. Challenges such as fear, lack of trust and poor communication can impact patient contentment and willingness to seek dental care. This narrative review explores these issues and presents innovative solutions to address them by searching PubMed and Scopus data sources. It examines factors affecting patient satisfaction and adherence across three phases—before, during and after treatment—emphasizing the roles of effective communication, payment and follow-up systems, appointment scheduling, welcoming reception and the treatment environment. The factors discussed in this study motivate patients to return for routine check-ups and preventive care, even if their initial visit was for an emergency.

Keywords: patient satisfaction, dentistry, dental access, dental care services

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Authors: Qiao Qiao

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With the development of The Times, the elderly demand for pension service facilities is increasing. Taking 26 street towns in Jiangjin District of Chongqing as examples, ArcGIS spatial analysis method was used to analyze the distribution status of the elderly population, the core density of the elderly population, and the spatial layout characteristics of institutional elderly care facilities in Jiangjin District of Chongqing. The results showed that there were differences in the structure and aging degree of the elderly population in each street town. There is a certain imbalance between the spatial distribution of the elderly population and the planning and construction of elderly care facilities. The accessibility of elderly care facilities is uneven. Therefore, a genetic algorithm is used to optimize the spatial layout of institutional elderly care facilities, improve the accessibility of facilities, strengthen the participation of multiple subjects, and provide a reference for the future construction planning of elderly care facilities.

Keywords: institutional pension facilities, spatial layout, accessibility, ArcGIS

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Authors: Vishnu Pratap Singh Kirar

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Artificial Neural Network (ANN) can be trained using backpropagation (BP). It is the most widely used algorithm for supervised learning with multi-layered feed-forward networks. Efficient learning by the BP algorithm is required for many practical applications. The BP algorithm calculates the weight changes of artificial neural networks, and a common approach is to use a two-term algorithm consisting of a learning rate (LR) and a momentum factor (MF). The major drawbacks of the two-term BP learning algorithm are the problems of local minima and slow convergence speeds, which limit the scope for real-time applications. Recently the addition of an extra term, called a proportional factor (PF), to the two-term BP algorithm was proposed. The third increases the speed of the BP algorithm. However, the PF term also reduces the convergence of the BP algorithm, and criteria for evaluating convergence are required to facilitate the application of the three terms BP algorithm. Although these two seem to be closely related, as described later, we summarize various improvements to overcome the drawbacks. Here we compare the different methods of convergence of the new three-term BP algorithm.

Keywords: neural network, backpropagation, local minima, fast convergence rate

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Xin Zhao

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3D printing is used in creating bone grafts of various architectures by printing materials in a layer-by-layer manner. Traditionally, to make materials printable, heating up or dissolving materials in organic solvents have been used, compromising their capability in loading biomolecules. Photocrosslinkable materials which are initially liquid and printable, and solidified upon light exposure are therefore developed. However, the existing photocrosslinkable materials are either too soft to bear load or non-degradable with potential long-term biocompatibility problems. Here, photocrosslinkable nanocomposite ink is developed composed of poly (lactide-co-propylene glycol-co-lactide) dimethacrylate (PmLnDMA) and hydroxyethyl methacrylate-functionalized hydroxyapatite nanoparticles (nHAMA) mimicking the hairy setae of gecko that can strongly interact with its surroundings to bear high load. Incorporation of nHAMA into PmLnDMA endows the nanocomposite ink with several advantages in (1) improved organic/inorganic interfacial compatibility to increase mechanical strength, (2) readily modulated rheological behaviors, wettability, and biodegradation, (3) enhanced osteoconductivity and osteoinductivity. Moreover, the ink can be rapidly crosslinked upon light exposure, load, and long-term release growth factors, and be printed into 3D bone scaffolds of various shapes and structures according to the patients’ needs. Altogether, this innovation will benefit patients all over the world who suffer from bone fractures, tumors, infections.

Keywords: photocrosslinkable nanocomposite, 3D printing, bone ink, personalized medicine

Procedia PDF Downloads 115

Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: community-based participatory research, elderly, heath care, Thailand.

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Authors: Wesahl Domingo, Prinslean Mahery

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Our paper focuses on the rights’ to contact and care of fathers in the heterosexual context, despite the reality of same sex parenting in South Africa. We argue that despite the new South African Children’s Act framework creating a shift from the idea of parental power over a child to the notion that parents have parental responsibilities and rights in respect of a child. This shift has however not fundamentally changed the constant battle that parents and other interested parties have over children. In most cases it is fathers who must battle to either maintain contact with their child/ren or fight to have care (which includes custody) of their child/ren. This is the case whether or not the father was married to the mother of the child in question. In part one of the paper, we deal with the historical development of rights to care and contact and describe the current system in the context of case law and legislation in South Africa. Part two provides a critical analysis of a few anthologies of “what fathers are complaining about.” In conclusion, in part three, we outline the way forward –“moving beyond the adversarial approach” through the “care of ethics approach.” So what is the care perspective? The care perspective is a relational ethic which views the primary moral concern as of creating and sustaining responsive connection to others. We apply the care of ethics approach to parenting plans and family law mediation in the context of fathers’ rights to care and contact. We argue by avoiding the adversarial system and engaging in a problem solving process focused on finding solutions for the future, divorcing parents can turn their attention to their children rather than battling each other.

Keywords: fathers' right to care, contact, custody, family law

Procedia PDF Downloads 475