Search results for: long term care facility
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11089

Search results for: long term care facility

10519 Comparison of Various Landfill Ground Improvement Techniques for Redevelopment of Closed Landfills to Cater Transport Infrastructure

Authors: Michael D. Vinod, Hadi Khabbaz

Abstract:

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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10518 Using Statistical Significance and Prediction to Test Long/Short Term Public Services and Patients' Cohorts: A Case Study in Scotland

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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10517 Possibility Theory Based Multi-Attribute Decision-Making: Application in Facility Location-Selection Problem under Uncertain and Extreme Environment

Authors: Bezhan Ghvaberidze

Abstract:

A fuzzy multi-objective facility location-selection problem (FLSP) under uncertain and extreme environments based on possibility theory is developed. The model’s uncertain parameters in the q-rung orthopair fuzzy values are presented and transformed in the Dempster-Shaper’s belief structure environment. An objective function – distribution centers’ selection ranking index as an extension of Dempster’s extremal expectations under discrimination q-rung orthopair fuzzy information is constructed. Experts evaluate each humanitarian aid from distribution centers (HADC) against each of the uncertain factors. HADCs location problem is reduced to the bicriteria problem of partitioning the set of customers by the set of centers: (1) – Minimization of transportation costs; (2) – Maximization of centers’ selection ranking indexes. Partitioning type constraints are also constructed. For an illustration of the obtained results, a numerical example is created from the facility location-selection problem.

Keywords: FLSP, multi-objective combinatorial optimization problem, evidence theory, HADC, q-rung orthopair fuzzy set, possibility theory

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10516 Extension of a Competitive Location Model Considering a Given Number of Servers and Proposing a Heuristic for Solving

Authors: Mehdi Seifbarghy, Zahra Nasiri

Abstract:

Competitive location problem deals with locating new facilities to provide a service (or goods) to the customers of a given geographical area where other facilities (competitors) offering the same service are already present. The new facilities will have to compete with the existing facilities for capturing the market share. This paper proposes a new model to maximize the market share in which customers choose the facilities based on traveling time, waiting time and attractiveness. The attractiveness of a facility is considered as a parameter in the model. A heuristic is proposed to solve the problem.

Keywords: competitive location, market share, facility attractiveness, heuristic

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10515 A Comparative Study on Supercritical C02 and Water as Working Fluids in a Heterogeneous Geothermal Reservoir

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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10514 Cost-Effectiveness of a Certified Service or Hearing Dog Compared to a Regular Companion Dog

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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10513 Single-Case Experimental Design: Exploratory Pilot Study on the Feasibility and Effect of Virtual Reality for Pain and Anxiety Management During Care

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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10512 Comprehensive Analysis of Electrohysterography Signal Features in Term and Preterm Labor

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

Abstract:

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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10511 The Representation of Anies Baswedan about the Issue of the Word 'Pribumi' in His DKI Jakarta Governor Inauguration Speech in Indonesian Media

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

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10510 Residential and Care Model for Elderly People Based on “Internet Plus”

Authors: Haoyi Sheng

Abstract:

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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10509 Battling against the Great Disruption to Surgical Care in a Pandemic: Experience of Eleven South and Southeast Asian Countries

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

Abstract:

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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10508 Exploring Content of Home-Based Care Education After Caesarean Section Provided by Nurse Midwives in Maternity Units

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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10507 Feasibility and Impact of the Community Based Supportive Housing Intervention for Individuals with Chronic Mental Illness in Bangladesh

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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10506 Photocrosslinkable Nanocomposite Ink for Printing of Strong, Biodegradable and Bioactive Bone Graft

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

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10505 Improving the Performance of Back-Propagation Training Algorithm by Using ANN

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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10504 Antenatal Monitoring of Pre-Eclampsia in a Low Resource Setting

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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10503 Correlation between Speech Emotion Recognition Deep Learning Models and Noises

Authors: Leah Lee

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This paper examines the correlation between deep learning models and emotions with noises to see whether or not noises mask emotions. The deep learning models used are plain convolutional neural networks (CNN), auto-encoder, long short-term memory (LSTM), and Visual Geometry Group-16 (VGG-16). Emotion datasets used are Ryerson Audio-Visual Database of Emotional Speech and Song (RAVDESS), Crowd-sourced Emotional Multimodal Actors Dataset (CREMA-D), Toronto Emotional Speech Set (TESS), and Surrey Audio-Visual Expressed Emotion (SAVEE). To make it four times bigger, audio set files, stretch, and pitch augmentations are utilized. From the augmented datasets, five different features are extracted for inputs of the models. There are eight different emotions to be classified. Noise variations are white noise, dog barking, and cough sounds. The variation in the signal-to-noise ratio (SNR) is 0, 20, and 40. In summation, per a deep learning model, nine different sets with noise and SNR variations and just augmented audio files without any noises will be used in the experiment. To compare the results of the deep learning models, the accuracy and receiver operating characteristic (ROC) are checked.

Keywords: auto-encoder, convolutional neural networks, long short-term memory, speech emotion recognition, visual geometry group-16

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10502 Awareness about Authenticity of Health Care Information from Internet Sources among Health Care Students in Malaysia: A Teaching Hospital Study

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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10501 Bridging the Gap through New Media Technology Acceptance: Exploring Chinese Family Business Culture

Authors: Farzana Sharmin, Mohammad Tipu Sultan

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Emerging new media technology such as social media and social networking sites have changed the family business dynamics in Eastern Asia. The family business trends in China has been developed at an exponential rate towards technology. In the last two decades, many of this family business has succeeded in becoming major players in the Chinese and world economy. But there are a very few availabilities of literature on Chinese context regarding social media acceptance in terms of the family business. Therefore, this study has tried to cover the gap between culture and new media technology to understand the attitude of Chinese young entrepreneurs’ towards the family business. This paper focused on two cultural dimensions (collectivism, long-term orientation), which are adopted from Greet Hofstede’s. Additionally perceived usefulness and ease of use adopted from the Technology Acceptance Model (TAM) to explore the actual behavior of technology acceptance for the family business. A quantitative survey method (n=275) used to collect data Chinese family business owners' in Shanghai. The inferential statistical analysis was applied to extract trait factors, and verification of the model, respectively. The research results found that using social media for family business promotion has highly influenced by cultural values (collectivism and long-term orientation). The theoretical contribution of this research may also assist policymakers and practitioners of other developing countries to advertise and promote the family business through social media.

Keywords: China, cultural dimensions, family business, technology acceptance model, TAM

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10500 Predictors of Behavior Modification Prior to Bariatric Surgery

Authors: Rosemarie Basile, Maria Loizos, John Pallarino, Karen Gibbs

Abstract:

Given that complications can be significant following bariatric surgery and with rates of long-term success measured in excess weight loss varying as low as 33% after five years, an understanding of the psychological factors that may mitigate findings and increase success and result in better screening and supports prior to surgery are critical. An internally oriented locus of control (LOC) has been identified as a predictor for success in obesity therapy, but has not been investigated within the context of bariatric surgery. It is hypothesized that making behavioral changes prior to surgery which mirror those that are required post-surgery may ultimately predict long-term success. 122 subjects participated in a clinical interview and completed self-report measures including the Multidimensional Health Locus of Control Scale, Overeating Questionnaire (OQ), and Lifestyle Questionnaire (LQ). Pearson correlations were computed between locus of control orientation and likelihood to make behavior changes prior to surgery. Pearson correlations revealed a positive correlation between locus of control and likelihood to make behavior changes r = 0.23, p < .05. As hypothesized, there was a significant correlation between internal locus of control and likelihood to make behavior changes. Participants with a higher LOC believe that they are able to make decisions about their own health. Future research will focus on whether this positive correlation is a predictor for future bariatric surgery success.

Keywords: bariatric surgery, behavior modification, health locus of control, overeating questionnaire

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10499 Modeling of CREB Pathway Induced Gene Induction: From Stimulation to Repression

Authors: K. Julia Rose Mary, Victor Arokia Doss

Abstract:

Electrical and chemical stimulations up-regulate phosphorylaion of CREB, a transcriptional factor that induces its target gene production for memory consolidation and Late Long-Term Potentiation (L-LTP) in CA1 region of the hippocampus. L-LTP requires complex interactions among second-messenger signaling cascade molecules such as cAMP, CAMKII, CAMKIV, MAPK, RSK, PKA, all of which converge to phosphorylate CREB which along with CBP induces the transcription of target genes involved in memory consolidation. A differential equation based model for L-LTP representing stimulus-mediated activation of downstream mediators which confirms the steep, supralinear stimulus-response effects of activation and inhibition was used. The same was extended to accommodate the inhibitory effect of the Inducible cAMP Early Repressor (ICER). ICER is the natural inducible CREB antagonist represses CRE-Mediated gene transcription involved in long-term plasticity for learning and memory. After verifying the sensitivity and robustness of the model, we had simulated it with various empirical levels of repressor concentration to analyse their effect on the gene induction. The model appears to predict the regulatory dynamics of repression on the L-LTP and agrees with the experimental values. The flux data obtained in the simulations demonstrate various aspects of equilibrium between the gene induction and repression.

Keywords: CREB, L-LTP, mathematical modeling, simulation

Procedia PDF Downloads 286
10498 Web Data Scraping Technology Using Term Frequency Inverse Document Frequency to Enhance the Big Data Quality on Sentiment Analysis

Authors: Sangita Pokhrel, Nalinda Somasiri, Rebecca Jeyavadhanam, Swathi Ganesan

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Tourism is a booming industry with huge future potential for global wealth and employment. There are countless data generated over social media sites every day, creating numerous opportunities to bring more insights to decision-makers. The integration of Big Data Technology into the tourism industry will allow companies to conclude where their customers have been and what they like. This information can then be used by businesses, such as those in charge of managing visitor centers or hotels, etc., and the tourist can get a clear idea of places before visiting. The technical perspective of natural language is processed by analysing the sentiment features of online reviews from tourists, and we then supply an enhanced long short-term memory (LSTM) framework for sentiment feature extraction of travel reviews. We have constructed a web review database using a crawler and web scraping technique for experimental validation to evaluate the effectiveness of our methodology. The text form of sentences was first classified through Vader and Roberta model to get the polarity of the reviews. In this paper, we have conducted study methods for feature extraction, such as Count Vectorization and TFIDF Vectorization, and implemented Convolutional Neural Network (CNN) classifier algorithm for the sentiment analysis to decide the tourist’s attitude towards the destinations is positive, negative, or simply neutral based on the review text that they posted online. The results demonstrated that from the CNN algorithm, after pre-processing and cleaning the dataset, we received an accuracy of 96.12% for the positive and negative sentiment analysis.

Keywords: counter vectorization, convolutional neural network, crawler, data technology, long short-term memory, web scraping, sentiment analysis

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10497 Quantification of Leachate Potential of the Quezon City Controlled Dumping Facility Using Help Model

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

Abstract:

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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10496 Impact of Emergency Medicine Department Crowding on Mortality

Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri

Abstract:

Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.

Keywords: mortality, emergency, department, crowding

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10495 Fabrication of a Potential Point-of-Care Device for Hemoglobin A1c: A Lateral Flow Immunosensor

Authors: Shu Hwang Ang, Choo Yee Yu, Geik Yong Ang, Yean Yean Chan, Yatimah Binti Alias, And Sook Mei Khor

Abstract:

With the high prevalence of Type 2 diabetes mellitus across the world, the morbidities and mortalities associated with Type 2 diabetes have significant impact on the production line for a nation. With routine scheduled clinical visits to manage Type 2 diabetes, diabetic patients with hectic lifestyles can have low clinical compliance. Hence, it often decreases the effectiveness of diabetic management personalized for each diabetic patient. Here, we report a useful developed point-of-care (POC) device that detect glycated hemoglobin (HbA1c, biomarker for long-term Type 2 diabetic management). In fact, the established POC devices certified to be used in clinical setting are not only expensive ($ 8 to $10 per test), they also require skillful practitioners to perform sampling and interpretation. As a paper-based biosensor, the developed HbA1c biosensor utilized lateral flow principle to offer an alternative for cost-effective (approximately $2 per test) and end-user friendly device for household testing. Requiring as little as 2 L of finger-picked blood, the test can be performed at the household with just simple dilution and washings. With visual interpretation of numbers of test lines shown on the developed biosensor, it can be interpreted as easy as a urine pregnancy test, aided with scale of intensity provided. In summary, the developed HbA1c immunosensor has been tested to have high selectivity towards HbA1c, and is stable with reasonably good performance in clinical testing. Therefore, our developed HbA1c immunosensor has high potential to be an effective diabetic management tool to increase patient compliance and thus contain the progression of the diabetes.

Keywords: blood, glycated hemoglobin (HbA1c), lateral flow, type 2 diabetes mellitus

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10494 Community‐Based Participatory Research in Elderly Health Care of Paisanee Ramintra 65 Community, Bangkok, Thailand

Authors: A. Kulprasutidilok

Abstract:

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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10493 Fathers’ Rights to Contact and Care: Moving Beyond the Adversarial Approach

Authors: Wesahl Domingo, Prinslean Mahery

Abstract:

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

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10492 Nutrient Foramina in the Shaft of Long Bones of Upper Limb

Authors: Madala Venkateswara Rao

Abstract:

The major blood supply to the long bones occurs through the nutrient arteries, which enters through the nutrient foramina. This is the study of nutrient Foramina in the shaft of upper limb long bones taken from the department of Anatomy at Narayana medical college nellore. Nutrient foramina play an important role in nutrition and growth of the bones. Most of the nutrient arteries follow the rule, 'to the elbow I go, from the knee I flee' but they are very variable in position. Their number, location, direction & its importance in the growing end of long bones were studied in the long bones of upper limb. The present study has variations in the position & direction of long bones especially in the radius & ulna, as most of the nutrient foramina are found in anterior surface of upper 1/3rd and middle 1/3rd of these bones. The study of nutrient foramina is not only of academic interest but also in medico-legal practice in relation to their position. Careful observation has also been made on the position of nutrient foramina in relation to upper end of long bones. This study also gives importance of length long bones to know the height of an individual. With the knowledge of variations in the nutrient foramen, placement of internal fixation devices can be appropriately done.

Keywords: nutrient artery, nutrient foramina, shaft of long bones, upper limb bones

Procedia PDF Downloads 492
10491 A Leaf-Patchable Reflectance Meter for in situ Continuous Monitoring of Chlorophyll Content

Authors: Kaiyi Zhang, Wenlong Li, Haicheng Li, Yifei Luo, Zheng Li, Xiaoshi Wang, Xiaodong Chen

Abstract:

Plant wearable sensors facilitate the real-time monitoring of plant physiological status. In situ monitoring of the plant chlorophyll content over days could provide valuable information on the photosynthetic capacity, nitrogen content, and general plant health. However, it cannot be achieved by current chlorophyll measuring methods. Here, a miniaturized and plant-wearable chlorophyll meter was developed for rapid, non-destructive, in situ, and long-term chlorophyll monitoring. This reflectance-based chlorophyll sensor with 1.5 mm thickness and 0.2 g weight (1000 times lighter than the commercial chlorophyll meter), includes a light emitting diode (LED) and two symmetric photodetectors (PDs) on a flexible substrate and is patched onto the leaf upper epidermis with a conformal light guiding layer. A chlorophyll content index (CCI) calculated based on this sensor shows a better linear relationship with the leaf chlorophyll content (r² > 0.9) than the traditional chlorophyll meter. This meter can wirelessly communicate with a smartphone to monitor the leaf chlorophyll change under various stresses and indicate the unhealthy status of plants for long-term application of plants under various stresses earlier than chlorophyll meter and naked-eye observation. This wearable chlorophyll sensing patch is promising in smart and precision agriculture.

Keywords: plant wearable sensors, reflectance-based measurements, chlorophyll content monitoring, smart agriculture

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10490 Pricing and Economic Benefits of Commercial Insurance Incorporated into Home-based Hospice Care

Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

Procedia PDF Downloads 206