Search results for: psychosocial assessment and intervention

Authors: Nayera E. Hassan, Salah Mostafa, Hamed Elkhayat, Kalled Hassan Sewidan, Sahar A. El-Masry, Manal Mouhamed Ali, Mones M. Abu Shady

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Pubertal growth is influenced by many factors including environmental and nutritional factors. Objective: To assess impact of nutritional status on pubertal staging, ovarian and uterine volumes among school girls. Method: Study was cross sectional and carried out on 1000 healthy school girls, aged 8-18 years selected randomly. They were categorized according to their ages into three groups: 8-12 years, 13-15 years and 16-18 years ±6 months, then according to their body mass index percentile to normal weight: (≥15-<85.), overweight (≥85-<95) and obese (≥95). All girls were subjected for physical, anthropometric (weight, height, body mass index), nutritional markers WAZ (weight/age Z score), HAZ (height/age Z score) and BMI-Z (body mass index Z score), pubertal assessment (Tanner stage) and pelvic transabdominal sonography (uterine and ovarian volumes). Results: Highly significant differences in ovarian and uterine volumes and nutritional markers (WAZ, HAZ and BMI-Z score) were detected among different grades of puberty in the two age groups (8-12 years, 13-15 years) coming in advance of obese girls (with increase of BMI); except HAZ in the second age group. Girls aged 16-18 years reached to final volume for the uterus and ovary with insignificant differences. Pubertal stage, ovarian and uterine sizes were highly significantly correlated with nutritional markers. Mean ages of onset: of puberty, menarche and complete puberty were, 11.65 + 1.84, 14.79 + 1.75 and 15.02 + 1.68 years respectively. Conclusion: Nutritional status has a crucial role in determining pubertal stage, ovarian and uterine volumes among Egyptian girls during the pubertal process.

Keywords: pubertal stage, nutritional markers, girls, ovarian and uterine volumes

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Authors: Felix Oromena Egara, Moeketsi Mosia

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The study aimed to evaluate the impact of blended learning on mathematics retention among secondary school students. Conducted in the Isoko North Local Government Area of Delta State, Nigeria, the research involved 1,235 senior class one (SS 1) students. Employing a non-equivalent control group pre-test-post-test quasi-experimental design, a sample of 70 students was selected from two secondary schools with ICT facilities through purposive sampling. Random allocation of students into experimental and control groups was achieved through balloting within each selected school. The investigation included three assessment points: pre-Mathematics Achievement Test (MAT), post-MAT, and post-post-MAT (retention), administered systematically by the researchers. Data collection utilized the established MAT instrument, which demonstrated a high reliability score of 0.86. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 28, with mean and standard deviation addressing study questions and analysis of covariance scrutinizing hypotheses at a significance level of .05. Results revealed significantly greater improvements in mathematics retention scores among students exposed to blended learning compared to those instructed through conventional methods. Moreover, noticeable differences in mean retention scores were observed, with male students in the blended learning group exhibiting notably higher performance. Based on these findings, recommendations were made, advocating for mathematics educators to integrate blended learning, particularly in geometry teaching, to enhance students’ retention of mathematical concepts.

Keywords: blended learning, flipped classroom model, secondary school students, station rotation model

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

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Authors: Barbara Roosen, Oswald Devisch

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Spatial projects are often contested. Despite participatory trajectories in official spatial development processes, citizens engage often by their power to say no. Participatory mapping helps to produce more legible and democratic ways of decision-making. It has proven its value in producing a multitude of knowledges and views, for individuals and community groups and local stakeholders to imagine desired and undesired futures and to give them the rhetorical power to present their views throughout the development process. From this perspective, mapping works as a social process in which individuals and groups share their knowledge, learn from each other and negotiate their relationship with each other as well as with space and power. In this way, these processes eventually aim to activate communities to intervene in cooperation in real problems. However, these are fragile and bumpy processes, sometimes leading to (local) conflict and intractable situations. Heterogeneous subjectivities and knowledge that become visible during the mapping process and which are contested by members of the community, is often the first trigger. This paper discusses a participatory mapping project conducted in a residential subdivision in Flanders to provide a deeper understanding of how or under which conditions the mapping process could moderate discordant situations amongst inhabitants, local organisations and local authorities, towards a more constructive outcome. In our opinion, this implies a thorough documentation and presentation of the different steps of the mapping process to design and moderate an open and transparent dialogue. The mapping project ‘Make the Neighbourhood’, is set up in the aftermath of a socio-spatial design intervention in the neighbourhood that led to polarization within the community. To start negotiation between the diverse claims that came to the fore, we co-create a desired future map of the neighbourhood together with local organisations and inhabitants as a way to engage them in the development of a new spatial development plan for the area. This mapping initiative set up a new ‘common’ goal or concern, as a first step to bridge the gap that we experienced between different sociocultural groups, bottom-up and top-down initiatives and between professionals and non-professionals. An atlas of elements (materials), an atlas of actors with different roles and an atlas of ways of cooperation and organisation form the work and building material of the future neighbourhood map, assembled in two co-creation sessions. Firstly, we will consider how the mapping procedures articulate the plurality of claims and agendas. Secondly, we will elaborate upon how social relations and spatialities are negotiated and reproduced during the different steps of the map making. Thirdly, we will reflect on the role of the rules, format, and structure of the mapping process in moderating negotiations between much divided claims. To conclude, we will discuss the challenges of visualizing the different steps of mapping process as a strategy to moderate tense negotiations in a more constructive direction in the context of spatial development processes.

Keywords: conflict, documentation, participatory mapping, residential subdivision

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Authors: Kuo-Wei Hsu, Jen-Chih, Chao, Pei-Chen, Wu

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With the rapid development of global economy, the increasing population, the highly industrialization, greenhouse gas emission and the ozone layer damage, the Global Warming happens. Facing the impact of global warming, the issue of “green transportation” began to be valued and promoted in each city. Taichung has been elected as the model of low-carbon city in Taiwan. To comply with international trends and the government policy, we tried to promote the energy saving and carbon reduction to create a “low-carbon Taichung with green life and eco-friendly economy”. To cooperate with the “green transportation” project, Taichung has promoted a number of public transports constructions and traffic policy in recent years like BRT, MRT, etc. The elevated railway is one of those important constructions. Cooperating with the green transport policy, elevated railway could help to achieve the carbon reduction for this low-carbon city. The current studies of the carbon emissions associated with railways and roads are focusing on the assessment on paving material, institutional policy and economic benefit. Except for changing the mode of transportation, elevated railways/roads also create space under the bridge. However, there is no research about the carbon emissions of the space underneath the elevated section up until now. This study investigated the effect of railway track elevation project in Taichung based on the carbon emissions and the factors that affect carbon emissions by research related theory and literature analysis. This study concluded that : railway track elevation increased the public transit, the bike lanes, the green areas and walking spaces. In the other hand it reduced the traffic congestions, the use of motorcycles as well as automobiles for carbon emissions.

Keywords: low-carbon city, green transportation, carbon emissions, Taichung, Taiwan

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Authors: Lucas Kurth de Azambuja, Loise Silveira da Silva, Gean Vitor Salmoria, Darlan Dallacosta, Carlos Rodrigo de Mello Roesler

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This work provides a physicochemical and thermal characterization assessment of three different hyaluronic acid (HA)-based injections used for rejuvenation skin treatments. The three products analyzed are manufactured by the same manufacturer and commercialized for application on different skin levels. According to the manufacturer, all three HA-based injections are crosslinked and have a concentration of 23 mg/mL of HA, and 0.3% of lidocaine. Samples were characterized by Fourier-transformed infrared (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and scanning electron microscope (SEM) techniques. FTIR analysis resulted in a similar spectrum when comparing the different products. DSC analysis demonstrated that the fusion points differ in each product, with a higher fusion temperature observed in specimen A, which is used for subcutaneous applications, when compared with B and C, which are used for the middle dermis and deep dermis, respectively. TGA data demonstrated a considerable mass loss at 100°C, which means that the product has more than 50% of water in its composition. TGA analysis also showed that Specimen A had a lower mass loss at 100°C when compared to Specimen C. A mass loss of around 220°C was observed on all samples, characterizing the presence of hyaluronic acid. SEM images displayed a similar structure on all samples analyzed, with a thicker layer for Specimen A when compared with B and C. This series of analyses demonstrated that, as expected, the physicochemical and thermal properties of the products differ according to their application. Furthermore, to better characterize the crosslinking degree of each product and their mechanical properties, a set of different techniques should be applied in parallel to correlate the results and, thereby, relate injection application with material properties.

Keywords: hyaluronic acid, characterization, soft-tissue fillers, injectable gels

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Authors: Kimberly Joyce A. Roguis, Mica Lorraine L. Fernando, Alan Vito B. Macadangdang, Jennina Mari C. Mijares, Maria Carinnes A. Gonzalez

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The paper showcases the vulnerability of the tourism industry especially the inevitable occurrence of natural disasters, implicating the necessity for post-disaster analysis on tourist attractions. This study discusses the aftermath of the super typhoon ‘Yolanda’ incident in the locality of Coron Island, Palawan, assessing its general effect on the community and its tourism livelihood through the analysis of responses from key role-players in the tourism industry of the area gathered through semi-structured interviews and direct observation. The local government’s instigation of recovery programs to their locality has been a pivotal factor in reviving the vitality of their tourism industry and the involvement of the community has been the determining condition that shifted the industry towards revival a year after the incidence. The study illuminates the disaster mitigation processes in the local tourism livelihood perspective, predominantly the diving industry. It did not suffer physical damage to a great extent but was affected because of the public imagery the disaster brought upon. Collaboration between the local government and the community is the highlight of the research for they maneuvered recovery revealing that cooperation between these two parties bridged the correlation of recovery to tourism development. The disaster paved way to a stance towards promoting progressive tourism outlooks, raising awareness among the public and private sectors and re-assessment of the tourism vitality in their locality. The mayhem and destruction proved to be a liberating creative process to give way to progression and was deemed to be of high significance in the over-all tourism system process despite its impediments in the case of the tourism industry in Coron, Palawan.

Keywords: disaster recovery, tourism development, diving, Palawan

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Authors: Vaikunthan Rajaratnam

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Intro: Motor imagery (MI) and mental practice (MP) can be an alternative to acquire mastery of surgical skills. One component of using this technique is the use of a mental script. The aim of this study was to design and develop a mental script for basic micro suturing training for skill acquisition using a low-fidelity rubber glove model and to describe the detailed methodology for this process. Methods: This study was based on a design and development research framework. The mental script was developed with 5 expert surgeons performing a cognitive walkthrough of the repair of a vertical opening in a rubber glove model using 8/0 nylon. This was followed by a hierarchal task analysis. A draft script was created, and face and content validity assessed with a checking-back process. The final script was validated with the recruitment of 28 participants, assessed using the Mental Imagery Questionnaire (MIQ). Results: The creation of the mental script is detailed in the full text. After assessment by the expert panel, the mental script had good face and content validity. The average overall MIQ score was 5.2 ± 1.1, demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. Conclusion: The methodological approach described in this study is based on an instructional design framework to teach surgical skills. This MP model is inexpensive and easily accessible, addressing the challenge of reduced opportunities to practice surgical skills. However, while motor skills are important, other non-technical expertise required by the surgeon is not addressed with this model. Thus, this model should act a surgical training augment, but not replace it.

Keywords: mental script, motor imagery, cognitive walkthrough, verbal protocol analysis, hierarchical task analysis

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Authors: Masoud Ghahvechi Pour

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Risk management is a systematic and regular process of identifying, analyzing and responding to risks throughout the project's life cycle in order to achieve the optimal level of elimination, reduction or control of risk. The purpose of project risk management is to increase the probability and effect of positive events and reduce the probability and effect of unpleasant events on the project. Risk management is one of the most fundamental parts of project management, so that unmanaged or untransmitted risks can be one of the primary factors of failure in a project. Effective risk management does not apply to risk regression, which is apparently the cheapest option of the activity. However, the main problem with this option is the economic sensitivity, because what is potentially profitable is by definition risky, and what does not pose a risk is economically interesting and does not bring tangible benefits. Therefore, in relation to the implemented project, effective risk management is finding a "middle ground" in its management, which includes, on the one hand, protection against risk from a negative direction by means of accurate identification and classification of risk, which leads to analysis And it becomes a comprehensive analysis. On the other hand, management using all mathematical and analytical tools should be based on checking the maximum benefits of these decisions. Detailed analysis, taking into account all aspects of the company, including stakeholder analysis, will allow us to add what will become tangible benefits for our project in the future to effective risk management. Identifying the risk of the project is based on the theory that which type of risk may affect the project, and also refers to specific parameters and estimating the probability of their occurrence in the project. These conditions can be divided into three groups: certainty, uncertainty, and risk, which in turn support three types of investment: risk preference, risk neutrality, specific risk deviation, and its measurement. The result of risk identification and project analysis is a list of events that indicate the cause and probability of an event, and a final assessment of its impact on the environment.

Keywords: risk, management, knowledge, risk management

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Authors: Mohammed Muharram

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The Blue Humanities aims to deepen our understanding of the oceans through the integration of arts and sciences, emphasizing their cultural, historical, and ecological significance. This study explores the role of visual arts within this interdisciplinary framework, focusing on the underwater sculptures of Jason deCaires Taylor as a case study. The research employs a multidisciplinary approach, combining art history, environmental science, and cultural studies to explore the significance of Taylor's underwater installations. Methodologies include analysis of the artistic elements and themes in Taylor's work, assessment of the ecological impact of the sculptures on marine environments, and examination of the cultural narratives they evoke. Key findings highlight how Taylor's sculptures serve as artificial reefs, promoting marine biodiversity while simultaneously raising awareness about ocean conservation. The artworks act as powerful symbols, merging environmental activism with artistic expression and transforming underwater spaces into immersive art galleries that challenge traditional notions of viewing art. By bridging the gap between visual arts and environmental science, this study demonstrates how Taylor's sculptures contribute to the Blue Humanities by fostering a deeper, more holistic appreciation of the marine world. The research advocates for the continued integration of artistic perspectives into marine conservation efforts, emphasizing the role of visual arts in shaping public perceptions and promoting ecological sustainability. In conclusion, this study underscores the transformative potential of visual arts within the Blue Humanities, exemplified by Jason deCaires Taylor's underwater sculptures, which inspire both aesthetic appreciation and environmental consciousness.

Keywords: blue humanities, visual art, underwater sculptures, Jason deCaires Taylor

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Authors: German Ricci

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The research aims to analyse the symbolic power of the International Monetary Fund (IMF) in its relationship with a borrowing country, drawing upon Pierre Bourdieu’s Field Theory. This theory of power, typical of constructivist structuralism, has been minor used in international relations. Thus, selecting this perspective offers a new understanding of how the IMF's power operates and is structured. The IMF makes periodic economic reviews in which the staff evaluates the Government's performance. It also offers “last instance” loans when private external credit is not accessible. This relationship generates great expectations in financial agents because the IMF’s statements indicate the capacity of the Nation-State to meet its payment obligations (or not). Therefore, it is argued that the IMF is a legitimate actor for financial agents concerned about a government facing an economic crisis both for the effects of its immediate economic contribution through loans and the promotion of adjustment programs, helpful to guarantee the payment of the external debt. This legitimacy implies a symbolic power relationship in addition to the already known economic power relationship. Obtaining the IMF's consent implies that the government partially puts its political-economic decisions into play since the monetary policy must be agreed upon with the Fund. This has consequences at the local level. First, it implies that the debtor state must establish a daily relationship with the Fund. This everyday interaction with the Fund influences how officials and policymakers internalize the meaning of political management. On the other hand, if the Government has access to the IMF's seal of approval, the State will be again in a position to re-enter the financial market and go back into debt to face external debt. This means that private creditors increase the chances of collecting the debt and, again, grant credits. Thus, it is argued that the borrowing country submits to the relationship with the IMF in search of the latter's economic and symbolic capital. Access to this symbolic capital has objective and subjective repercussions at the national level that might tend to reproduce the relevance of the financial market and legitimizes the IMF’s intervention during economic crises. The paper has Argentina as its case study, given its historical relationship with the IMF and the relevance of the current indebtedness period, which remains largely unexplored. Argentina’s economy is characterized by recurrent financial crises, and it is the country to which the Fund has lent the most in its entire history. It surpasses more than three times the second, Egypt. In addition, Argentina is currently the country that owes the most to the Fund after receiving the largest loan ever granted by the IMF in 2018, and a new agreement in 2022. While the historical strong association with the Fund culminated in the most acute economic and social crisis in the country’s contemporary history, producing an unprecedented political and institutional crisis in 2001, Argentina still recognized the IMF as the only way out during economic crises.

Keywords: IMF, fields theory, symbolic power, Argentina, Bourdieu

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Authors: Muhammad Dildar Gogi, Muhammad Arshad, Muhammad Ahsan Khan, M. Sufian, Ahmad Nawaz, Mubashir Iqbal, Muhammad Junaid Nisar, Waleed Afzal Naveed

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Larvae of silkworm (Bombyx mori) exhibit very high mortality when reared on mulberry leaves collected from mulberry orchards which get contaminated with metallic/nonmetallic compounds through either drift-deposition or chemigation. There is need to screen out such metallic compound for their toxicity at their various concentrations. The present study was carried out to assess toxicity of metals in different instars of silkworm. Aqueous solutions of nine heavy-metal based salts were prepared by dissolving 50, 100, 150, 200, 250, 300, 350 and 400 mg of each salt in one liter of water and were applied on the mulberry leaves by leaf-dip methods. The results reveal that mortality in 1st, 2nd, 3rd, 4th and 5th instar larvae caused by each heavy metal salts increased with an increase in their concentrations. The 1st instar larvae were found more susceptible to metal salts followed by 2nd, 3rd, 4th and 5th instar larvae of silkworm. Overall, Nickel chloride proved more toxic for all larval instar as it demonstrated approximately 40-99% mortality. On the basis of LC2 and larval mortality, the order of toxicity of heavy metals against all five larval instar was Nickel chloride (LC₂ = 1.9-13.9 mg/L; & 15.0±1.2-69.2±1.7% mortality) followed by Chromium nitrate (LC₂ = 3.3-14.8 mg/L; & 13.3±1.4-62.4±2.8% mortality), Cobalt nitrate (LC₂ = 4.3-30.9; &11.4±0.07-54.9±2.0% mortality), Lead acetate (LC₂ =8.8-53.3 mg/L; & 9.5±1.3-46.4±2.9% mortality), Aluminum sulfate (LC₂ = 15.5-76.6 mg/L; & 8.4±0.08-42.1±2.8% mortality), Barium sulfide (LC₂ = 20.9-105.9; & 7.7±1.1-39.2±2.5% mortality), Copper sulfate (LC2 = 28.5-12.4 mg/L; & 7.3±0.06-37.1±2.4% mortality), Manganese chloride (LC₂ = 29.9-136.9 mg/L; & 6.8±0.09-35.3±1.6% mortality) and Zinc nitrate (LC₂ = 36.3-15 mg/L; & 6.2±1.2-32.1±1.9% mortality). Zinc nitrate @ 50 and 100 mg/L, Barium sulfide @ 50 mg/L, Manganese chloride @ 50 and 100 mg/L and Copper sulfate @ 50 mg/L proved safe for 5th instar larvae as these interaction attributed no mortality. All the heavy metal salts at a concentration of 50 mg/L demonstrated less than 10% mortality.

Keywords: heavy-metals, larval-instars, lethal-concentration, mortality, silkworm

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Authors: Peter Iyobosa Asemota

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This study on solid waste management practices addressed aspects of environmental and health impacts resulting from poor management of solid waste. The study was occasioned by the observed rate and volume of illegal and indiscriminate dumping of solid waste materials especially in informal settlements. The main focus of this study was to establish the impact of waste management practices on human health and the environment. The study, therefore, presents a critical analysis of the state of solid waste management in the study area and the implications for human health and the environment. The study was carried out in Kayamandi informal settlement within Stellenbosch municipality. The sustainable management of solid waste is very important in order to minimize the environmental and public health risks associated with improper solid waste management. There is no denying the fact that the problems of waste management will become critical as time goes on because of improper and inefficient waste management practices. Towns and cities exhibit the burdens of waste management which is a characteristics feature of most African cities. The study critically assess the implementation of waste management practices by the residents of the informal settlement; identify the factors affecting management issues in the operation of solid waste management system by the municipality; identify factors militating against the implementation of waste management policies and legislation. Furthermore, a waste assessment study was carried out to assess the generation; composition of the waste stream and also determine the attitudes and behavior of the residents with regard to waste management practices. Findings from the study revealed that Kayamandi is not different from other informal settlements with regards to waste management. People are of the opinion that solid waste management is the sole responsibility of municipal authorities and as such, the government should be responsible for bearing the cost of solid waste management.

Keywords: environment, waste, waste composition, waste stream, policy, waste categories, sanitary landfill, waste collection, integrated solid waste management

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Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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Authors: Pardis Abolghasemi, Benyamin Hatamsaz

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Background: Diabetic nephropathy is a serious health problem described by specific kidney structure and functional disturbance. Renoprotective effects of the stem cells secretase have been shown in many kidney diseases. The aim is to evaluate the capability of human Wharton’s jelly mesenchymal stem cells conditioned media (hWJMSCs-CM) to alleviate DN in streptozotocin (STZ)-induced diabetes. Methods: Diabetic nephropathy was induced by injection of STZ (60 mg/kg, IP) in twenty rats. Conditioned media was extracted from hWJMSCs at third passages. At week 8, diabetic rats were divided into two groups: treated (hWJMSCs-CM, 500 μl/rat for three weeks, IP) and not treated (DN). In the 11th week, three groups (control, DN and DN+hWJMSCs-CM) were kept in metabolic cages and urine was collected for 24h. Blood pressure (BP) and heart rate (HR) were continuously recorded. The serum samples were maintained for measuring BUN, Cr and angiotensin-converting enzyme (ACE) activity. The left kidney was kept at -80°C for ACE activity assessment. The right kidney and pancreas were used for histopathologic evaluation. Result: Diabetic nephropathy was detected by microalbuminuria and increased albumin/creatinine ratio, as well as the pancreas and renal structural disturbance. Glomerular filtration rate, BP and HR increased in the DN group. The ACE activity was elevated in the serum and kidneys of the DN group. Administration of hWJMSCs-CM modulated the renal functional and structural disturbance and decreased the ACE activity. Conclusion: Conditioned media was extracted from hWJMSCs may have a Renoprotective effect in diabetic nephropathy. This may happen through regulation of ACE activity and renin-angiotensin system inhibition.

Keywords: diabetic nephropathy, mesenchymal stem cells, immunomodulation, anti-inflammation

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Authors: F. Sarkinfada, Dabo N. Tukur, Abbas A. Muaz, Adamu A. Yahuza

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Appropriate Quality Assurance (QA) of parasite-based diagnosis of malaria to justify Artemisinin-based Combination Therapy (ACT) is essential for Malaria Programmes. In Low and Middle Income Countries (LMIC), resource constrain appears to be a major challenge in implementing the conventional QA system. We designed and implemented a modified LQAS model for QA of malaria parasite (MP) microscopy and RDT in a State Specialist Hospital (SSH) and a University Health Clinic (UHC) in Kano, Nigeria. The capacities of both facilities for MP microscopy and RDT were assessed before implementing a modified LQAS over a period of 3 months. Quality indicators comprising the qualities of blood film and staining, MP positivity rates, concordance rates, error rates (in terms of false positives and false negatives), sensitivity and specificity were monitored and evaluated. Seventy one percent (71%) of the basic requirements for malaria microscopy was available in both facilities, with the absence of certifies microscopists, SOPs and Quality Assurance mechanisms. A daily average of 16 to 32 blood samples were tested with a blood film staining quality of >70% recorded in both facilities. Using microscopy, the MP positivity rates were 50.46% and 19.44% in SSH and UHS respectively, while the MP positivity rates were 45.83% and 22.78% in SSH and UHS when RDT was used. Higher concordance rates of 88.90% and 93.98% were recorded in SSH and UHC respectively using microscopy, while lower rates of 74.07% and 80.58% in SSH and UHC were recorded when RDT was used. In both facilities, error rates were higher when RDT was used than with microscopy. Sensitivity and specificity were higher when microscopy was used (95% and 84% in SSH; 94% in UHC) than when RDT was used (72% and 76% in SSH; 78% and 81% in UHC). It could be feasible to implement an integrated QA model for MP microscopy and RDT using modified LQAS in Malaria Control Programmes in Low and Middle Income Countries that might have resource constrain for parasite-base diagnosis of malaria to justify ACT treatment.

Keywords: malaria, microscopy, quality assurance, RDT

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Authors: Reham Algheshairy, Khaled Tayeb, Christopher Smith, Rebecca Gregg, Haruna Musa

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Background: Diabetes is a medical condition that refers to the pancreas’ inability to secrete sufficient insulin levels, a hormone responsible for controlling glucose levels in the body. Any surplus glucose in the blood stream is excreted through the urinary system. Insulin resistance in blood cells can also cause this condition despite the fact that the pancreas is producing the required amount of insulin A number of researchers claim that the prevalence of diabetes in Saudi Arabia has reached epidemic proportions, although one study did observe one positive in the rise in the awareness of diabetes, possibly indicative of Saudi Arabia’s improving healthcare system. While a number of factors can cause diabetes, the ever-increasing incidence of the disease in Saudi Arabia has been blamed primarily on low levels of physical activity and high levels of obesity. Objectives: The project has two aims. The first aim of the project is to investigate the regulatory effects of consumption of Nigella seeds and Ajwah dates on blood glucose levels in diabetic patients with type 2 diabetes. The second aim of the project is to investigate whether these dietary factors may have potentially beneficial effects in controlling the complications that associated with type 2 diabetes. Methods: This use a random-cross intervention trail of 75 Saudi male and female with type 2 diabetes in Al-Noor hospital in Makkah ( KSA) aged between 18 and 70 years were divided into 3 groups. Group 1 will consume 2g of Nigella Sativa seeds daily along with a modified diet for 12 weeks, group 2 will be given Ajwah dates daily with a modified diet for 12 weeks and group 3 will follow a modified diet for 12 weeks. Anthropometric measurements were taken at baseline, along with bloods for HbA1c, fasting blood sugar and at the end of 12 weeks. Results: This study found significant decrease in blood level (FBG & 2PPBG) and HbA1c in the groups with diet and Nigella seeds) compared to Ajwa date. However, there is no significant change were found in HbA1c, FBG and 2hrpp regarding Ajwa group. Conclusion: This study illustrated a significant improvement in some markers of glycaemia following 2 g of Ns and diet for 12 weeks. The dose of 2g/day of consumed Nigella seeds was found to be more effective in controlling BGL and HbA1c than control and Ajwa groups. This suggests that Nigella seeds and following a diet may have a potential effect (a role in controlling outcomes for type 2 diabetes and controlling the disease). Further research is needed on a large scale to determine the optimum dose and duration of Nigella and Ajwa in order to achieve the desired results.

Keywords: type 2 diabetes, Nigella seeds, Ajwa dates, fasting blood glucose, control

Procedia PDF Downloads 289

Authors: Mir Md Abdus Salam, Muhammad Mohsin, Pertti Pulkkinen, Paavo Pelkonen, Ari Pappinen

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Soils contaminated with metals, e.g., copper (Cu), zinc (Zn) and nickel (Ni) are one of the main global environmental problems. Zn is an important element for plant growth, but excess levels may become a threat to plant survival. Soils polluted with metals may also pose risks and hazards to human health. Afforestation based on short rotation Salix crops may be a good solution for the reduction of metals toxicity levels in the soil and in ecosystem restoration of severely polluted sites. In a greenhouse experiment, plant growth and zinc (Zn) uptake by four Salix cultivars grown in Zn contaminated soils collected from a mining area in Finland were tested to assess their suitability for phytoextraction. The sequential extraction technique and inductively coupled plasma‒mass spectrometry (ICP–MS) were used to determine the extractable metals and evaluate the fraction of metals in the soil that could be potentially available for plant uptake. The cultivars displayed resistance to heavily polluted soils throughout the whole experiment. After uptake, the total mean Zn concentrations ranged from 776 to 1823 mg kg⁻¹. The average uptake percentage of Zn across all cultivars and treatments ranged from 97 to 223%. Lime and wood ash addition showed a significant effect on plant dry biomass growth and metal uptake percentage of Zn in most of the cultivars. The results revealed that Salix cultivars have the potential to accumulate and take up significant amounts of Zn. Ecological restoration of polluted soils could be environmentally favorable in conjunction with economically profitable practices, such as forestry and bioenergy production. As such, the utilization of Salix for phytoextraction and bioenergy purposes is of considerable interest.

Keywords: lime, phytoextraction, Salix, wood ash, zinc

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Authors: Bara' Al-Mistarehi

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Documentation and assessment of conservation state of an archaeological structure is a significant procedure in any management plan. However, it has always been a challenge to apply this with a low coast and safe methodology. It is also a time-demanding procedure. Therefore, a low cost, efficient methodology for documenting the state of a structure is needed. In the scope of this research, this paper will employ digital photogrammetry and laser scanner to one of highly significant structures in Germany, The Old Castle (German: Altes Schloss). The site is well known for its unique features. However, the castle suffers from serious deterioration threats because of the environmental conditions and the absence of continuous monitoring, maintenance and repair plans. Digital photogrammetry is a generally accepted technique for the collection of 3D representations of the environment. For this reason, this image-based technique has been extensively used to produce high quality 3D models of heritage sites and historical buildings for documentation and presentation purposes. Additionally, terrestrial laser scanners are used, which directly measure 3D surface coordinates based on the run-time of reflected light pulses. These systems feature high data acquisition rates, good accuracy and high spatial data density. Despite the potential of each single approach, in this research work maximum benefit is to be expected by a combination of data from both digital cameras and terrestrial laser scanners. Within the paper, the usage, application and advantages of the technique will be investigated in terms of building high realistic 3D textured model for some parts of the old castle. The model will be used as diagnosing tool of the conservation state of the castle and monitoring mean for future changes.

Keywords: Digital photogrammetry, Terrestrial laser scanners, 3D textured model, archaeological structure

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Authors: Simon Mauma Efange

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The main aims of this research were to describe, in co-relational terms, the relationship, if any, between reading comprehension and academic achievement in science studied at the secondary level and, secondly, to find out possible trends in gender differences, such as whether boys would perform better than girls or vice versa. This research employed a quantitative design. Two kinds of instruments were employed: the Oxford Online Placement Test and the Local Assessment System Test. The Oxford Online Placement Test assesses students' English level quickly and easily. The results of these tests were subjected to statistical analysis using a special statistical software called SPSS. Statistical tools such as mean, standard deviation, percentages, frequencies, t-tests, and Pearson’s coefficient of correlation were used for the analysis of the results. Results of the t-test showed that the means are significantly different. Calculating the p-value revealed that the results were extremely statistically significant at p <.05. The value of r (Pearson correlation coefficient) was 0.2868. Although technically there is a positive correlation, the relationship between the variables is only weak (the closer the value is to zero, the weaker the relationship). However, in conclusion, calculations from the t-test using SPSS revealed that the results were statistically significant at p <.05, confirming a relationship between the two variables, and high scores in reading will give rise to slightly high scores in science. The research also revealed that having a high score in reading comprehension doesn’t necessarily mean having a high score in science or vice versa. Female subjects performed much better than male subjects in both tests, which is in line with the literature reviewed for this research.

Keywords: achievement in science, achievement in English, and bilingual students, relationship

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Authors: Aniqa Jabeen

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The aim of this study was to evaluate the effectiveness of Tc-99m MIBI (Technetium 99-methoxy-iso-butyl-isonitrile) scintigraphy to differentiate malignancies from benign lesions, which were detected on planar bone scans. Materials and Methods: 59 patients with bone lesions were enrolled in the study. The scintigraphic findings were compared with the clinical, radiological and the histological findings. Each patient initially underwent a three-phase bone scan with Tc-99m MDP (Methylene Diphosphonate) and if evidence of lesion found, the patient then underwent a dynamic and static MIBI scintigraphy after three to four days. The MDP and MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratios of lesions and contralateral normal side (L/C) were taken by region of interests drawn on scans. The Student T test was applied to assess the significant difference between benign and malignant lesions p-value < 0.05 was considered significant. Result: The MDP scans showed the increase tracer uptake, but there was no significant difference between benign and malignant uptake of the radiotracer. However significant difference (p-value 0.015), in uptake was seen in malignant (L/C = 3.51 ± 1.02) and benign lesion (L/C = 2.50±0.42) on MIBI scan. Three of thirty benign lesions did not show significant MIBI uptake. Seven malignant appeared as false negatives. Specificity of the scan was 86.66%, and its Negative Predictive Value (NPV) was 81.25% whereas the sensitivity of scan was 79.31%. In excluding the axial metastasis from the lesions, the sensitivity of MIBI scan increased to 91.66% and the NPV also increased to 92.85%. Conclusion: MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions. MIBI also correctly identifies metastatic lesions. The negative predictive value of the scan points towards its ability to accurately diagnose the normal (benign) cases. However, biopsy remains the gold standard and a definitive diagnostic modality in musculoskeletal tumors. MIBI scan provides useful information in preoperative assessment and in distinguishing between malignant and benign lesions.

Keywords: benign, malignancies, MDP bone scan, MIBI scintigraphy

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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Authors: Sadaf Kalhori

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Introduction: Doxorubicin (DOX)-induced cardiotoxicity is widely known as the most severe complication of anthracycline-based chemotherapy in patients with cancer. It is unknown whether Deferiprone (DFP), could reduce the severity of DOX-induced cardiotoxicity by inhibiting free radical reactions. Thus, this study was performed to assess the protective effect of Deferiprone on DOX-induced cardiotoxicity in a rat model. Methods: The rats were divided into five groups. Group one was a control group. Group 2 was DOX (2 mg/kg/day, every other day for 12 days), and Group three to five which receiving DOX as in group 2 and DFP 75,100 and 150 mg/kg/day, for 19 days, respectively. DFP was starting 5 days prior to the first DOX injection and two days after the last DOX injection throughout the study. Electrocardiographic and hemodynamic studies, along with histopathological examination, were conducted. In addition, serum sample was taken and total cholesterol, Malone dialdehyde, triglyceride, albumin, AST, ALT, total protein, lactate dehydrogenase, total anti-oxidant and creatine kinase were assessed. Result: Our results showed the normal structure of endocardial, myocardial and pericardial in the control group. Pathologic data such as edema, hyperemia, bleeding, endocarditis, myocarditis and pericarditis, hyaline degeneration, cardiomyocyte necrosis, myofilament degeneration and nuclear chromatin changes were assessed in all groups. In the DOX group, all pathologic data was seen with mean grade of 2±1.25. In the DFP group with a dose of 75 and 100 mg, the mean grade was 1.41± 0.31 and 1±.23, respectively. In DFP group with a dose of 150, the pathologic data showed a milder change in comparison with other groups with e mean grade of 0.45 ±0.19. Most pathologic data in DFP groups showed significant changes in comparison with the DOX group (p < 0.001). Discussion: The results also showed that DFP treatment significantly improved DOX-induced heart damage, structural changes in the myocardium, and ventricular function. Our data confirm that DFP is protective against cardiovascular-related disorders induced by DOX. Clinical studies are needed to be involved to examine these findings in humans.

Keywords: cardiomyopathy, deferiprone, doxorubicin, rat

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Authors: Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton, Jo Parsons

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The problem: Women in the UK are offered influenza (flu), pertussis (whooping cough) and COVID-19 vaccinations during their pregnancy but uptake of all three vaccines is below the desired rate. These vaccines are offered during pregnancy as pregnant women are at an increased risk of hospitalisation, morbidity, and mortality from these illnesses. Exposure to these diseases during pregnancy can also have a negative impact on the unborn baby with an increased risk of serious complications both while in utero and following birth. The research aims to explore perceptions about the vaccinations offered in pregnancy both from the perspectives of pregnant women and midwives. To determine factors that influence pregnant women’s decisions about whether or not to accept the vaccines following the Covid-19 pandemic and to explore midwives’ experiences of recommending and delivering vaccines. The approach: This research follows a qualitative design involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy, and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Midwives were recruited via participating hospitals and midwife specific social media groups. Pregnant women were recruited via participating hospitals and community groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented here will focus on data from midwives. Topics identified included three key themes for midwives. These were 1) Delivery of vaccinations which includes the convenience of offering vaccinations while attending standard antenatal appointments and practical barriers faced in delivering these vaccinations at hospital. 2) Messages and guidance included the importance of up-to-date informational needs for midwives to deliver vaccines and that uncertainty and conflicting messages about the COVID-19 vaccine during pregnancy were a barrier to delivery. 3) Recommendations to have vaccines look at all aspects of recommendations such as how recommendations are communicated, the contents of the recommendation, the importance of the vaccine and the impact of those recommendations on whether women accept the vaccine. Implications: Findings highlight the importance for midwives to receive clear and consistent information so they can feel confident in relaying this information while recommending and delivering vaccines to pregnant women. Emphasising why vaccines are important when recommending vaccinations to pregnant women in addition to standard information on the availability and timing will add to the strength and impact of that recommendation in helping women to make informed decisions about accepting vaccines. The findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, Covid-19, midwives

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Authors: K. Omkar, D. Nayan

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Rapid urbanization is one of the consequences of rapid population explosion, which has also led to massive increase in number of motorized vehicles essential for carrying out all activities needed for sustaining urban livelihood. With this increased use of motorized vehicles over the time there has also been an increase in number of accidents. Study of road network and geometric features are essential to tackle problems of road accidents in any district or town. The increase in road accidents is one of the burning issues in the present society. Records show that there is one death at every 3.7 minutes because of road accident. It has been found from the research that, accidents occur due to, mistakes of the driver (86%) followed by bad street condition (5%), mistake of pedestrian (4%), as well as technical and maintenance defects (1%). Here, case study of Ahmedabad, Gujarat is taken up where first road safety level is assessed considering various parameters. The study confined to accident characteristics of all types of vehicles. For deeper analysis, road safety index for various stretches in Ahmedabad was found out. Crash rate for same stretches was found out. Based on various parameters priority was decided so that which stretch should be look out first to minimize road accidents on that stretch and which stretch should look out last. The major findings of the study are that accident severity of Ahmedabad has increased, but accident fatality risk has decreased; thus there is need to undertake some traffic engineering measures or make some traffic rules that are strictly followed by traffic. From the above study and literature studied it is found that Ahmedabad is suffering from similar problem of accidents and injuries and deaths caused by them, after properly investigating the issue short-term and long-term solutions to minimize road accidents have been presented in this paper.

Keywords: accident severity index, accident fatality rate, accident fatality risk, accident risk, road safety index

Procedia PDF Downloads 137

Authors: Alireza Pirkhaefi

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Background: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). Given the importance of cognitive disorders in patients with multiple sclerosis, the present study was in order to compare cognitive functions (Working memory, Attention and Centralization, and Visual-spatial perception) in patients with relapsing- remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). Method: Present study was performed as a retrospective study. This research was conducted with Ex-Post Facto method. The samples of research consisted of 60 patients with multiple sclerosis (30 patients relapsing-retrograde and 30 patients secondary progressive), who were selected from Tehran Community of MS Patients Supported as convenience sampling. 30 normal persons were also selected as a comparison group. Montreal Cognitive Assessment (MOCA) was used to assess cognitive functions. Data were analyzed using multivariate analysis of variance. Results: The results showed that there were significant differences among cognitive functioning in patients with RRMS, SPMS, and normal individuals. There were not significant differences in working memory between two groups of patients with RRMS and SPMS; while significant differences in these variables were seen between the two groups and normal individuals. Also, results showed significant differences in attention and centralization and visual-spatial perception among three groups. Conclusions: Results showed that there are differences between cognitive functions of RRMS and SPMS patients so that the functions of RRMS patients are better than SPMS patients. These results have a critical role in improvement of cognitive functions; reduce the factors causing disability due to cognitive impairment, and especially overall health of society.

Keywords: multiple sclerosis, cognitive function, secondary-progressive, normal subjects

Procedia PDF Downloads 231

Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber

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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.

Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition

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Authors: Rubab Ammad, Abdelgadir Abuelgasim

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UAE typically lies in one of the aridest regions of the world and is thus home to geologic features common to such climatic conditions including vast open deserts, sand dunes, saline soils, inland Sabkha and coastal Sabkha. Sabkha are characteristic salt flats formed in arid environment due to deposition and precipitation of salt and silt over sand surface because of low laying water table and rates of evaporation exceeding rates of precipitation. The study area, which comprises of western UAE, is heavily concentrated with inland Sabkha. Remote sensing is conventionally used to study the soil salinity of agriculturally degraded lands but not so broadly for Sabkha. The focus of this study was to identify these highly saline Sabkha areas on remotely sensed data, using salinity indices. The existing salinity indices in the literature have been designed for agricultural soils and they have not frequently used the spectral response of short-wave infra-red (SWIR1 and SWIR2) parts of electromagnetic spectrum. Using Landsat 8 OLI data and field ground truthing, this study formulated indices utilizing NIR-SWIR parts of spectrum and compared the results with existing salinity indices. Most indices depict reasonably good relationship between salinity and spectral index up until a certain value of salinity after which the reflectance reaches a saturation point. This saturation point varies with index. However, the study findings suggest a role of incorporating near infra-red and short-wave infra-red in salinity index with a potential of showing a positive relationship between salinity and reflectance up to a higher salinity value, compared to rest.

Keywords: Sabkha, salinity index, saline soils, Landsat 8, SWIR1, SWIR2, UAE desert

Procedia PDF Downloads 203

Authors: Nuchjaree Kidjawan, Orapan Thosingha, Pawinee Vaipatama, Prakrankiat Youngkong, Sirinapha Malangputhong, Kitti Thamrongaphichartkul, Phatcharaporn Phetcharat

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NPI uses technology sensorization of things and processed by AI system. The main features are an individual interface pressure sensor system in contact with the mattress and a position management system where the sensor detects the determined pressure with automatic pressure reduction and distribution. The role of NPI is to monitor, identify the risk and manage the interface pressure automatically when the determined pressure is detected. This study aims to evaluate the effects of “Never Pressure Injury (NPI),” an innovative mattress, on the incidence of pressure injuries in critically ill patients. An observational case-control study was employed to compare the incidence of pressure injury between the case and the control group. The control group comprised 80 critically ill patients admitted to a critical care unit of Phyathai3 Hospital, receiving standard care with the use of memory foam according to intensive care unit guidelines. The case group comprised 80 critically ill patients receiving standard care and with the use of the Never Pressure Injury (NPI) innovation mattress. The patients who were over 20 years old and showed scores of less than 18 on the Risk Assessment Pressure Ulcer Scale – ICU and stayed in ICU for more than 24 hours were selected for the study. The patients’ skin was assessed for the occurrence of pressure injury once a day for five consecutive days or until the patients were discharged from ICU. The sample comprised 160 patients with ages ranging from 30-102 (mean = 70.1 years), and the Body Mass Index ranged from 13.69- 49.01 (mean = 24.63). The case and the control group were not different in their sex, age, Body Mass Index, Pressure Ulcer Risk Scores, and length of ICU stay. Twenty-two patients (27.5%) in the control group had pressure injuries, while no pressure injury was found in the case group.

Keywords: pressure injury, never pressure injury, innovation mattress, critically ill patients, prevent pressure injury

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Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

Procedia PDF Downloads 128