Search results for: exploratory factors analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 33850

Search results for: exploratory factors analysis

26920 Enhancing Inservice Education Training Effectiveness Using a Mobile Based E-Learning Model

Authors: Richard Patrick Kabuye

Abstract:

This study focuses on the addressing the enhancement of in-service training programs as a tool of transforming the existing traditional approaches of formal lectures/contact hours. This will be supported with a more versatile, robust, and remotely accessible means of mobile based e-learning, as a support tool for the traditional means. A combination of various factors in education and incorporation of the eLearning strategy proves to be a key factor in effective in-service education. Key factor needs to be factored in so as to maintain a credible co-existence of the programs, with the prevailing social, economic and political environments. Effective in-service education focuses on having immediate transformation of knowledge into practice for a good time period, active participation of attendees, enable before training planning, in training assessment and post training feedback training analysis which will yield knowledge to the trainers of the applicability of knowledge given out. All the above require a more robust approach to attain success in implementation. Incorporating mobile technology in eLearning will enable the above to be factored together in a more coherent manner, as it is evident that participants have to take time off their duties and attend to these training programs. Making it mobile, will save a lot of time since participants would be in position to follow certain modules while away from lecture rooms, get continuous program updates after completing the program, send feedback to instructors on knowledge gaps, and a wholly conclusive evaluation of the entire program on a learn as you work platform. This study will follow both qualitative and quantitative approaches in data collection, and this will be compounded incorporating a mobile eLearning application using Android.

Keywords: in service, training, mobile, e- learning, model

Procedia PDF Downloads 203
26919 A Multidimensional Exploration of Narcissistic Personality Disorder Through Psycholinguistic Analysis and Neuroscientific Correlates

Authors: Dalia Elleuch

Abstract:

Narcissistic Personality Disorder (NPD) manifests as a personality disorder marked by inflated self-importance, heightened sensitivity to criticism, a lack of empathy, a preoccupation with appearance over substance, and features such as arrogance, grandiosity, a constant need for admiration, a tendency to exploit others, and an inclination towards demanding special treatment due to a sense of excessive entitlement (APA, 2013). This interdisciplinary study delves into NPD through the systematic synthesis of psycholinguistic analysis and neuroscientific correlates. The cognitive and emotional dimensions of NPD reveal linguistic patterns, including grandiosity, entitlement, and manipulative communication. Neuroscientific investigations reveal structural brain differences and alterations in functional connectivity, further explaining the neural underpinnings of social cognition deficits observed in individuals with NPD. Genetic predispositions and neurotransmitter imbalances add a layer of complexity to the understanding of NPD. The necessity for linguistic intervention in diagnosing and treating Narcissistic Personality Disorder is underscored by an interdisciplinary study that intricately synthesizes psycholinguistic analysis and neuroscientific correlates, offering a comprehensive understanding of NPD’s cognitive, emotional, and neural dimensions and paving the way for future practical, theoretical, and pedagogical approaches to address the complexities of this personality disorder.

Keywords: Narcissistic Personality Disorder (NPD), psycholinguistic analysis, neuroscientific correlates, interpersonal dysfunction, cognitive empathy

Procedia PDF Downloads 43
26918 Customer’s Choice of a Bank: An Empirical Enquiry from the Banked Ghanaian

Authors: Emmanuel Larbi Offei, Felix Agyei-Sasu, Maura Naa Densua Ashong

Abstract:

Ghana has 26 universal banks and several banking and non-banking financial institutions operating in the country. The growing number of banks has heightened competition among banks to attract and retain customers more customers to ensure sustainability. Hence the need to identify and understand factors that influences customers’ choice of banks cannot be overemphasised. This study investigates the determinants of bank selection criteria by banking customers in Ghana. Four banks were purposively sampled for this study namely Barclays, Standard Chartered, Sahel Sahara and Unibank. Convenience sampling was then used to select 114 bank customers in Accra and interviewed. Questionnaires were used to collect data that were analysed in tables and charts with the use of STATA software. The findings of the study revealed that quick/prompt services and complaint handling, safety of funds, networked branches, easy access to functional Automated Teller Machines (ATMs) and low/moderate service charges were the major determinants of customers’ choice of banks. The results further show that 89.5 percent of all deposits are held in either current or savings accounts. About 22.1 percent of the respondents indicated that they have plans of changing their banks in the near future because they are not satisfied with their banks. A gender analysis of the choice criteria showed differences between the choice criteria of the male as compared to the female. The study recommends that banks in Ghana should focus on products and policies that will not compromise on the safety of funds of their customers. Again, banks must address customer complaints and dissatisfactions as promptly as possible by taking pragmatic steps to address administrative bureaucracies and infrastructural challenges that prolong the duration of banking transactions.

Keywords: Ghana, banks, determinants, customers’ choice, competition

Procedia PDF Downloads 423
26917 Modeling the Acquisition of Expertise in a Sequential Decision-Making Task

Authors: Cristóbal Moënne-Loccoz, Rodrigo C. Vergara, Vladimir López, Domingo Mery, Diego Cosmelli

Abstract:

Our daily interaction with computational interfaces is plagued of situations in which we go from inexperienced users to experts through self-motivated exploration of the same task. In many of these interactions, we must learn to find our way through a sequence of decisions and actions before obtaining the desired result. For instance, when drawing cash from an ATM machine, choices are presented in a step-by-step fashion so that a specific sequence of actions must be performed in order to produce the expected outcome. But, as they become experts in the use of such interfaces, do users adopt specific search and learning strategies? Moreover, if so, can we use this information to follow the process of expertise development and, eventually, predict future actions? This would be a critical step towards building truly adaptive interfaces that can facilitate interaction at different moments of the learning curve. Furthermore, it could provide a window into potential mechanisms underlying decision-making behavior in real world scenarios. Here we tackle this question using a simple game interface that instantiates a 4-level binary decision tree (BDT) sequential decision-making task. Participants have to explore the interface and discover an underlying concept-icon mapping in order to complete the game. We develop a Hidden Markov Model (HMM)-based approach whereby a set of stereotyped, hierarchically related search behaviors act as hidden states. Using this model, we are able to track the decision-making process as participants explore, learn and develop expertise in the use of the interface. Our results show that partitioning the problem space into such stereotyped strategies is sufficient to capture a host of exploratory and learning behaviors. Moreover, using the modular architecture of stereotyped strategies as a Mixture of Experts, we are able to simultaneously ask the experts about the user's most probable future actions. We show that for those participants that learn the task, it becomes possible to predict their next decision, above chance, approximately halfway through the game. Our long-term goal is, on the basis of a better understanding of real-world decision-making processes, to inform the construction of interfaces that can establish dynamic conversations with their users in order to facilitate the development of expertise.

Keywords: behavioral modeling, expertise acquisition, hidden markov models, sequential decision-making

Procedia PDF Downloads 242
26916 lncRNA Gene Expression Profiling Analysis by TCGA RNA-Seq Data of Breast Cancer

Authors: Xiaoping Su, Gabriel G. Malouf

Abstract:

Introduction: Breast cancer is a heterogeneous disease that can be classified in 4 subgroups using transcriptional profiling. The role of lncRNA expression in human breast cancer biology, prognosis, and molecular classification remains unknown. Methods and results: Using an integrative comprehensive analysis of lncRNA, mRNA and DNA methylation in 900 breast cancer patients from The Cancer Genome Atlas (TCGA) project, we unraveled the molecular portraits of 1,700 expressed lncRNA. Some of those lncRNAs (i.e, HOTAIR) are previously reported and others are novel (i.e, HOTAIRM1, MAPT-AS1). The lncRNA classification correlated well with the PAM50 classification for basal-like, Her-2 enriched and luminal B subgroups, in contrast to the luminal A subgroup which behaved differently. Importantly, estrogen receptor (ESR1) expression was associated with distinct lncRNA networks in lncRNA clusters III and IV. Gene set enrichment analysis for cis- and trans-acting lncRNA showed enrichment for breast cancer signatures driven by breast cancer master regulators. Almost two third of those lncRNA were marked by enhancer chromatin modifications (i.e., H3K27ac), suggesting that lncRNA expression may result in increased activity of neighboring genes. Differential analysis of gene expression profiling data showed that lncRNA HOTAIRM1 was significantly down-regulated in basal-like subtype, and DNA methylation profiling data showed that lncRNA HOTAIRM1 was highly methylated in basal-like subtype. Thus, our integrative analysis of gene expression and DNA methylation strongly suggested that lncRNA HOTAIRM1 should be a tumor suppressor in basal-like subtype. Conclusion and significance: Our study depicts the first lncRNA molecular portrait of breast cancer and shows that lncRNA HOTAIRM1 might be a novel tumor suppressor.

Keywords: lncRNA profiling, breast cancer, HOTAIRM1, tumor suppressor

Procedia PDF Downloads 91
26915 Major Sucking Pests of Rose and Their Seasonal Abundance in Bangladesh

Authors: Md Ruhul Amin

Abstract:

This study was conducted in the experimental field of the Department of Entomology, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Bangladesh during November 2017 to May 2018 with a view to understanding the seasonal abundance of the major sucking pests namely thrips, aphid and red spider mite on rose. The findings showed that the thrips started to build up their population from the middle of January with abundance 1.0 leaf⁻¹, increased continuously, reached to the peak level (2.6 leaf⁻¹) in the middle of February and then declined. Aphid started to build up their population from the second week of November with abundance 6.0 leaf⁻¹, increased continuously, reached to the peak level (8.4 leaf⁻¹) in the last week of December and then declined. Mite started to build up their population from the first week of December with abundance 0.8 leaf⁻¹, increased continuously, reached to the peak level (8.2 leaf⁻¹) in the second week of March and then declined. Thrips and mite prevailed until the last week of April, and aphid showed their abundance till last week of May. The daily mean temperature, relative humidity, and rainfall had an insignificant negative correlation with thrips and significant negative correlation with aphid abundance. The daily mean temperature had significant positive, relative humidity had an insignificant positive, and rainfall had an insignificant negative correlation with mite abundance. The multiple linear regression analysis showed that the weather parameters together contributed 38.1, 41.0 and 8.9% abundance on thrips, aphid and mite on rose, respectively and the equations were insignificant.

Keywords: aphid, mite, thrips, weather factors

Procedia PDF Downloads 150
26914 Black Protests in Poland: Analysis of Women's Movement in Poland, 2016-2018

Authors: Aneta Ostaszewska

Abstract:

The purpose of this research is to reflect on 'black protests' of women in Poland. 'Black protests' have been organized nationwide since October 2016 as a sign of opposition and resistance to anti-women government’s policy and its attempts to exacerbate abortion law. Women protest not only in the biggest cities (Warsaw, Cracow or Wroclaw) but in over 140 towns and villages all over Poland. The research represents qualitative methodological approach – an active research method. It has involved the observation, description, and analysis of 'black protests' carried out mainly in Warsaw (the capital of Poland). The focus has been on behavior and attitudes of protesting women: protesters’ slogans, statements, and views, the ways of dressing up, ways of participating and involvement in protests. Research also involves the analysis of social media discourse: the analysis of content published by women on social media. Black protests are an example of a grassroots social initiative of women in Poland. What unites women is opposition to government policy. The primary space of communication has become the Internet – especially social media (Facebook). A new social movement 'Dziewuchy dziewuchom' (Girls for girls) has been born as well as organization of 'Ogolnopolski Strajk Kobiet' (Nationwide women's strike) as a result of 'black protest'. These protests and marches became a way of emphasizing women’s subjectivity as well as political and civic activity.

Keywords: women, black protests, communitas, experience, Poland, abortion law

Procedia PDF Downloads 365
26913 The Evaluation of the Effects of Atypical Antipsychotics on Sperm Quality by Computer-Assisted Sperm Analysis in Rats

Authors: O. Atli Eklioglu

Abstract:

Atypical antipsychotics such as quetiapine, olanzapine, and risperidone have been frequently and chronically used to treat psychiatric disorders accompanied by psychosis mainly schizophrenia. Since these drugs are commonly used in male patients of reproductive age, it is required to determine the possible effects of them on the reproductive system. In this study, it was aimed to evaluate the possible toxic effects of quetiapine, olanzapine and risperidone, which are the most frequently prescribed and chronically used psychiatric drugs, on sperm parameters. For this purpose, quetiapine (10, 20 and 40 mg/kg), olanzapine (2.5, 5 and 10 mg/kg), and risperidone (1.25, 2.5 and 3 mg/kg) were administered to male rats for 28 consecutive days. At the end of this period, sperm concentration, motility, and morphology were investigated by a computer-assisted sperm analysis system. According to the results, sperm parameters were negatively affected by antipsychotic use.

Keywords: quetiapine, olanzapine, risperidone, sperm count, motility, sperm morphology, computer-assisted sperm analysis

Procedia PDF Downloads 137
26912 The Mitigation Strategy Analysis of Kuosheng Nuclear Power Plant Spent Fuel Pool Using MELCOR2.1/SNAP

Authors: Y. Chiang, J. R. Wang, J. H. Yang, Y. S. Tseng, C. Shih, S. W. Chen

Abstract:

Kuosheng nuclear power plant (NPP) is a BWR/6 plant in Taiwan. There is more concern for the safety of Spent Fuel Pools (SFPs) in Taiwan after Fukushima event. In order to estimate the safety of Kuosheng NPP SFP, by using MELCOR2.1 and SNAP, the safety analysis of Kuosheng NPP SFP was performed combined with the mitigation strategy of NEI 06-12 report. There were several steps in this research. First, the Kuosheng NPP SFP models were established by MELCOR2.1/SNAP. Second, the Station Blackout (SBO) analysis of Kuosheng SFP was done by TRACE and MELCOR under the cooling system failure condition. The results showed that the calculations of MELCOR and TRACE were very similar in this case. Second, the mitigation strategy analysis was done with the MELCOR model by following the NEI 06-12 report. The results showed the effectiveness of NEI 06-12 strategy in Kuosheng NPP SFP. Finally, a sensitivity study of SFP quenching was done to check the differences of different water injection time and the phenomena during the quenching. The results showed that if the cladding temperature was over 1600 K, the water injection may have chance to cause the accident more severe with more hydrogen generation. It was because of the oxidation heat and the “Breakaway” effect of the zirconium-water reaction. An animation model built by SNAP was also shown in this study.

Keywords: MELCOR, SNAP, spent fuel pool, quenching

Procedia PDF Downloads 347
26911 Investigation of Input Energy Efficiency in Corn (KSC704) Farming in Khoy City, Iran

Authors: Nasser Hosseini

Abstract:

Energy cycle is one of the essential points in agricultural ecosystems all over the world. Corn is one of the important products in Khoy city. Knowing input energy level and evaluating output energy from farms to reduce energy and increase efficiency in farms is very important if one can reduce input energy level into farms through the indices like poisons, fertilization, tractor energy and labour force. In addition to the net income of the farmers, this issue would play a significant role in preserving farm ecosystem from pollution and wrecker factors. For this reason, energy balance sheet in corn farms as well as input and output energy in 2012-2013 were researched by distributing a questionnaire among farmers in various villages in Khoy city. Then, the input energy amount into farms via energy-consuming factors, mentioned above, with regard to special coefficients was computed. Energy was computed on the basis of seed corn function, chemical compound and its content as well. In this investigation, we evaluated the level of stored energy 10792831 kcal per hectare. We found out that the greatest part of energy depended on irrigation which has 5136141.8 kcal and nitrate fertilizer energy with 2509760 kcal and the lowest part of energy depended on phosphor fertilizer, the rate of posited energy equaled 36362500 kcal and energy efficiency on the basis of seed corn function were estimated as 3.36. We found some ways to reduce consumptive energy in farm and nitrate fertilizer and, on the other hand, to increase balance sheet. They are, to name a few, using alternative farming and potherbs for biological stabilizing of nitrogen and changing kind of fertilizers such as urea fertilizer with sulphur cover, and using new generation of irrigation, the compound of water super absorbent like colored hydrogels and using natural fertilizer to preserve.

Keywords: corn (KSC704), output and input, energy efficiency, Khoy city

Procedia PDF Downloads 425
26910 Challenges and Success Factors in Introducing Information Systems for Students' Online Registration

Authors: Stanley Fore, Sharon Chipeperekwa

Abstract:

The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.

Keywords: online registration, information systems, University of Technology, end-users

Procedia PDF Downloads 234
26909 Air Pollution on Stroke in Shenzhen, China: A Time-Stratified Case Crossover Study Modified by Meteorological Variables

Authors: Lei Li, Ping Yin, Haneen Khreis

Abstract:

Stroke is the second leading cause of death and a third leading cause of death and disability worldwide in 2019. Given the significant role of environmental factors in stroke development and progression, it is essential to investigate the effect of air pollution on stroke occurrence while considering the modifying effects of meteorological variables. This study aimed to evaluate the association between short-term exposure to air pollution and the incidence of stroke subtypes in Shenzhen, China, and to explore the potential interactions of meteorological factors with air pollutants. The study analyzed data from January 1, 2006, to December 31, 2014, including 88,214 cases of ischemic stroke and 30,433 cases of hemorrhagic stroke among residents of Shenzhen. Using a time-stratified case–crossover design with conditional quasi-Poisson regression, the study estimated the percentage changes in stroke morbidity associated with short-term exposure to nitrogen dioxide (NO₂), sulfur dioxide (SO₂), particulate matter less than 10 mm in aerodynamic diameter (PM10), carbon monoxide (CO), and ozone (O₃). A five-day moving average of air pollution was applied to capture the cumulative effects of air pollution. The estimates were further stratified by sex, age, education level, and season. The additive and multiplicative interaction between air pollutants and meteorologic variables were assessed by the relative excess risk due to interaction (RERI) and adding the interactive term into the main model, respectively. The study found that NO₂ was positively associated with ischemic stroke occurrence throughout the year and in the cold season (November through April), with a stronger effect observed among men. Each 10 μg/m³ increment in the five-day moving average of NO₂ was associated with a 2.38% (95% confidence interval was 1.36% to 3.41%) increase in the risk of ischemic stroke over the whole year and a 3.36% (2.04% to 4.69%) increase in the cold season. The harmful effect of CO on ischemic stroke was observed only in the cold season, with each 1 mg/m³ increment in the five-day moving average of CO increasing the risk by 12.34% (3.85% to 21.51%). There was no statistically significant additive interaction between individual air pollutants and temperature or relative humidity, as demonstrated by the RERI. The interaction term in the model showed a multiplicative antagonistic effect between NO₂ and temperature (p-value=0.0268). For hemorrhagic stroke, no evidence of the effects of any individual air pollutants was found in the whole population. However, the RERI indicated a statistically additive and multiplicative interaction of temperature on the effects of PM10 and O₃ on hemorrhagic stroke onset. Therefore, the insignificant conclusion should be interpreted with caution. The study suggests that environmental NO₂ and CO might increase the morbidity of ischemic stroke, particularly during the cold season. These findings could help inform policy decisions aimed at reducing air pollution levels to prevent stroke and other health conditions. Additionally, the study provides valuable insights into the interaction between air pollution and meteorological variables, which underscores the need for further research into the complex relationship between environmental factors and health.

Keywords: air pollution, meteorological variables, interactive effect, seasonal pattern, stroke

Procedia PDF Downloads 71
26908 Tibial Hemimelia Type VIIa: A Case Report

Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

Abstract:

Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

Procedia PDF Downloads 145
26907 An Analysis of the Causes of SMEs Failure in Developing Countries: The Case of South Africa

Authors: Paul Saah, Charles Mbohwa, Nelson Sizwe Madonsela

Abstract:

In the context of developing countries, this study explores a crucial component of economic development by examining the reasons behind the failure of small and medium-sized enterprises (SMEs). SMEs are acknowledged as essential drivers of economic expansion, job creation, and poverty alleviation in emerging countries. This research uses South Africa as a case study to evaluate the reasons why SMEs fail in developing nations. This study explores a quantitative research methodology to investigate the complex causes of SME failures using statistical tools and reliability tests. To ensure the viability of data collection, a sample size of 400 small business owners was chosen using a non-probability selection technique. A closed-ended questionnaire was the primary technique used to obtain detailed information from the participants. Data was analysed and interpreted using computer software packages such as the Statistical Package for the Social Sciences (SPSS). According to the findings, the main reasons why SMEs fail in developing nations are a lack of strategic business planning, a lack of funding, poor management, a lack of innovation, a lack of business research and a low level of education and training. The results of this study show that SMEs can be sustainable and successful as long as they comprehend and use the suggested small business success determining variables into their daily operations. This implies that the more SMEs in developing countries implement the proposed determinant factors of small business success in their business operations the more the businesses are likely to succeed and vice versa.

Keywords: failure, developing countries, SMEs, economic development, South Africa

Procedia PDF Downloads 58
26906 Influence of Genetic Counseling in Family Dynamics in Patients with Deafness in Merida, Yucatán, Mexico

Authors: Damaris Estrella Castillo, Zacil ha Vilchis Zapata, Leydi Peraza Gómez

Abstract:

Hearing loss is an etiologically heterogeneous condition, where almost 60% is genetic in origin, 20% is due to environmental factors, and 20% have unknown causes. However, it is now known that the gene, GJB2, which encodes the connexin 26 protein, accounts for a large percentage of non-syndromic genetic hearing loss, and variants in this gene have been identified to be a common cause of hereditary hearing loss in many populations. The literature reports that the etiology in deafness helps improve family functioning but low-income countries this is difficult. Therefore, it is difficult to contribute the right of families to know about the genetic risk in future pregnancies as well as determining the certainty of being a carrier or affected. In order to assess the impact of genetic counseling and the functionality, 100 families with at least one child with profound hearing loss, were evaluated by specialists in audiology, clinical genetics and psychology. Targeted mutation analysis for one of the two known large deletions of upstream of GJB2/GJB6 gene (35delG; and including GJB2 regulatory sequences and GJB6) were performed in patients with diagnosis of non-syndromic hearing loss. Genetic counseling was given to all parents and primary caregivers, and APGAR family test was applied before and after the counseling. We analyzed a total of 300 members (children, parents) to determine the presence of the GJB2 gene mutation. Twelve patients (carriers and affected) were positive for the mutation, from 5 different families. The subsequent family APGAR testing and genetic counseling, showed that 14% perceived their families as functional, 62 % and 24 % moderately functional dysfunctional. This shows the importance of genetic counseling in the perception of family function that can directly impact the quality of life of these families.

Keywords: family dynamics, deafness, APGAR, counseling

Procedia PDF Downloads 636
26905 Association Between Advanced Parental Age and Implantation Failure: A Prospective Cohort Study in Anhui, China

Authors: Jiaqian Yin, Ruoling Chen, David Churchill, Huijuan Zou, Peipei Guo, Chunmei Liang, Xiaoqing Peng, Zhikang Zhang, Weiju Zhou, Yunxia Cao

Abstract:

Purpose: This study aimed to explore the interaction of male and female age on implantation failure from in vitro fertilisation (IVF)/ intracytoplasmic sperm injection (ICSI) treatments in couples following their first cycles using the Anhui Maternal-Child Health Study (AMCHS). Methods: The AMCHS recruited 2042 infertile couples who were physically fit for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment at the Reproductive Centre of the First Affiliated Hospital of Anhui Medical University between May 2017 to April 2021. This prospective cohort study analysed the data from 1910 cohort couples for the current paper data analysis. The multivariate logistic regression model was used to identify the effect of male and female age on implantation failure after controlling for confounding factors. Male age and female age were examined as continuous and categorical (male age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40; female age: 20-<25, 25-<30, 30-<35, 35-<40, ≥40) predictors. Results: Logistic regression indicated that advanced maternal age was associated with increased implantation failure (P<0.001). There was evidence of an interaction between maternal age (30-<35 and ≥ 35) and paternal age (≥35) on implantation failure. (p<0.05). Only when the male was ≥35 years of increased maternal age was associated with the risk of implantation failure. Conclusion: In conclusion, there was an additive effect on implantation failure with advanced parental age. The impact of advanced maternal age was only seen in the older paternal age group. The delay of childbearing in both men and women will be a serious public issue that may contribute to a higher risk of implantation failure in patients needing assisted reproductive technology (ART).

Keywords: parental age, infertility, cohort study, IVF

Procedia PDF Downloads 134
26904 Numerical Analysis of Cold-Formed Steel Shear Wall Panels Subjected to Cyclic Loading

Authors: H. Meddah, M. Berediaf-Bourahla, B. El-Djouzi, N. Bourahla

Abstract:

Shear walls made of cold formed steel are used as lateral force resisting components in residential and low-rise commercial and industrial constructions. The seismic design analysis of such structures is often complex due to the slenderness of members and their instability prevalence. In this context, a simplified modeling technique across the panel is proposed by using the finite element method. The approach is based on idealizing the whole panel by a nonlinear shear link element which reflects its shear behavior connected to rigid body elements which transmit the forces to the end elements (studs) that resist the tension and the compression. The numerical model of the shear wall panel was subjected to cyclic loads in order to evaluate the seismic performance of the structure in terms of lateral displacement and energy dissipation capacity. In order to validate this model, the numerical results were compared with those from literature tests. This modeling technique is particularly useful for the design of cold formed steel structures where the shear forces in each panel and the axial forces in the studs can be obtained using spectrum analysis.

Keywords: cold-formed steel, cyclic loading, modeling technique, nonlinear analysis, shear wall panel

Procedia PDF Downloads 279
26903 A Content Analysis of Us Media Framing of Conflict: Effects on Global Journalism and Its Social Consequences

Authors: Lee Artz

Abstract:

This presentation outlines US media frames of recent interventions in Iraq, Afghanistan, and Syria and their impact on global media and public discourse. A content analysis of sources, descriptors, and contexts of leading US media (AP, New York Times, Fox News) finds that news coverage highlights terrorism, justifies military action, and downplays the human costs. These media frames that normalize intervention also omit coverage of the environmental consequences of war, with scant or no reporting on pollution, destruction and contamination of agricultural infrastructures and the difficulty of any environmentally sustainable recovery. A content analysis of leading European and Middle East media (Daily Mail, Le Monde, Deutsch Welle, Al Jazeera) indicates that they have adopted the same reporting practices, frames, and techniques resulting in a hybrid, yet homogeneous, increasingly global news environment that does a disservice to the public interest and democracy.

Keywords: conflict, environment, media framing, public interest

Procedia PDF Downloads 181
26902 Family Quality of Life in the Context of Pediatric Sickle Cell Disease in Oman

Authors: Wafa Al Jabri

Abstract:

Sickle cell disease (SCD) is a genetic blood disorder that is characterized by a severe painful crisis. SCD among children requires long term dependencies and high caregiving demands that increase the overall family burdens. It is, therefore, essential to examine, support, and promote the well-being of families of children with SCD. Although there has been considerable progress in the international research on family quality of life (FQOL) in recent years; however, research in this field is relatively recent and diverse. Oman is a country in which family quality of life has definitely been under-researched. Therefore, the purpose of the study is to describe the FQOL in families of children with SCD in Oman. The study will also examine the relationships between child, mother, and family-related factors that may influence the overall FQOL. Theoretical Framework: The study is guided by the unified theory of family quality of life to help in understanding the concept of FQOL and the factors that shape it. Method:A convenience sample of 98 mothers of children with SCD will be recruited from the pediatric hematology clinic at Sultan Qaboos University Hospital in Oman to participate in this descriptive, cross sectional, correlational study. Data will be obtained using a self-administered questionnaire that includes child and mother socio-demographic data, questions about the number of visits and admissions to health care facilities for vaso- occlusive crises (VOCs), the Perceived Stress Scale-10, and the Beachcenter-FQOL scale. Anticipated Results: It is expected to find an association among frequency of VOCs, mother’s perceived stress level, and FQOL in families of children with SCD in Oman. Family type, socio-economic status, and number of SCD children in the family are also expected to influence the overall FQOL. Conclusion: The findings of the study might be pivotal in designing and implementing tailored family-based interventions to improve families’ wellbeing.

Keywords: family quality of life, sickle cell disaes, children, family well-being

Procedia PDF Downloads 120
26901 Factor Influencing Pharmacist Engagement and Turnover Intention in Thai Community Pharmacist: A Structural Equation Modelling Approach

Authors: T. Nakpun, T. Kanjanarach, T. Kittisopee

Abstract:

Turnover of community pharmacist can affect continuity of patient care and most importantly the quality of care and also the costs of a pharmacy. It was hypothesized that organizational resources, job characteristics, and social supports had direct effect on pharmacist turnover intention, and indirect effect on pharmacist turnover intention via pharmacist engagement. This research aimed to study influencing factors on pharmacist engagement and pharmacist turnover intention by testing the proposed structural hypothesized model to explain the relationship among organizational resources, job characteristics, and social supports that effect on pharmacist turnover intention and pharmacist engagement in Thai community pharmacists. A cross sectional study design with self-administered questionnaire was conducted in 209 Thai community pharmacists. Data were analyzed using Structural Equation Modeling technique with analysis of a moment structures AMOS program. The final model showed that only organizational resources had significant negative direct effect on pharmacist turnover intention (β =-0.45). Job characteristics and social supports had significant positive relationship with pharmacist engagement (β = 0.44, and 0.55 respectively). Pharmacist engagement had significant negative relationship with pharmacist turnover intention (β = - 0.24). Thus, job characteristics and social supports had significant negative indirect effect on turnover intention via pharmacist engagement (β =-0.11 and -0.13, respectively). The model fit the data well (χ2/ degree of freedom (DF) = 2.12, the goodness of fit index (GFI)=0.89, comparative fit index (CFI) = 0.94 and root mean square error of approximation (RMSEA) = 0.07). This study can be concluded that organizational resources were the most important factor because it had direct effect on pharmacist turnover intention. Job characteristics and social supports were also help decrease pharmacist turnover intention via pharmacist engagement.

Keywords: community pharmacist, influencing factor, turnover intention, work engagement

Procedia PDF Downloads 184
26900 English Learning Motivation in Communicative Competence

Authors: Sebastianus Menggo

Abstract:

The aim of communicative language teaching is to enable learners to communicate in the target language. Each learner is required to perform the micro and macro components in each utterance produced. Utterances produced must be in line with the understanding of competence and performance of each speaker. These are inter-depended. Competence and performance are obliged to be appeared proportionally in creating the utterances. The representative of competence and performance reflects the linguistics identity of a speaker in providing sentences in each certain language community. Each lexicon spoken may lead that interlocutor in comprehending the intentions utterances given. However proportional performance of both components in an utterance needed to be further elaborated. Finding appropriate gap between competence and performance components in a communicative competence must be supported positive response given by the learners.The learners’ inability to keep communicative competence proportionally is caused by inside and outside factors. The inside factors are certain lacks such as lack of self-confidence and lack of motivation which could make students feel ashamed to produce utterances, scared to make mistakes, and have no enough confidence. Knowing learner’s English learning motivation is an urgent variable to be considered in creating conducive atmosphere classroom which will raise the learners to do more toward the achievement of communicative competence. Meanwhile, the outside factor is related with the teacher. The teacher should be able to recognize the students’ problem in creating conducive atmosphere in the classroom that will raise the students’ ability to be an English speaker qualified. Moreover, the aim of this research is to know and describe the English learning motivation affecting students’ communicative competence of 48 students of XI grade of science program at catholic senior of Saint Ignasius Loyola Labuan Bajo, West Flores, Indonesia. Correlation design with purposive procedure applied in this research. Data were collected through questionnaire, interview, and students’ speaking achievement document. Result shows the description of motivation significantly affecting students’ communicative competence.

Keywords: communicative, competence, English, learning, motivation

Procedia PDF Downloads 183
26899 Environment Patterns and Mental Health of Older Adults in Long-Term Care Facilities: The Role of Activity Profiles

Authors: Shiau-Fang Chao, Yu-Chih Chen

Abstract:

Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.

Keywords: activity, environment, mental health, older LTC residents

Procedia PDF Downloads 173
26898 Variable Mapping: From Bibliometrics to Implications

Authors: Przemysław Tomczyk, Dagmara Plata-Alf, Piotr Kwiatek

Abstract:

Literature review is indispensable in research. One of the key techniques used in it is bibliometric analysis, where one of the methods is science mapping. The classic approach that dominates today in this area consists of mapping areas, keywords, terms, authors, or citations. This approach is also used in relation to the review of literature in the field of marketing. The development of technology has resulted in the fact that researchers and practitioners use the capabilities of software available on the market for this purpose. The use of science mapping software tools (e.g., VOSviewer, SciMAT, Pajek) in recent publications involves the implementation of a literature review, and it is useful in areas with a relatively high number of publications. Despite this well-grounded science mapping approach having been applied in the literature reviews, performing them is a painstaking task, especially if authors would like to draw precise conclusions about the studied literature and uncover potential research gaps. The aim of this article is to identify to what extent a new approach to science mapping, variable mapping, takes advantage of the classic science mapping approach in terms of research problem formulation and content/thematic analysis for literature reviews. To perform the analysis, a set of 5 articles on customer ideation was chosen. Next, the analysis of key words mapping results in VOSviewer science mapping software was performed and compared with the variable map prepared manually on the same articles. Seven independent expert judges (management scientists on different levels of expertise) assessed the usability of both the stage of formulating, the research problem, and content/thematic analysis. The results show the advantage of variable mapping in the formulation of the research problem and thematic/content analysis. First, the ability to identify a research gap is clearly visible due to the transparent and comprehensive analysis of the relationships between the variables, not only keywords. Second, the analysis of relationships between variables enables the creation of a story with an indication of the directions of relationships between variables. Demonstrating the advantage of the new approach over the classic one may be a significant step towards developing a new approach to the synthesis of literature and its reviews. Variable mapping seems to allow scientists to build clear and effective models presenting the scientific achievements of a chosen research area in one simple map. Additionally, the development of the software enabling the automation of the variable mapping process on large data sets may be a breakthrough change in the field of conducting literature research.

Keywords: bibliometrics, literature review, science mapping, variable mapping

Procedia PDF Downloads 98
26897 An Exploratory Study on the Level of Awareness and Common Barriers of Physicians on Overweight and Obesity Management in Bangladesh

Authors: Kamrun Nahar Koly, Saimul Islam

Abstract:

Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.

Keywords: obesity management, physician, awareness, barriers, Bangladesh

Procedia PDF Downloads 154
26896 Securing Communities to Bring Sustainable Development, Building Peace and Community Safety: the Ethiopian Community Policing in Amhara National Regional State of Ethiopia

Authors: Demelash Kassaye

Abstract:

The Ethiopia case study reveals a unique model of community policing that has developed from a particular political context in which there is a history of violent political transition, a political structure characterized by ethnic federalism and a political ideology that straddles liberal capitalism and democracy on the one hand, and state-led development and centralized control on the other. The police see community policing as a way to reduce crime. Communities speak about community policing as an opportunity to take on policing responsibilities themselves. Both of these objectives are brought together in an overarching rhetoric of community policing as a way of ‘mobilizing for development’ – whereby the community cooperate with the police to reduce crime, which otherwise inhibits development progress. Community policing in Amhara has primarily involved the placement of Community Police Officers at the kebele level across the State. In addition, a number of structures have also been established in the community, including Advisory Councils, Conflict Resolving Committees, family police and the use of shoe shiner’s and other trade associations as police informants. In addition to these newly created structures, community policing also draws upon pre-existing customary actors, such as militia and elders. Conflict Resolving Committees, Community Police Officers and elders were reported as the most common first ports of call when community members experience a crime. The analysis highlights that the model of community policing in Amhara increased communities’ access to policing services, although this is not always attended by increased access to justice. Community members also indicate that public perceptions of the police have improved since the introduction of community policing, in part due to individual Community Police Officers who have, with limited resources, innovated some impressive strategies to improve safety in their neighborhoods. However, more broadly, community policing has provided the state with more effective surveillance of the population – a potentially oppressive function in the current political context. Ultimately, community policing in Amhara is anything but straightforward. It has been a process of attempting to demonstrate the benefits of newfound (and controversial) ‘democracy’ following years of dictatorship, drawing on generations of customary dispute resolution, providing both improved access to security for communities and an enhanced surveillance capacity for the state. For external actors looking to engage in community policing, this case study reveals the importance of close analysis in assessing potential merits, risks and entry points of programming. Factors found to be central in shaping the nature of community policing in the Amhara case include the structure of the political system, state-society relations, cultures dispute resolution and political ideology.

Keywords: community policing, community, militias, ethiopia

Procedia PDF Downloads 104
26895 Comparative Analysis of DTC Based Switched Reluctance Motor Drive Using Torque Equation and FEA Models

Authors: P. Srinivas, P. V. N. Prasad

Abstract:

Since torque ripple is the main cause of noise and vibrations, the performance of Switched Reluctance Motor (SRM) can be improved by minimizing its torque ripple using a novel control technique called Direct Torque Control (DTC). In DTC technique, torque is controlled directly through control of magnitude of the flux and change in speed of the stator flux vector. The flux and torque are maintained within set hysteresis bands. The DTC of SRM is analysed by two methods. In one of the methods, the actual torque is computed by conducting Finite Element Analysis (FEA) on the design specifications of the motor. In the other method, the torque is computed by Simplified Torque Equation. The variation of peak current, average current, torque ripple and speed settling time with Simplified Torque Equation model is compared with FEA based model.

Keywords: direct toque control, simplified torque equation, finite element analysis, torque ripple

Procedia PDF Downloads 464
26894 Experimental and Numerical Analysis of Mustafa Paşa Mosque in Skopje

Authors: Ozden Saygili, Eser Cakti

Abstract:

The masonry building stock in Istanbul and in other cities of Turkey are exposed to significant earthquake hazard. Determination of the safety of masonry structures against earthquakes is a complex challenge. This study deals with experimental tests and non-linear dynamic analysis of masonry structures modeled through discrete element method. The 1:10 scale model of Mustafa Paşa Mosque was constructed and the data were obtained from the sensors on it during its testing on the shake table. The results were used in the calibration/validation of the numerical model created on the basis of the 1:10 scale model built for shake table testing. 3D distinct element model was developed that represents the linear and nonlinear behavior of the shake table model as closely as possible during experimental tests. Results of numerical analyses with those from the experimental program were compared and discussed.

Keywords: dynamic analysis, non-linear modeling, shake table tests, masonry

Procedia PDF Downloads 406
26893 Toxicity of Bisphenol-A: Effects on Health and Regulations

Authors: Tuğba Özdal, Neşe Şahin Yeşilçubuk

Abstract:

Bisphenol-A (BPA) is one of the highest volume chemicals produced worldwide in the plastic industry. This compound is mostly used in producing polycarbonate plastics that are often used for food and beverage storage, and BPA is also a component of epoxy resins that are used to line food and beverage containers. Studies performed in this area indicated that BPA could be extracted from such products while they are in contact with food. Therefore, BPA exposure is presumed. In this paper, the chemical structure of BPA, factors affecting BPA migration to food and beverages, effects on health, and recent regulations will be reviewed.

Keywords: BPA, health, regulations, toxicity

Procedia PDF Downloads 321
26892 Are Oral Health Conditions Associated with Children’s School Performance and School Attendance in the Kingdom of Bahrain - A Life Course Approach

Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore

Abstract:

Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.

Keywords: dental caries, life course, Bahrain, school outcomes

Procedia PDF Downloads 88
26891 Evaluation of the Spectrum of Cases of Perforation Peritonitis at Jawaharlal Nehru Medical College, Aligarh Muslim University

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

Abstract:

Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

Procedia PDF Downloads 246