Search results for: levels of care

Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) are a major cause of pain and disability. It is likely to become a greater economic and public health burden that is unnecessary. Thus, reliable prevalence figures are important for both clinicians and policy-makers to plan health care needs for those affected with the disease. This study estimated hospital based real-world prevalence of MSDs in Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out to identify common MSDs including low back pain (LBP), cervical spondylosis (CSD), post immobilization stiffness (PIS), sprain, osteoarthritis (OA), and other conditions. Occupational class of the patients was determined using the International Labour Classification (ILO). Data were analysed using descriptive statistics of frequency and percentages. Overall, medical charts of 3,340 patients were reviewed within the span of ten years (2009 to 2018). Majority of the patients (62.8%) were in the middle class, and the remaining were in low class (25.1%) and high class (10.5%) category. An overall prevalence of 47.35% of MSD was found within the span of ten years. Of this, the prevalence of LBP, CSD, PIS, sprain, OA, and other conditions was 21.6%, 10%, 18.9%, 2%, 6.3%, and 41.3%, respectively. The highest (14.2%) and lowest (10.5%) prevalence of MSDs was recorded in the year of 2012 and 2018, respectively. The prevalence of MSDs is considerably high among Nigerian patients attending outpatient a physiotherapy clinic. The high prevalence of MSDs underscores the need for clinicians and decision makers to put in place appropriate strategies to reduce the prevalence of these conditions. In addition, they should plan and evaluate healthcare services to improve the health outcomes of patients with MSDs. Further studies are required to determine the economic burden of the condition and examine the clinical and cost-effectiveness of physiotherapy interventions for patients with MSDs.

Keywords: musculoskeletal disorders, Nigeria, prevalence, real world

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Authors: Yuet Wah Echo Yeung

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Practice learning is an important component of social work education. Practice educators are charged with the responsibility to support and enable learning while students are on placement. They also play a key role in teaching students to integrate theory and practice, as well as assessing their performance. Current literature highlights the structural factors that make it difficult for practice educators to create a positive learning environment for students. Practice educators find it difficult to give sufficient attention to their students because of the lack of workload relief, the increasing emphasis on managerialism and bureaucratisation, and a range of competing organisational and professional demands. This paper reports the challenges practice educators face and how they manage these challenges in this context. Semi-structured face-to-face interviews were conducted with thirteen practice educators who support students in statutory and voluntary social care settings in the Northwest of England. Interviews were conducted between April and July 2017 and each interview lasted about 40 minutes. All interviews were recorded and transcribed. All practice educators are experienced social work practitioners with practice experience ranging from 6 to 42 years. On average they have acted as practice educators for 13 years and all together have supported 386 students. Our findings reveal that apart from the structural factors that impact how practice educators perform their roles, they also faced other challenges when supporting students on placement. They include difficulty in engaging resistant students, complexity in managing power dynamics in the context of practice learning, and managing the dilemmas of fostering a positive relationship with students whilst giving critical feedback. Suggestions to enhance the practice educators’ role include support from organisations and social work teams; effective communication with university tutors, and a forum for practice educators to share good practice and discuss placement issues.

Keywords: social work education, placement challenges, practice educator, practice learning

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Authors: Sourabh Jain, Vikas Jain, Dharmendar Kumar

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The present study investigated the antidiabetic potential of Cedrus deodara heart wood aqueous extract. Aqueous extract of Cedrus deodara was found to reduce blood sugar level in alloxan induced diabetic rats. Reduction in blood sugar could be seen from 5th day after continuous administration of the extract and on 21st day sugar levels were found to be reduced by 40.20%. Oxidative stress produced by alloxan was found to be significantly lowered by the administration of Cedrus deodara aqueous extract (500 mg/kg). This was evident from a significant decrease in lipid per oxidation level in liver induced by alloxan. The level of Glutathione, Catalase, Superoxide dismutase and Glutathione-S-Transferase in liver, kidney and pancreas tissue were found to be increased significantly after drug administration. The results obtained in the present study suggest that the Cedrus deodara aqueous extract effectively and significantly reduced the oxidative stress induced by alloxan and produced a reduction in blood sugar level.

Keywords: Cedrus deodara, heartwood, antioxidant, anti-diabetic, anti-inflammatory

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Authors: Minho Kwon, Jeonghee Lim, Yeongseok Jeong, Donghoon Shin, Kiyoung Kim

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Recently, global warming phenomenon has led to natural disasters caused by global environmental changes, and due to abnormal weather events, the frequency and intensity of heavy rain storm typhoons are increasing. Therefore, it is imperative to prepare for future heavy rain storms and typhoons. This study selects arbitrary target bridges and performs numerical analysis to evaluate the safety of bridge piers in the event that the water level changes. The numerical model is based on two-dimensional surface elements. Actual reinforced concrete was simulated by modeling concrete to include reinforcements, and a contact boundary model was applied between the ground and the concrete. The water level applied to the piers was considered at 18 levels between 7.5 m and 16.1 m. The elastic modulus, compressive strength, tensile strength, and yield strength of the reinforced concrete were calculated using 250 random combinations and numerical analysis was carried out for each water level. In the results of analysis, the bridge exceeded the stated limit at 15.0 m. At the maximum water level of 16.1m, the concrete’s failure rate was 35.2%, but the probability that the reinforcement would fail was 61.2%.

Keywords: Monte-Carlo method, pier, water level change, limit state

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Authors: Sajeli A. Begum, Ameer Basha, Kirti Hira, Rukaiyya Khan

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Cyclic dipeptides are simple diketopiperazine derivatives being investigated by several scientists for their biological effects which include anticancer, antimicrobial, haematological, anticonvulsant, immunomodulatory effect, etc. They are potentially active microbial metabolites having been synthesized too, for developing into drug candidates. Cultures of Pseudomonas species have earlier been reported to produce cyclic dipeptides, helping in quorum sensing signals and bacterial–host colonization phenomena during infections, causing cell anti-proliferation and immunosuppression. Fluorescing Pseudomonas species have been identified to secrete lipid derivatives, peptides, pyrroles, phenazines, indoles, aminoacids, pterines, pseudomonic acids and some antibiotics. In the present work, results of investigation on the cyclic dipeptide metabolites secreted by the culture broth of Pseudomonas species as potent pro-inflammatory cytokine inhibitors are discussed. The bacterial strain was isolated from the rhizospheric soil of groundnut crop and identified as Pseudomonas aeruginosa by 16S rDNA sequence (GenBank Accession No. KT625586). Culture broth of this strain was prepared by inoculating into King’s B broth and incubating at 30 ºC for 7 days. The ethyl acetate extract of culture broth was prepared and lyophilized to get a dry residue (EEPA). Lipopolysaccharide (LPS)-induced ELISA assay proved the inhibition of tumor necrosis factor-alpha (TNF-α) secretion in culture supernatant of RAW 264.7 cells by EEPA (IC50 38.8 μg/mL). The effect of oral administration of EEPA on plasma TNF-α level in rats was tested by ELISA kit. The LPS mediated plasma TNF-α level was reduced to 45% with 125 mg/kg dose of EEPA. Isolation of the chemical constituents of EEPA through column chromatography yielded ten cyclic dipeptides, which were characterized using nuclear magnetic resonance and mass spectroscopic techniques. These cyclic dipeptides are biosynthesized in microorganisms by multifunctional assembly of non-ribosomal peptide synthases and cyclic dipeptide synthase. Cyclo (Gly-L-Pro) was found to be more potentially (IC50 value 4.5 μg/mL) inhibiting TNF-α production followed by cyclo (trans-4-hydroxy-L-Pro-L-Phe) (IC50 value 14.2 μg/mL) and the effect was equal to that of standard immunosuppressant drug, prednisolone. Further, the effect was analyzed by determining mRNA expression of TNF-α in LPS-stimulated RAW 264.7 macrophages using quantitative real-time reverse transcription polymerase chain reaction. EEPA and isolated cyclic dipeptides demonstrated diminution of TNF-α mRNA expression levels in a dose-dependent manner under the tested conditions. Also, they were found to control the expression of other pro-inflammatory cytokines like IL-1β and IL-6, when tested through their mRNA expression levels in LPS-stimulated RAW 264.7 macrophages under LPS-stimulated conditions. In addition, significant inhibition effect was found on Nitric oxide production. Further all the compounds exhibited weak toxicity to LPS-induced RAW 264.7 cells. Thus the outcome of the study disclosed the effectiveness of EEPA and the isolated cyclic dipeptides in down-regulating key cytokines involved in pathophysiology of autoimmune diseases.In another study led by the investigators, microbial cyclic dipeptides were found to exhibit excellent antimicrobial effect against Fusarium moniliforme which is an important causative agent of Sorghum grain mold disease. Thus, cyclic dipeptides are emerging small molecular drug candidates for various autoimmune diseases.

Keywords: cyclic dipeptides, cytokines, Fusarium moniliforme, Pseudomonas, TNF-alpha

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Authors: Bohsiu Wu

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This study compares the differences in social dynamics between rural and urban areas in California to explain homicides involving family members. It is hypothesized that rural homicides are better explained by social isolation and lack of intervention resources, whereas urban homicides are attributed to social disadvantage factors. Several critical social dynamics including social isolation, social disadvantages, acculturation, and intervention resources were entered in a hierarchical linear model (HLM) to examine whether county-level factors affect how each specific dynamic performs at the ZIP code level, a proxy measure for communities. Homicide data are from the Supplementary Homicide Report for all 58 counties in California from 1997 to 1999. Predictors at both the county and ZIP code levels are derived from the 2000 US census. Preliminary results from a HLM analysis show that social isolation is a significant but moderate predictor to explain rural family homicide and various social disadvantage factors are significant factors accounting for urban family homicide. Acculturation has little impact. Rurality and urbanity appear to interact with various social dynamics in explaining family homicide. The implications for prevention at both the county and community level as well as directions for future study on the differences between rural and urban locales are explored in the paper.

Keywords: communities, family, HLM, homicide, rural, urban

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Authors: Bukola Tola Aluko, Omotade Ibidun Oloyede

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Ocimum americanum L. (Lamiaceae) is an annual herb that is native to tropical Africa. The in vitro and in vivo antioxidant activity of its aqueous extract was carefully investigated by assessing the DPPH radical scavenging activity, ABTS radical scavenging activity and hydrogen peroxide radical scavenging activity. The reducing power, total phenol, total flavonoids and flavonols content of the extract were also evaluated. The data obtained revealed that the extract is rich in polyphenolic compounds and scavenged the radicals in a concentration-dependent manner. This was done in comparison with the standard antioxidants such as BHT and Vitamin C. Also, the induction of oxidative damage with paracetamol (2000 mg/kg) resulted in the elevation of lipid peroxides and significant (P < 0.05) decrease in activities of superoxide dismutase, glutathione peroxidase, glutathione reductase and catalase in the liver and kidney of rats. However, the pretreatment of rats with aqueous extract of O. americanum leaves (200 and 400 mg/kg), and silymarin (100 mg/kg) caused a significant (P < 0.05) reduction in the values of lipid peroxides and restored the levels of antioxidant parameters in these organs. These findings suggest that the leaves of O. americanum have potent antioxidant properties which may be responsible for its acclaimed folkloric uses.

Keywords: antioxidants, free radicals, ocimum americanum, scavenging activity

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Authors: Mohammad Darbani, Jafar Masoud Sinaki, Armaghan Abedzadeh Neyshaburi

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An experiment was conducted as split plot factorial design using randomized complete block design in Damghan in 2012-2013 in order to investigate the effects of irrigation cut off (based on the Phenological stages of plants) on physiological properties of forage millet cultivars. The treatments included three irrigation levels (control with full irrigation, irrigation cut off when flowering started, and irrigation cut off when flowering ended) in the main plots, and applying nitroxin biofertilizer (+), not applying nitroxin biofertilizer (control), and Iranian forage millet cultivars (Bastan, Pishahang, and Isfahan) in the subplots. The highest rate of ashes and water-soluble carbohydrates content were observed in the cultivar Bastan (8.22 and 8.91%, respectively), the highest content of fiber and water (74.17 and 48.83%, respectively) in the treatment of irrigation cut off when flowering started, and the largest proline concentration (μmol/gfw-1) was seen in the treatment of irrigation cut off when flowering started. very rapid growth of millet, its short growing season, drought tolerance, its unique feature regarding harvest time, and its response to nitroxin biofertilizer can help expanding its cultivation in arid and semi-arid regions of Iran.

Keywords: irrigation cut off, forage millet, Nitroxin fertilizer, physiological properties

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Authors: Jennifer Reese, Josh Biber, Howard Weeks, Rachel Hess

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Aim: The Edinburgh Postnatal Depression Screen (EPDS) is a mental health screening for pregnant women that has been widely used over the last 30 years. This screen is typically given in clinic on paper to patients throughout pregnancy and postpartum. The screen helps identify patients who may be at risk for pregnancy related depression or postpartum depression. In early 2016, University of Utah Health implemented an electronic version of the EPDS as well as the PROMIS Depression v1.0 instrument for all pregnant and postpartum patients. We asked patients both instruments to understand coverage of patients identified as at risk for each instrument. Methods: The EPDS is currently administered as part of our PRO template for pregnant and postpartum women. We also administer the PROMIS Depression as part of a standard PRO assessment to all patients. Patients are asked to complete an assessment no more often than every eight weeks. PRO assessments are either completed at home or in clinic with a tablet computer. Patients with a PROMIS score of ≥ 65 or a EPDS score of ≥ 10 were identified as at risk for depression Results: From April 2016 to April 2017, 1,330 unique patients were screened at University of Utah Health in OBGYN clinics with both the EPDS and PROMIS depression instrument on the same day. There were 28 (2.1%) patients were identified as at risk for depression using the PROMIS depression screen, while 262 (19.7%) patients were identified as at risk for postpartum depression using the EPDS screen. Overall, 27 (2%) patients were identified as at risk on both instruments. Conclusion: The EPDS identified a higher percent (19.7%) of patients at risk for depression when compared to the PROMIS depression (2.1%). Ninety-six percent of patients who screened positive on the PROMIS depression screen also screened positive on the EPDS screen. Mental health is an important component to a patient’s overall wellbeing. We want to ensure all patients, particularly pregnant or post-partum women, receive screening and treatment when necessary. A combination of screenings may be necessary to provide the overall best care for patients and to identify the highest percentage of patients at risk.

Keywords: patient reported outcomes, mental health, maternal, depression

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Authors: M. H. Mehrabi, S. S. Ghodsi, Zainah Ibrahim, Meldi Suhatril

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Standard routes for upgrading existing buildings to improve their seismic response can be expensive in terms of both time and cost due to the modifications required to the foundations. As a result, interest has grown in the installation of viscoelastic dampers (VEDs) in mid and high-rise buildings. Details of a low-cost viscoelastic passive control device, the rotary rubber braced damper (RRBD), are presented in this paper. This design has the added benefits of being lightweight and simple to install. Experimental methods and finite element modeling were used to assess the performance of the proposed VED design and its effect on building response during earthquakes. The analyses took into account the behaviors of non-linear materials and large deformations. The results indicate that the proposed RRBD provides high levels of energy absorption, ensuring the stable cyclical response of buildings in all scenarios considered. In addition, time history analysis was employed in this study to evaluate the RRBD’s ability to control the displacements and accelerations experienced by steel frame structures. It was demonstrated that the device responds well even at low displacements, highlighting its suitability for use in seismic events of varying severity.

Keywords: dynamic response, passive control, performance test, seismic protection

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Authors: Heather E. Ewart, Keith Jensen, Rebecca N. Cliffe

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Fragmentation and changes in the structural composition of tropical forests – as a result of intensifying anthropogenic disturbance – are increasing pressures on local biodiversity. Species with low dispersal abilities have some of the highest extinction risks in response to environmental change, as even small-scale environmental variation can substantially impact their space use and energetic balance. Understanding the implications of forest disturbance is therefore essential, ultimately allowing for more effective and targeted conservation initiatives. Here, the impact of different levels of forest disturbance on the space use, energetics, movement and behavior of 18 brown-throated sloths (Bradypus variegatus) were assessed in the South Caribbean of Costa Rica. A multi-scale framework was used to measure forest disturbance, including large-scale (landscape-level classifications) and fine-scale (within and surrounding individual home ranges) forest composition. Three landscape-level classifications were identified: primary forests (undisturbed), secondary forests (some disturbance, regenerating) and urban forests (high levels of disturbance and fragmentation). Finer-scale forest composition was determined using measurements of habitat structure and quality within and surrounding individual home ranges for each sloth (home range estimates were calculated using autocorrelated kernel density estimation [AKDE]). Measurements of forest quality included tree connectivity, density, diameter and height, species richness, and percentage of canopy cover. To determine space use, energetics, movement and behavior, six sloths in urban forests, seven sloths in secondary forests and five sloths in primary forests were tracked using a combination of Very High Frequency (VHF) radio transmitters and Global Positioning System (GPS) technology over an average period of 120 days. All sloths were also fitted with micro data-loggers (containing tri-axial accelerometers and pressure loggers) for an average of 30 days to allow for behavior-specific movement analyses (data analysis ongoing for data-loggers and primary forest sloths). Data-loggers included determination of activity budgets, circadian rhythms of activity and energy expenditure (using the vector of the dynamic body acceleration [VeDBA] as a proxy). Analyses to date indicate that home range size significantly increased with the level of forest disturbance. Female sloths inhabiting secondary forests averaged 0.67-hectare home ranges, while female sloths inhabiting urban forests averaged 1.93-hectare home ranges (estimates are represented by median values to account for the individual variation in home range size in sloths). Likewise, home range estimates for male sloths were 2.35 hectares in secondary forests and 4.83 in urban forests. Sloths in urban forests also used nearly double (median = 22.5) the number of trees as sloths in the secondary forest (median = 12). These preliminary data indicate that forest disturbance likely heightens the energetic requirements of sloths, a species already critically limited by low dispersal ability and rates of energy acquisition. Energetic and behavioral analyses from the data-loggers will be considered in the context of fine-scale forest composition measurements (i.e., habitat quality and structure) and are expected to reflect the observed home range and movement constraints. The implications of these results are far-reaching, presenting an opportunity to define a critical index of habitat connectivity for low dispersal species such as sloths.

Keywords: biodiversity conservation, forest disturbance, movement ecology, sloths

Procedia PDF Downloads 91

Authors: Summer Isaacson

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Research on gender differences in environmental behavior has long claimed that women engage less than men in environmental political participation (EPP) (protests, petitions), despite their higher levels of environmental concern and vulnerability. Using recent data from the ISSP’s 2020 Environment module including 28 countries, we revisit the gender gap in EPP. Arguing that increasing gender equality and socio-economic development can allow women to voice their environmental grievances, we use multi-level models to examine the effects of macro-level gender equality on gender differences in environmental protests, petitions, and boycotts. By distinguishing individual from collective and non-confrontational from confrontational engagement forms, this study offers an encompassing understanding of gendered patterns of participation. Women do participate more than men, but mainly in individual and non-confrontational EPP forms (petitions, boycotts) and with substantial variation across countries. Moreover, considering how women have historically been restrained from participating in politics, we argue that structural gender inequality remains an important limitation to women’s engagement. Cross-level interactions indicate that in more egalitarian countries, women are more likely to engage in several types of EPP than men. The study offers new perspectives and findings on gender differences in EPP, highlighting the impact of gender inequality on women’s participation.

Keywords: environmental activism, political participation, gender equality, pro-environmental behavior

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Authors: Savaş Karpuz, Sami Küçükşen

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The aim of this study is to investigate the effectiveness of neurological rehabilitation in patients with traumatic brain injury. Participants were 45 consecutive adults with traumatic brain injury who were received the neurologic rehabilitation. Sociodemographic characteristics of the patients, the cause of the injury, the duration of the coma and posttraumatic amnesia, the length of stay in the other inpatient clinics before rehabilitation, the time between injury and admission to the rehabilitation clinic, and the length of stay in the rehabilitation clinic were recorded. The differences in functional status between admission and discharge were determined with Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Functional Ambulation Scale (FAS) and levels of cognitive functioning determined with Ranchos Los Amigos Scale (RLAS). According to admission time, there was a significant improvement identified in functional status of patients who had been given the intensive in-hospital cognitive rehabilitation program. At discharge time, the statistically significant differences were obtained in DRS, FIM, FAS and RLAS scores according to admission time. Better improvement in functional status was detected in patients with lower scores in DRS, and higher scores FIM and RLAS scores at the entry time. The neurologic rehabilitation significantly affects the recovery of functional status after traumatic brain injury.

Keywords: traumatic brain injury, rehabilitation, functional status, neurological

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Authors: Krizette Ladera

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Fathers are there not only to provide the financial stability of a family but a father is also there to provide the love and support that usually people would see as the mother’s responsibility. To describe the lived experiences and how fathers make sense of their lived experiences with their children who have cerebral palsy is the main objective of the study. A qualitative research using a thematic analysis was used for the study. The qualitative research focused on the personal narratives, self-report and expression of the participant’s memory in terms of how they tell their stories. The interpretative phenomenological analysis was used to focus on the experience of the participants on how they will describe their experiences, and to also add on that the IPA will also attempt to describe and explain the meaning of human experiences using interview, specifically on the father who have a child that suffers from cerebral palsy. For the sampling technique, the snowball technique was used to gather participants from the referral of other participants. The five non-randomly selected fathers will be served as the participants for the research. A self-made interview with an open-ended question was used as the research instrument; it includes profiling of the respondent as well as their experiences in taking care of their child that suffers from cerebral palsy. In analyzing a data, the researcher used the thematic analysis where in the interview was made into a transcript, then it was organized and divided themes. After that, the relations of each themes, was identified and it was later documented and translated into written text format using thematic grouping. Finally, the researcher analyzed each data according to its themes and put it in a table to be presented in the result section of the study And as for the result of the study, the researcher was able to come up with the four (4) main themes that most of the participants experienced and those are: The experiences in finding out about the condition of the Child, disclosing the condition of the child to the family and its emotional effect, The experiences of living the day of day realities in providing the physical, financial, emotional and a well balanced environment to the child, and the religious perspectives of the fathers. Along with those four (4) themes comes the subtheme which explains the themes in a more detailed explanation.

Keywords: cerebral palsy, children, fathers, lived experiences

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Authors: Andriy Fedorenko

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Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

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Authors: Antonia Harold-Barry, Eugene Dempsey

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Background: The objective is to examine the survival and outcome of infants born under 26 weeks gestation in an Irish tertiary maternity hospital from 2007-2016 and to describe the survival and neurodevelopmental outcomes of these extremely preterm infants. Method: The population is 132 infants born at 23, 24, and 25 weeks in Cork University Maternity Hospital from 2007 to 2016. Ethical approval was granted by the Cork Clinical Research Ethics Committee. Patient details were obtained from the Vermont Oxford and Badger Networks. Survival rates and Bayley scores were calculated to assess neurodevelopmental outcomes. Statistical analysis with SPSS included frequencies, distributions, and comparisons between data from 2007-2011 and 2012-2016. Results: Overall survival rate was 63%. Of the surviving babies, 61% had Bayley scores calculated. Survival stood at 39% for delivery at 23 weeks, 50% at 24 weeks, and 83% at 25 weeks. The 2012 to 2016 cohort has shown further increases in survival, with 50% of babies at 23 weeks, 58% at 24 weeks, and 89% at 25 weeks. Corresponding figures for 2007-2011 are 20%, 39%, and 75%. Gestational age and incidence of periventricular leukomalacia were statistically significant, with a p-value of 0.022. Gestational age and delivery room deaths had a p-value of 0.025, as did gestational age and birth weight. A comparison of the two cohorts (2007-2011 and 2012-2016) with the administration of antenatal steroids showed a statistically significant p-value of 0.044. Conclusion: There is less morbidity and mortality in infants born at 25 than at 23 or 24 weeks. Survival of extremely premature infants has increased significantly over the past ten years. Survival rates with normal neurodevelopmental outcomes are comparable with international standards and reflect positive changes in attitude and practices in neonatal intensive care. This study will inform parents about the potential outcomes of extreme prematurity and policy regarding the management of extreme prematurity.

Keywords: extreme of viability, neurodevelopmental outcome, periventricular leukomalacia, prematurity

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Authors: Aikaterini Amanatidou

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We describe the case of a 20-year-old female patient diagnosed with Ehlers-Danlos Syndrome (EDS) who was scheduled to undergo a wisdom teeth extraction in outpatient surgery. EDS is a hereditary connective tissue disorder characterized by joint hypermobility, skin hyper-extensibility, and vascular and soft tissue fragility. There are six subtypes of Ehlers-Danlos, and in our case, the patient had EDS hyper-mobility (HT) type disorder. One important clinical feature of this syndrome is chronic pain, which is often poorly understood and treated. Our patient had a long history of articular and lumbar pain when she was diagnosed. She was prescribed analgesic treatment for acute and neuropathic pain and had multiple sessions of psychotherapy and physiotherapy to ease the pain. Unfortunately, her extensive medical history was underrated by our anesthetic team, and no further measures were taken for the operation. Despite an uneventful intra-operative phase, the patient experienced several episodes of hyperalgesia during the immediate post-operative care. Management of pain was challenging for the anesthetic team: initial opioid treatment had only a temporary effect and a paradoxical reaction after a while. Final pain relief was eventually obtained with psycho-physiologic treatment, high doses of ketamine, and patient-controlled analgesia infusion of morphine-ketamine-dehydrobenzperidol. We suspected an episode of Opioid-Induced hyperalgesia. This case report supports the hypothesis that anti-hyperalgesics such as ketamine as well as lidocaine, and dexmedetomidine should be considered intra-operatively to avoid opioid-induced hyperalgesia and may be an alternative solution to manage complex chronic pain like others in neuropathic pain syndromes.

Keywords: Ehlers-Danlos, post-operative management, hyperalgesia, opioid-induced hyperalgesia, rare disease

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Authors: Ahmed Zahran

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Bifidobacterium breve ATCC 15700, Bifidobacterium adolescents ATCC 15704 and Bifidobacterium longum ATCC 15707 were tested for their growth, acid production, bile tolerance, antibiotic resistance and adherence to columnar epithelial cells of the small intestine of goat. The growth of all studied species was determined in the MRSL medium. B.longum 15707 was the most active species in comparison with the other two species; it was also more resistant to bile acids. The adhesion of the studied species to the columnar epithelial cells was studied. All the studied species showed some degree of adhesion; however, B.longum adhered more than the other two species. This species was resistant to four types of antibiotics and was sensitive to chloramphenicol 30 µg. The activity of Bifidobacterium species in soymilk was evaluated by measuring the development of titratalle acidity. B.longum 15707 was the most active species in terms of growth and activity of soymilk. So, soymilk containing bifidobacteria could be added to goat milk to produce acceptable functional soy yogurt, using the ratio of (1:4) soy milk to goat milk. This product could be of unique health benefits, especially in the case of high cholesterol levels and replenishment of intestinal flora after antibiotic therapy.

Keywords: bifidobacteria physiological properties, soy milk, goat milk, attachment epithelial cells, columnar tissues, probiotic food

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Authors: Shoumodip Roy, Ankit Singhania, Santanu Mallick, Abhiram Jha, M. K. Agarwal, R. V. Ramna, Uttam Singh

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The quality of hot metal at any blast furnace is judged by the silicon content in it. Lower hot metal silicon not only enhances process efficiency at steel melting shops but also reduces hot metal costs. The Hot metal produced at G-Blast furnace Tata Steel Jamshedpur has a significantly higher Si content than Benchmark Blast furnaces. The higher content of hot metal Si is mainly due to inferior raw material quality than those used in benchmark blast furnaces. With minimum control over raw material quality, the only option left to control hot metal Si is via optimizing the furnace parameters. Therefore, in order to identify the levers to reduce hot metal Si, Data mining was carried out, and multiple regression models were developed. The statistical analysis revealed that Slag B3{(CaO+MgO)/SiO2}, Slag Alumina and Hot metal temperature are key controllable parameters affecting hot metal silicon. Contour Plots were used to determine the optimum range of levels identified through statistical analysis. A trial plan was formulated to operate relevant parameters, at G blast furnace, in the identified range to reduce hot metal silicon. This paper details out the process followed and subsequent reduction in hot metal silicon by 15% at G blast furnace.

Keywords: blast furnace, optimization, silicon, statistical tools

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Authors: Nilgun Karatas, Bihter Sakin

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In this study, the relationships between the use of language learning strategies and English language exit exam success were investigated in the university EFL learners’ context. The study was conducted at Fatih University Prep School. To collect data 3 classes from the A1 module in English language classes completed a questionnaire known as the English Language Learning Strategy Inventory or ELLSI. The data for the present study were collected from the preparatory class students who are studying English as a second language at the School of Foreign Languages. The students were placed into four different levels of English, namely A1, A2, B1, and B2 level of English competency according to European Union Language Proficiency Standard, by means of their English placement test results. The Placement test was conveyed at the beginning of the spring semester in 2014-2015.The ELLSI consists of 30 strategy items which students are asked to rate from 1 (low frequency) to 5 (high frequency) according to how often they use them. The questionnaire and exit exam results were entered onto SPSS and analyzed for mean frequencies and statistical differences. Spearman and Pearson correlation were used in a detailed way. There were no statistically significant results between the frequency of strategy use and exit exam results. However, most questions correlate at a significant level with some of the questions.

Keywords: individual differences, language learning strategies, Fatih University, English language

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Authors: Mark Shiu-kee Shum, Dan Shi

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The paper aims to introduce the ‘Reading to Learn, Learning to Write’ (R2L) pedagogy and its application in teaching reading and writing to non-Chinese speaking (NCS) students in Hong Kong. Guided by the teaching and learning cycles accentuated in R2L pedagogy, sufficient scaffolding was provided for students with an explicit teaching method in literacy education. To understand the influence of using R2L pedagogy on students’ reading and writing abilities across different genres, quantitative data were collected by pre- and post-test of reading and writing tasks in the two different genres of narration and explanation. The pre-test and post-test were used to assess students’ writing performance based on the three textual components of context, discourse, and graphic features, while the reading abilities were assessed at the literal, inferred and interpretive levels of reading comprehension to measure the effectiveness of R2L pedagogy on their literacy improvement. The findings show the use of R2L pedagogy has been proven more effective in improving NCS students’ writing abilities than developing their reading capacity. It is hoped that the R2L-based pedagogic practices can serve as teaching references and pedagogic rationale for L1 language teachers and raise their metalinguistic awareness in teaching Chinese to non-Chinese speaking students in Hong Kong and beyond.

Keywords: pedagogical inclusiveness, literacy education, ethnic minority, reading and writing

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Authors: Dilson Subedi

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Current transformers are an integral part of power system because it provides a proportional safe amount of current for protection and measurement applications. However, due to upgradation of electromechanical relays to numerical relays and electromechanical energy meters to digital meters, the connected burden, which defines some of the CT characteristics, has drastically reduced. This has led to the system experiencing high currents damaging the connected relays and meters. Since the protection and metering equipment's are designed to withstand only certain amount of current with respect to time, these high currents pose a risk to man and equipment. Therefore, during such instances, the CT saturation characteristics have a huge influence on the safety of both man and equipment and on the reliability of the protection and metering system. This paper shows the effectiveness of a bank of parallel connected resistors, as a burden compensation technique, in compensating the burden of under-burdened CT’s. The response of the CT in the case of failure of one or more resistors at different levels of overcurrent will be captured using the LabVIEWTM data acquisition hardware (DAQ). The analysis is done on the real-time data gathered using LabVIEWTM. Variation of current transformer saturation characteristics with changes in burden will be discussed.

Keywords: accuracy limiting factor, burden, burden compensation, current transformer

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Authors: Huang Yueh Chen, Sheng Ang Shen

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Purpose: Sexual assault has always been a highly anticipated crime in Taiwan. People assume that the career of sexual offenders tends to be highly specialized. This study hopes to analyze the crime career and risk factors of offenders by means of another classification. Methods: A total of 145 sexual offenders were sentenced on the parole or expiration date from 2009 to 2011, through analysis of official existing documents such as ‘Re-infringement risk assessment report’ and ‘case assessment report’. Results: The section ‘Various Types of Crimes ‘ of criminal career is analyzed. The highest number of ‘ versatile sexual offender’ followed by ‘adult sexual offender’ is about 2.5, representing more than 1.5 kinds of non-sex crimes besides sexual crimes. Different specialized sexual offenders have had extensive experience in the ‘Sexual Assault Experiences in Children and School’, ‘Static 99 Levels’, ‘Pre-Commuted Substance Use’, ‘Excited Deviant Sexual Behavior’, ‘Various Types of Crimes,’ and ‘Sexual Crime in Forerunner’ , ‘Type of Index Crime’ and other projects to achieve significant differences. Conclusions: Resources continue to be devoted to specialized offenders, the character of first-time sexual offender depends on further research and makes the public aware of the different assumptions of diversified offenders from traditional professional offenses that reduce unnecessary panic in society.

Keywords: versatile sexual offender, specialized sexual offender, criminal career, risk factor

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Authors: Ali M. Mutlag, Yang Zhiqiang, Meng Jiaren, Zhang Jingyan, Li Jianxi

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The object of this study was to investigate several hormones correlated to the reproduction and Inhibin A, Inhibin B and NO levels in the infertile dairy cows as attempt to illustrate the physiological causes of dairy cows infertility. 40 Holstein cows (21 infertile and 19 fertile) were used at estrous phase of the cycle, Hormones FSH, LH, E2, Testosterone, Were measured using ELISA method. Inhibin A and B also estimated by ELISA method, Nitric oxide was measured by Greiss reagent method. The results showed different concentrations of the hormone in which FSH illustrated significantly higher concentration in the infertile cows than fertile cows (P<0.05). LH and E2 showed significant decrease in the infertile cows than the fertile cows (P<0.05), No significant difference appeared in testosterone concentrations in the fertile cows and infertile cows (P>0.05). The both inhibins A and B showed significant P<0.05 decrease concentrations in the infertile cows also NO showed clearly significant decrease P<0.05 in the infertile cows. In conclusion, The present study approved the poorly ovarian activities and reproduction disturbance of infertile cows in spite of trigger estrous signs, The study confirmed a positive correlation between inhibins and NO to regulate the ovarian physiology. These inhibins represent effective markers of dairy cows infertility.

Keywords: cows, inhibins A and B, infertility, nitric oxide (NO)

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Authors: Min-Tao Hsu

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This study aims to explore the lived experiences of women with breast cancer, including their life world of illness and their adaptation to breast cancer. Breast cancer is not only a potentially lethal disease, but also a disease that may lead to many irreversible changes for female patients. Especially, in a culture where the wholeness is pursuit as an essential value, the sickness and/or broken body bring great challenge of life. Based on holism and symbolic interactionism, this study used interpretive ethnography including in-depth interviews and participant observations to collect the narrative of women with breast cancer concerning their illness experience. In addition, this study used Agar’s hermeneutic cycle to analyze data. The average age of 35 participants was 54.2. A total of 15 patients were within 2 years of onset, 5 patients were within 2-5 years of the treatment observation period, and 15 patients suffered from breast cancer for more than 5 years. The average age of onset was 50.4. Result: The main storyline of the life world of illness is ‘breast cancer is a turning point of life.’ Loss of breast was in terms of ‘no more a woman’ in Taiwanese culture. Two young women, one in her newly wedded and another right before marry, were divorced and cancelled wedding right after being diagnosed. All of them addressed that they have a ‘broken body.’ Single women accounted that they won’t marry for not being humiliated and most of married women said they never show female body in front of her husband or partner even in intimacy encounter. Three common themes were discovered: 1) new self and new identity; 2) new social relationships and new me; 3) new body and new life. The intertwining bodies, illness, selves, suffering, and medical treatments of female patients were observed. More, the recovery, of cause, was happened when new self, relationship, and new body were generated. Their identity to be a woman and a wife is shattered and their life is urged into another facet. For helping them to recovery from such situation, building a new identity and new social fabric on the new body need to be included in nursing care plan.

Keywords: breast cancer, illness narrative, world of illness, self-healing, interpretive ethnography

Procedia PDF Downloads 324

Authors: Mikel Niño, Roberto V. Zicari, Todor Ivanov, Kim Hee, Naveed Mushtaq, Marten Rosselli, Concha Sánchez-Ocaña, Karsten Tolle, José Miguel Blanco, Arantza Illarramendi, Jörg Besier, Harry Underwood

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One of the application fields for data analysis techniques and technologies gaining momentum is the area of social good or “common good”, covering cases related to humanitarian crises, global health care, or ecology and environmental issues, among others. The promotion of data-driven projects in this field aims at increasing the efficacy and efficiency of social initiatives, improving the way these actions help humanity in general and people in need in particular. This application field, however, poses its own barriers and challenges when developing data-driven projects, lagging behind in comparison with other scenarios. These challenges derive from aspects such as the scope and scale of the social issue to solve, cultural and political barriers, the skills of main stakeholders and the technological resources available, the motivation to be engaged in such projects, or the ethical and legal issues related to sensitive data. This paper analyzes the application of data projects in the field of social good, reviewing its current state and noteworthy initiatives, and presenting a framework covering the key aspects to analyze in such projects. The goal is to provide guidelines to understand the main challenges and opportunities for this type of data project, as well as identifying the main differential issues compared to “classical” data projects in general. A case study is presented on the initial steps and stakeholder analysis of a data project for the inclusion of refugees in the city of Frankfurt, Germany, in order to empirically confront the framework with a real example.

Keywords: data-driven projects, humanitarian operations, personal and sensitive data, social good, stakeholders analysis

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Authors: Abdulfatah A Raji

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This paper started with the definitions of literature, Arabic literature, transformation and went further to highlight the components of educational transformation. The general history of Arabic literature was discussed with focus on how it undergoes some transformations from pre-Islamic period through Quranic era, Abbasid literature to renaissance period in which the modernization of Arabic literature started in Egypt. It also traces the spread of Arabic literature in Nigeria from the pre-colonial era during the Kanuri rulers to Jihad of Usman Dan Fodio and the development of literature which manifested to the Teacher’s Colleges and Bayero University in Northern Nigeria. Also, the establishment of primary and post-primary schools by Muslim organizations in many cities and towns of the Western part of Nigeria. Literary criticism was also discussed in line with Arabic literature. Poetry work of eminent poets were cited to show its importance in line with educational transformation in Nigerian literature and lessons from the cited Arabic poetry works were also highlighted to include: motivation to behave well and to tolerate others, better spirits of interaction, love and co-existence among different sexes, religion etc. All these can help in developing a better educational transformation in Nigeria which can in turn help in how to conduct researches for national development. The paper recommended compulsory Arabic literature at all levels of the nations’ educational system as well as publication of Arabic books and journals to encourage peace in this era of conflicts and further transform Nigeria’s educational system for better.

Keywords: Arabic, literature, peace, development, Nigeria

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Authors: Joel A. Gordon, Nazmiye Balta-Ozkan, Seyed Ali Nabavi

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Hydrogen-fueled technologies are rapidly advancing as a critical component of the low-carbon energy transition. In countries historically reliant on natural gas for home heating, such as the UK, hydrogen may prove fundamental for decarbonizing the residential sector, alongside other technologies such as heat pumps and district heat networks. While the UK government is set to take a long-term policy decision on the role of domestic hydrogen by 2026, there are considerable uncertainties regarding consumer preferences for ‘hydrogen homes’ (i.e., hydrogen-fueled appliances for space heating, hot water, and cooking. In comparison to other hydrogen energy technologies, such as road transport applications, to date, few studies have engaged with the social acceptance aspects of the domestic hydrogen transition, resulting in a stark knowledge deficit and pronounced risk to policymaking efforts. In response, this study aims to safeguard against undesirable policy measures by revealing the underlying relationships between the factors of domestic hydrogen acceptance and their respective dimensions: attitudinal, socio-political, community, market, and behavioral acceptance. The study employs an online survey (n=~2100) to gauge how different UK householders perceive the proposition of switching from natural gas to hydrogen-fueled appliances. In addition to accounting for housing characteristics (i.e., housing tenure, property type and number of occupants per dwelling) and several other socio-structural variables (e.g. age, gender, and location), the study explores the impacts of consumer heterogeneity on hydrogen acceptance by recruiting respondents from across five distinct groups: (1) fuel poor householders, (2) technology engaged householders, (3) environmentally engaged householders, (4) technology and environmentally engaged householders, and (5) a baseline group (n=~700) which filters out each of the smaller targeted groups (n=~350). This research design reflects the notion that supporting a socially fair and efficient transition to hydrogen will require parallel engagement with potential early adopters and demographic groups impacted by fuel poverty while also accounting strongly for public attitudes towards net zero. Employing a second-order multigroup confirmatory factor analysis (CFA) in Mplus, the proposed hydrogen acceptance model is tested to fit the data through a partial least squares (PLS) approach. In addition to testing differences between and within groups, the findings provide policymakers with critical insights regarding the significance of knowledge and awareness, safety perceptions, perceived community impacts, cost factors, and trust in key actors and stakeholders as potential explanatory factors of hydrogen acceptance. Preliminary results suggest that knowledge and awareness of hydrogen are positively associated with support for domestic hydrogen at the household, community, and national levels. However, with the exception of technology and/or environmentally engaged citizens, much of the population remains unfamiliar with hydrogen and somewhat skeptical of its application in homes. Knowledge and awareness present as critical to facilitating positive safety perceptions, alongside higher levels of trust and more favorable expectations for community benefits, appliance performance, and potential cost savings. Based on these preliminary findings, policymakers should be put on red alert about diffusing hydrogen into the public consciousness in alignment with energy security, fuel poverty, and net-zero agendas.

Keywords: hydrogen homes, social acceptance, consumer heterogeneity, heat decarbonization

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Authors: V. Antevska, B. Dejanova, L. Todorovska, J. Pluncevic, E. Sivevska, S. Petrovska, S. Mancevska, I. Karagjozova

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Introduction: The aim of this study was to optimise the laboratory oxidative stress (OS) markers in soccer players. Material and methods: In a number of 37 soccer players (21±3 years old) and 25 control subjects (sedenters), plasma samples were taken for d-ROMs (reactive oxygen metabolites) and NO (nitric oxide) determination. The d-ROMs test was performed by measurement of hydroperoxide levels (Diacron, Italy). For NO determination the method of nitrate enzyme reduction with the Greiss reagent was used (OXIS, USA). The parameters were taken after the training of the soccer players and were compared with the control group. Training was considered as maximal exercise treadmill test. The criteria of maximum loading for each subject was established as >95% maximal heart rate. Results: The level of d-ROMs was found to be increased in the soccer players vs. control group but no significant difference was noticed. After the training d-ROMs in soccer players showed increased value of 299±44 UCarr (p<0.05). NO showed increased level in all soccer players vs. controls but significant difference was found after the training 102±29 μmol (p<0.05). Conclusion: Due to these results we may suggest that the measuring these OS markers in sport medicine may be useful for better estimation and evaluation of the training program. More oxidative stress should be used to clarify optimization of the training intensity program.

Keywords: oxidative stress markers, soccer players, training, sport

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Authors: Michelle C. S. Azevedo, Priscila M. Colavite, Carolina F. Francisconi, Ana P. Trombone, Gustavo P. Garlet

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VIP (vasoactive intestinal peptide) know as a potential protective factor in the view of its marked immunosuppressive properties. In this work, we investigated a possible association of VIP with the clinical status of experimental periapical granulomas and the association with expression markers in the lesions potentially associated with periapical lesions pathogenesis. C57BL/6WT mice were treated or not with recombinant VIP. Animals with active/progressive (N=40), inactive/stable (N=70) periapical granulomas and controls (N=50) were anesthetized and the right mandibular first molar was surgically opened, allowing exposure of dental pulp. Endodontic pathogenic bacterial strains were inoculated: Porphyromonas gingivalis, Prevotella nigrescens, Actinomyces viscosus, and Fusobacterium nucleatum subsp. polymorphum. The cavity was not sealed after bacterial inoculation. During lesion development, animals were treated or not with recombinant VIP 3 days post infection. Animals were killed after 3, 7, 14, and 21 days of infection and the jaws were dissected. The extraction of total RNA from periodontal tissues was performed and the integrity of samples was checked. qPCR reaction using TaqMan chemistry with inventoried primers were performed in ViiA7 equipment. The results, depicted as the relative levels of gene expression, were calculated in reference to GAPDH and β-actin expression. Periodontal tissues from upper molars were vested and incubated supplemented RPMI, followed by processing with 0.05% DNase. Cell viability and couting were determined by Neubauer chamber analysis. For flow cytometry analysis, after cell counting the cells were stained with the optimal dilution of each antibody; (PE)-conjugated and (FITC)-conjugated antibodies against CD4, CD25, FOXP3, IL-4, IL-17 and IFN-γ antibodies, as well their respective isotype controls. Cells were analyzed by FACScan and CellQuest software. Results are presented as the number of cells in the periodontal tissues or the number of positive cells for each marker in the CD4+FOXp3+, CD4+IL-4+, CD4+IFNg+ and CD4+IL-17+ subpopulations. The levels mRNA were measured by qPCR. The VIP expression was predominated in inactive lesions, as well part of the clusters of cytokine/Th markers identified as protective factors and a negative correlation between VIP expression and lesion evolution was observed. A quantitative analysis of IL1β, IL17, TNF, IFN, MMP2, RANKL, OPG, IL10, TGFβ, CTLA4, COL5A1, CTGF, CXCL11, FGF7, ITGA4, ITGA5, SERP1 and VTN expression was measured in experimental periapical lesions treated with VIP 7 and 14 days after lesion induction and healthy animals. After 7 days, all targets presented a significate increase in comparison to untreated animals. About migration kinetics, profile of chemokine receptors expression of TCD4+ subsets and phenotypic analysis of Tregs, Th1, Th2 and Th17 cells during the course of experimental periodontal disease evaluated by flow cytometry and depicted as the number of positive cells for each marker. CD4+IFNg+ and CD4+FOXp3+ cells migration were significate increased 7 days post VIP treatment. CD4+IL17+ cells migration were significate increased 7 and 14 days post VIP treatment, CD4+IL4+ cells migration were significate increased 14 and 21 days post VIP treatment compared to the control group. In conclusion, our experimental data support VIP involvement in determining the inactivity of periapical lesions. Financial support: FAPESP #2015/25618-2.

Keywords: chronic inflammation, cytokines, osteolytic lesions, VIP (Vasoactive Intestinal Peptide)

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