Search results for: successful treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10195

Search results for: successful treatment

9505 Nutritional Potentials of Two Nigerian Green Leafy Vegetables

Authors: Philippa C. Ojimelukwe, Felix C. Okpalanma, Emmanuel A. Mazi

Abstract:

The carotenoid content, vitamins (ascorbic acid, riboflavin, thiamin, niacin and vitamin K) and mineral contents (K, Ca, Mg, Zn and Fe) of raw, cooked (moist heat treatment) and stored Gnetum africanum and Pterocarpus mildbraedii leaves were investigated in the present research. Raw G. africanum contained higher total carotenoids (246.93µg/g edible portion) than P. mildbraedii (83.53µg/g edible portion) However, moist heat treatment significantly improved the total carotenoid content of P. mildbraedii. The carotenoid profiles of P. mildbraedii and G. africanum showed improved contents of beta cryptoxanthin , 9-cis, 11-cis and 13 cis beta carotenes due to moist heat treatment. Lutein contents of the two green leafy vegetables were quite high in raw, heat treated and stored samples. The two green leafy vegetables were good sources of vitamin K (118-120 µg). Moist heat treatment significantly (p < 0.05) increased the mineral contents of P.mildbraedii and G. africanum. The vitamin contents were reduced. Storage at ambient temperature (30oC) in the dark led to good retention of the minerals but not the vitamins.

Keywords: Gnetum africanum, Pterocarpus mildbraedii, carotenoid profile, vitamins, minerals

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9504 Rosuvastatin Improves Endothelial Progenitor Cells in Rheumatoid Arthritis

Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

Abstract:

Background: Endothelial Progenitor Cells (EPCs) are depleted and contribute to increased cardiovascular (CV) risk in rheumatoid arthritis (RA). Statins exert a protective effect in CAD partly by promoting EPC mobilization. This vasculoprotective effect of statin has not yet been investigated in RA. We aimed to investigate the effect of rosuvastatin on EPCs in RA. Methods: 50 RA patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=25) and placebo (n=25) as an adjunct to existing stable antirheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures included DAS28, CRP and ESR were measured at baseline and after treatment. Lipids and pro-inflammatory cytokines (TNF-α, IL-6, and IL-1) were estimated at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. At baseline, EPCs inversely correlated with DAS28 and TNF-α in both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin but did not show significant change with placebo. Rosuvastatin exerted positive effect on lipid spectrum: lowering total cholesterol, LDL, non HDL and elevation of HDL as compared with placebo. At 6 months, DAS28, ESR, CRP, TNF-α and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and DAS28, CRP, TNF-α, and IL-6 after treatment with rosuvastatin. Conclusion: First study to show that rosuvastatin improves inflammation and EPC biology in RA possibly through its anti-inflammatory and lipid lowering effect. This beneficial effect of rosuvastatin may provide a novel strategy to prevent cardiovascular events in RA.

Keywords: RA, Endothelial Progenitor Cells, rosuvastatin, cytokines

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9503 Endometriosis: The Optimal Treatment of Recurrent Endometrioma in Infertile Patients

Authors: Smita Lakhotia, C. Kew, S. H. M. Siraj, B. Chern

Abstract:

Up to 50% of those with endometriosis may suffer from infertility due to either distorted pelvic anatomy/impaired oocyte release or inhibit ovum pickup and transport, altered peritoneal function, endocrine and anovulatory disorders, including LUF, impaired implantation, progesterone resistance or decreased levels of cellular immunity. The dilemma continues as to whether the surgery or IVF is the optimal management for such recurrent endometriomas. The core question is whether surgery adds anything of value for infertile women with recurrent endometriosis or not. Complete and detailed information on risks and benefits of treatment alternatives must be offered to patients, giving a realistic estimate of chances of success of repetitive surgery and of multiple IVF cycles in order to allow unbiased choices between different possible optionsAn individualized treatment plan should be developed taking into account patient age, duration of infertility, previous pregnancies and specific clinical conditions and wish.

Keywords: recurrent endometriosis, infertility, oocyte release, pregnancy

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9502 Evaluation of the Efficacy and Tolerance of Gabapentin in the Treatment of Neuropathic Pain

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

Abstract:

INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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9501 The Art and Science of Trauma-Informed Psychotherapy: Guidelines for Inter-Disciplinary Clinicians

Authors: Daphne Alroy-Thiberge

Abstract:

Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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9500 Navigating Weight Loss Among Breast Cancer Survivors: A Qualitative Study of Overweight and Obese Patients' Experiences

Authors: Yi Fung Lin, Pei Chen Tsai

Abstract:

Purpose: Many breast cancer survivors actively seek information about diet, exercise, and nutritional supplements to expedite recovery, reduce the risk of recurrence, and enhance their quality of life. While weight loss is not a primary concern for overweight or obese patients during the active treatment phase, they continue to face the additional burden and risks associated with excess weight post-treatment. This group has complex views on weight loss: they are concerned that exercise or dietary control might exacerbate symptoms, yet they also believe that obesity could negatively impact health. These perceptions can have both positive and negative effects on weight management. Therefore, this qualitative study aimed to explore the factors that influence overweight or obese breast cancer survivors' ability to manage their weight. Method: Eight women participated in in-depth interviews in 2022. Data was extracted based on the verbatim transcripts of the audio files, and the analysis was conducted through careful reading of the text. This qualitative research collected data until data saturation was reached. Results: A total of 22 codes were identified and subsequently integrated into three main themes: (1) Facilitators, including support systems, others' successful weight loss experiences, education, responsibility to others, and motivation; (2) Barriers, encompassing physical limitations, the stigma associated with weight loss, the cost of weight loss, antiestrogen medication, and cancer symptoms; (3) Variable Factors, which comprise perspectives on cancer, perspectives on obesity, and past experiences with weight loss. Conclusions: These findings are similar to previous research on barriers and motivators, highlighting variable factors that exist and can lead to either positive or negative effects on weight loss. The results can inform the development of weight management programs tailored to the needs of overweight or obese breast cancer survivors. Additionally, the identified factors represent vital variables for future studies, serving as valuable references for further research in this area.

Keywords: weight management, breast cancer, overweight, obese, cancer survivors

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9499 Psychosocial Development: The Study of Adaptation and Development and Post-Retirement Satisfaction in Ageing Australians

Authors: Sahar El-Achkar, Mizan Ahmad

Abstract:

Poor adaptation of developmental milestones over the lifespan can significantly impact emotional experiences and Satisfaction with Life (SWL) post-retirement. Thus, it is important to understand how adaptive behaviour over the life course can predict emotional experiences. Broadly emotional experiences are either Positive Affect (PA) or Negative Affect (NA). This study sought to explore the impact of successful adaptation of developmental milestones throughout one’s life on emotional experiences and satisfaction with life following retirement. A cross-sectional self-report survey was completed by 132 Australian retirees between the ages 55 and 70 years. Three hierarchical regression models were fitted, controlling for age and gender, to predict PA, NA, and SWL. The full model predicting PA was statistically significant overall, F (8, 121) = 17.97, p < .001, account for 57% of the variability in PA. Industry/Inferiority were significantly predictive of PA. The full model predicting NA was statistically significant overall, F (8, 121) = 12.00, p < .001, accounting for 51% of the variability in NA. Age and Trust/Mistrust were significantly predictive of NA. The full model predicting NA was statistically significant overall, F (8, 121) = 12.00, p < .001, accounting for 51% of the variability in NA. Age and Trust/Mistrust were significantly predictive of NA. The full model predicting SWL, F (8, 121) = 11.05, p < .001, accounting for 45% of the variability in SWL. Trust/Mistrust and Ego Integrity/Despair were significantly predictive of SWL. A sense of industry post-retirement is important in generating PA. These results highlight that individuals presenting with adaptation and identity issues are likely to present with adjustment challenges and unpleasant emotional experiences post-retirement. This supports the importance of identifying and understanding the benefits of successful adaptation and development throughout the lifespan and its significance for the self-concept. Most importantly, the quality of lives of many may be improved, and the future risk of continued poor emotional experiences and SWL post-retirement may be mitigated. Specifically, the clinical implications of these findings are that they support the promotion of successful adaption over the life course and healthy ageing.

Keywords: adaptation, development, negative affect, positive affect, retirement, satisfaction with life

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9498 Modeling of in 738 LC Alloy Mechanical Properties Based on Microstructural Evolution Simulations for Different Heat Treatment Conditions

Authors: M. Tarik Boyraz, M. Bilge Imer

Abstract:

Conventionally cast nickel-based super alloys, such as commercial alloy IN 738 LC, are widely used in manufacturing of industrial gas turbine blades. With carefully designed microstructure and the existence of alloying elements, the blades show improved mechanical properties at high operating temperatures and corrosive environment. The aim of this work is to model and estimate these mechanical properties of IN 738 LC alloy solely based on simulations for projected heat treatment conditions or service conditions. The microstructure (size, fraction and frequency of gamma prime- γ′ and carbide phases in gamma- γ matrix, and grain size) of IN 738 LC needs to be optimized to improve the high temperature mechanical properties by heat treatment process. This process can be performed at different soaking temperature, time and cooling rates. In this work, micro-structural evolution studies were performed experimentally at various heat treatment process conditions, and these findings were used as input for further simulation studies. The operation time, soaking temperature and cooling rate provided by experimental heat treatment procedures were used as micro-structural simulation input. The results of this simulation were compared with the size, fraction and frequency of γ′ and carbide phases, and grain size provided by SEM (EDS module and mapping), EPMA (WDS module) and optical microscope for before and after heat treatment. After iterative comparison of experimental findings and simulations, an offset was determined to fit the real time and theoretical findings. Thereby, it was possible to estimate the final micro-structure without any necessity to carry out the heat treatment experiment. The output of this microstructure simulation based on heat treatment was used as input to estimate yield stress and creep properties. Yield stress was calculated mainly as a function of precipitation, solid solution and grain boundary strengthening contributors in microstructure. Creep rate was calculated as a function of stress, temperature and microstructural factors such as dislocation density, precipitate size, inter-particle spacing of precipitates. The estimated yield stress values were compared with the corresponding experimental hardness and tensile test values. The ability to determine best heat treatment conditions that achieve the desired microstructural and mechanical properties were developed for IN 738 LC based completely on simulations.

Keywords: heat treatment, IN738LC, simulations, super-alloys

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9497 Exploring Salient Shifts and Transdiagnostic Factors in Eating Disordered Women

Authors: Francesca Favero, Despina Learmonth

Abstract:

Carbohydrate addiction is said to be the sustained dependence on hyperpalatable foods rich in carbohydrates and sugar. This addiction manifests in increased consumption of carbohydrates through binging: a behaviour typically associated with eating disorders. There is a lack of consensus amongst relevant experts as to whether carbohydrates are physiologically or psychologically addictive. With an increased focus on carbohydrate addiction, an outpatient treatment programme, HELP, has been established in Cape Town, South Africa, to specifically address this issue. This research aimed to explore, pre-and post-intervention, the possible presence of, and subsequent shifts in, the maintaining mechanisms identified in the transdiagnostic model for eating disorders. However, the potential for the emergence of other perpetuating factors was not discounted and the nature of the analysis allowed for this possibility. Eight women between the ages of twenty-two and fifty, who had completed the outpatient treatment programme in the last six months, were interviewed. They were asked to speak retrospectively about their personal difficulties, eating and food, and their experience of the treatment. Thematic analysis was employed to identify themes arising from the data. Five themes congruent with the transdiagnostic model’s factors emerged: over-evaluation of weight and shape, core low self-esteem, interpersonal difficulties, clinical perfectionism and mood intolerance. A variety of sub-themes, elaborating upon the various ways in which the disordered eating was maintained, also emerged from the data. Shifts in these maintaining mechanisms were identified. Although not necessarily indicative of recovery, the results suggest that the outpatient HELP programme had a positive overall influence on the participants; and that the transdiagnostic model may be useful in understanding and guiding the treatment of clients who engage in this type of treatment programme.

Keywords: eating disorders, binge eating disorder, carbohydrate addiction, transdiagnostic model, maintaining mechanisms, thematic analysis, outpatient treatment

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9496 Impact of the Dog-Technic for D1-D4 and Longitudinal Stroke Technique for Diaphragm on Peak Expiratory Flow (PEF) in Asthmatic Patients

Authors: Victoria Eugenia Garnacho-Garnacho, Elena Sonsoles Rodriguez-Lopez, Raquel Delgado-Delgado, Alvaro Otero-Campos, Jesus Guodemar-Perez, Angelo Michelle Vagali, Juan Pablo Hervas-Perez

Abstract:

Asthma is a heterogeneous disease which has always had a drug treatment. Osteopathic treatment that we propose is aimed, seen through a dorsal manipulation (Dog Technic D1-D4) and a technique for diaphragm (Longitudinal Stroke) forced expiratory flow in spirometry changes there are in particular that there is an increase in the volumes of the Peak Flow and Post intervention and effort and that the application of these two techniques together is more powerful if we applied only a Longitudinal (Stroke). Also rating if this type of treatment will have repercussions on breathlessness, a very common symptom in asthma. And finally to investigate if provided vertebra pain decreased after a manipulation. Methods—Participants were recruited between students and professors of the University, aged 18-65, patients (n = 18) were assigned randomly to one of the two groups, group 1 (longitudinal Stroke and manipulation dorsal Dog Technic) and group 2 (diaphragmatic technique, Longitudinal Stroke). The statistical analysis is characterized by the comparison of the main indicator of obstruction of via area PEF (peak expiratory flow) in various situations through the peak flow meter Datospir Peak-10. The measurements were carried out in four phases: at rest, after the stress test, after the treatment, after treatment and the stress test. After each stress test was evaluated, through the Borg scale, the level of Dyspnea on each patient, regardless of the group. In Group 1 in addition to these parameters was calculated using an algometer spinous pain before and after the manipulation. All data were taken at the minute. Results—12 Group 1 (Dog Technic and Longitudinal Stroke) patients responded positively to treatment, there was an increase of 5.1% and 6.1% of the post-treatment PEF and post-treatment, and effort. The results of the scale of Borg by which we measure the level of Dyspnea were positive, a 54.95%, patients noted an improvement in breathing. In addition was confirmed through the means of both groups group 1 in which two techniques were applied was 34.05% more effective than group 2 in which applied only a. After handling pain fell by 38% of the cases. Conclusions—The impact of the technique of Dog-Technic for D1-D4 and the Longitudinal Stroke technique for diaphragm in the volumes of peak expiratory flow (PEF) in asthmatic patients were positive, there was a change of the PEF Post intervention and post-treatment, and effort and showed the most effective group in which only a technique was applied. Furthermore this type of treatment decreased facilitated vertebrae pain and was efficient in the improvement of Dyspnea and the general well-being of the patient.

Keywords: ANS, asthma, manipulation, manual therapy, osteopathic

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9495 The Core Obstacles of Continuous Improvement Implementation: Some Key Findings from Health and Education Sectors

Authors: Abdullah Alhaqbani

Abstract:

Purpose: Implementing continuous improvement is a challenge that public sector organisations face in becoming successful. Many obstacles hinder public organisations from successfully implementing continuous improvement. This paper aims to highlight the key core obstacles that face public organisations to implement continuous improvement programmes. Approach: Based on the literature, this paper reviews 66 papers that were published between 2000 and 2013 and that focused on the concept of continuous improvement and improvement methodologies in the context of public sector organisations. The methodologies for continuous improvement covered in these papers include Total Quality Management, Six Sigma, process re-engineering, lean thinking and Kaizen. Findings: Of the 24 obstacles found in the literature, 11 barriers were seen as core barriers that frequently occurred in public sector organisations. The findings indicate that lack of top management commitment; organisational culture and political issues and resistance to change are significant obstacles for improvement programmes. Moreover, this review found that improvement methodologies share some core barriers to successful implementation within public organisations. These barriers as well are common in the different geographic area. For instance lack of top management commitment and training that found in the education sector in Albanian are common barriers of improvement studies in Kuwait, Saudi Arabia, Spain, UK and US. Practical implications: Understanding these core issues and barriers will help managers of public organisations to improve their strategies with respect to continuous improvement. Thus, this review highlights the core issues that prevent a successful continuous improvement journey within the public sector. Value: Identifying and understanding the common obstacles to successfully implementing continuous improvement in the public sector will help public organisations to learn how to improve in launching and successfully sustaining such programmes. However, this is not the end; rather, it is just the beginning of a longer improvement journey. Thus, it is intended that this review will identify key learning opportunities for public sector organisations in developing nations which will then be tested via further research.

Keywords: continuous improvement, total quality management, obstacles, public sector

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9494 Removal of Hexavalent Chromium from Aqueous Solutions by Biosorption Using Macadamia Nutshells: Effect of Different Treatment Methods

Authors: Vusumzi E. Pakade, Themba D. Ntuli, Augustine E. Ofomaja

Abstract:

Macadamia nutshell biosorbents treated in three different methods (raw Macadamia nutshell powder (RMN), acid-treated Macadamia nutshell (ATMN) and base-treated Macadamia nutshell (BTMN)) were investigated for the adsorption of Cr(VI) from aqueous solutions. Fourier transform infrared spectroscopy (FT-IR) spectra of free and Cr(VI)-loaded sorbents as well as thermogravimetric analysis (TGA) revealed that the acid and base treatments modified the surface properties of the sorbents. The optimum conditions for the adsorption of Cr(VI) by sorbents were pH 2, contact time 10 h, adsorbent dosage 0.2 g L-1, and concentration 100 mg L-1. The different treatment methods altered the surface characteristics of the sorbents and produced different maximum binding capacities of 42.5, 40.6 and 37.5 mg g-1 for RMN, ATMN and BTMN, respectively. The data was fitted into the Langmuir, Freundlich, Redlich-Peterson and Sips isotherms. No single model could clearly explain the data perhaps due to the complexity of process taking place. The kinetic modeling results showed that the process of Cr(VI) biosorption with Macadamia sorbents was better described by a process of chemical sorption in pseudo-second order. These results showed that the three treatment methods yielded different surface properties which then influenced adsorption of Cr(VI) differently.

Keywords: biosorption, chromium(VI), isotherms, Macadamia, reduction, treatment

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9493 Electrochemical Treatment and Chemical Analyses of Tannery Wastewater Using Sacrificial Aluminum Electrode, Ethiopia

Authors: Dessie Tibebe, Muluken Asmare, Marye Mulugeta, Yezbie Kassa, Zerubabel Moges, Dereje Yenealem, Tarekegn Fentie, Agmas Amare

Abstract:

The performance of electrocoagulation (EC) using Aluminium electrodes for the treatment of effluent-containing chromium metal using a fixed bed electrochemical batch reactor was studied. In the present work, the efficiency evaluation of EC in removing physicochemical and heavy metals from real industrial tannery wastewater in the Amhara region, collected from Bahirdar, Debre Brihan, and Haik, was investigated. The treated and untreated samples were determined by AAS and ICP OES spectrophotometers. The results indicated that selected heavy metals were removed in all experiments with high removal percentages. The optimal results were obtained regarding both cost and electrocoagulation efficiency with initial pH = 3, initial concentration = 40 mg/L, electrolysis time = 30 min, current density = 40 mA/cm2, and temperature = 25oC favored metal removal. The maximum removal percentages of selected metals obtained were 84.42% for Haik, 92.64% for Bahir Dar and 94.90% for Debre Brihan. The sacrificial electrode and sludge were characterized by FT-IR, SEM and XRD. After treatment, some metals like chromium will be used again as a tanning agent in leather processing to promote a circular economy.

Keywords: electrochemical, treatment, aluminum, tannery effluent

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9492 Decision Making in Medicine and Treatment Strategies

Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi

Abstract:

Three reasons make good use of the decision theory in medicine: 1. Increased medical knowledge and their complexity makes it difficult treatment information effectively without resorting to sophisticated analytical methods, especially when it comes to detecting errors and identify opportunities for treatment from databases of large size. 2. There is a wide geographic variability of medical practice. In a context where medical costs are, at least in part, by the patient, these changes raise doubts about the relevance of the choices made by physicians. These differences are generally attributed to differences in estimates of probabilities of success of treatment involved, and differing assessments of the results on success or failure. Without explicit criteria for decision, it is difficult to identify precisely the sources of these variations in treatment. 3. Beyond the principle of informed consent, patients need to be involved in decision-making. For this, the decision process should be explained and broken down. A decision problem is to select the best option among a set of choices. The problem is what is meant by "best option ", or know what criteria guide the choice. The purpose of decision theory is to answer this question. The systematic use of decision models allows us to better understand the differences in medical practices, and facilitates the search for consensus. About this, there are three types of situations: situations certain, risky situations, and uncertain situations: 1. In certain situations, the consequence of each decision are certain. 2. In risky situations, every decision can have several consequences, the probability of each of these consequences is known. 3. In uncertain situations, each decision can have several consequences, the probability is not known. Our aim in this article is to show how decision theory can usefully be mobilized to meet the needs of physicians. The decision theory can make decisions more transparent: first, by clarifying the data systematically considered the problem and secondly by asking a few basic principles should guide the choice. Once the problem and clarified the decision theory provides operational tools to represent the available information and determine patient preferences, and thus assist the patient and doctor in their choices.

Keywords: decision making, medicine, treatment strategies, patient

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9491 Place of Surgery in the Treatment of Painful Lumbar Degenerative Disc Disease

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

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9490 An Interpretive Study of Entrepreneurial Experience towards Achieving Business Growth Using the Theory of Planned Behaviour as a Lens

Authors: Akunna Agunwah, Kevin Gallimore, Kathryn Kinmond

Abstract:

Entrepreneurship is widely associated and seen as a vehicle for economic growth; however, different scholars have studied entrepreneurship from various perspectives, resulting in multiple definitions. It is surprising to know most entrepreneurship definition does not incorporate growth as part of their definition of entrepreneurship. Economic growth is engineered by the activities of the entrepreneurs. The purpose of the present theoretical study is to explore the working practices of the successful entrepreneurs towards achieving business growth by understanding the experiences of the entrepreneur using the Theory of Planned Behaviour (TPB) as a lens. Ten successful entrepreneurs in the North West of England in various business sectors were interviewed using semi-structured interview method. The recorded audio interviews transcribed and subsequently evaluated using the thematic deductive technique (qualitative approach). The themes were examined using Theory of Planned Behaviour to ascertain the presence of the three intentional antecedents (attitude, subjective norms, and perceived behavioural control). The findings categorised in two folds, firstly, it was observed that the three intentional antecedents, which make up Theory of Planned Behaviour were evident in the transcript. Secondly, the entrepreneurs are most concerned with achieving a state of freedom and realising their visions and ambitions. Nevertheless, the entrepreneur employed these intentional antecedents to enhance business growth. In conclusion, the work presented here showed a novel way of understanding the working practices and experiences of the entrepreneur using the theory of planned behaviour in qualitative approach towards enhancing business growth. There exist few qualitative studies in entrepreneurship research. In addition, this work applies a novel approach to studying the experience of the entrepreneurs by examining the working practices of the successful entrepreneurs in the North-West England through the lens of the theory of planned behaviour. Given the findings regarding TPB as a lens in the study, the entrepreneur does not differentiate between the categories of the antecedents reasonably sees them as processes that can be utilised to enhance business growth.

Keywords: business growth, experience, interpretive, theory of planned behaviour

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9489 Efficiency of Pre-Treatment Methods for Biodiesel Production from Mixed Culture of Microalgae

Authors: Malith Premarathne, Shehan Bandara, Kaushalya G. Batawala, Thilini U. Ariyadasa

Abstract:

The rapid depletion of fossil fuel supplies and the emission of carbon dioxide by their continued combustion have paved the way for increased production of carbon-neutral biodiesel from naturally occurring oil sources. The high biomass growth rate and lipid production of microalgae make it a viable source for biodiesel production compared to conventional feedstock. In Sri Lanka, the production of biodiesel by employing indigenous microalgae species is at its emerging stage. This work was an attempt to compare the various pre-treatment methods before extracting lipids such as autoclaving, microwaving and sonication. A mixed culture of microalgae predominantly consisting of Chlorella sp. was obtained from Beire Lake which is an algae rich, organically polluted water body located in Colombo, Sri Lanka. After each pre-treatment method, a standard solvent extraction using Bligh and Dyer’s method was used to compare the total lipid content in percentage dry weight (% dwt). The fatty acid profiles of the oils extracted with each pretreatment method were analyzed using gas chromatography-mass spectrometry (GC-MS). The properties of the biodiesels were predicted by Biodiesel Analyzer© Version 1.1, in order to compare with ASTM 6751-08 biodiesel standard.

Keywords: biodiesel, lipid extraction, microalgae, pre-treatment

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9488 H2 Production and Treatment of Cake Wastewater Industry via Up-Flow Anaerobic Staged Reactor

Authors: Manal A. Mohsen, Ahmed Tawfik

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Hydrogen production from cake wastewater by anaerobic dark fermentation via upflow anaerobic staged reactor (UASR) was investigated in this study. The reactor was continuously operated for four months at constant hydraulic retention time (HRT) of 21.57 hr, PH value of 6 ± 0.6, temperature of 21.1°C, and organic loading rate of 2.43 gCOD/l.d. The hydrogen production was 5.7 l H2/d and the hydrogen yield was 134.8 ml H2 /g CODremoved. The system showed an overall removal efficiency of TCOD, TBOD, TSS, TKN, and Carbohydrates of 40 ± 13%, 59 ± 18%, 84 ± 17%, 28 ± 27%, and 85 ± 15% respectively during the long term operation period. Based on the available results, the system is not sufficient for the effective treatment of cake wastewater, and the effluent quality of UASR is not complying for discharge into sewerage network, therefore a post treatment is needed (not covered in this study).

Keywords: cake wastewater industry, chemical oxygen demand (COD), hydrogen production, up-flow anaerobic staged reactor (UASR)

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9487 The Effectschemical Treatment on Alkyl Phenol Modified Sisal Fiber Reinforced Epoxy Composite

Authors: Rajesh Panda, Jimi Tjong, Sanjay K. Nayak, Mohini M. Sain

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The aim of this manuscript was to evaluate the effect of chemical treatment of sisal fibre on the mechanical and viscoelastic properties of bio based epoxy/fibre composites. The composite samples were manufactured through a vacuum infusion process by adding alkyl phenols from cashew nutshell liquid (CSNL). Changes in the chemical structure of the sisal fibres resulting from the treatments were analyzed by Fourier transform infrared spectroscopy (FTIR). Both alkali and silane treatments produced enhancements in the mechanical properties of sisal fibre bundles. The alkali treatment, when combined with the silane treatment, the mechanical properties of epoxy composites notably improved (13%) in comparison to untreated sisal fibre reinforced composites.This was attributed to an enhanced fibre/matrix interface. The incorporation of CSNL into the sisal/epoxy composite enhanced the fibre-matrix interfacial properties because of the addition of -OH groups to the epoxy matrix. The incorporation of sisal fibre imparts stiffness to the epoxy matrix.

Keywords: phenalkamine, sisal fiber, vacuum infusion, cashew nutshell liquid, cashew nutshell liquid (CSNL)

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9486 Reintegrating Forensic Mental Health Service Users into Communities in the Western Cape, South Africa

Authors: Zolani Metu

Abstract:

The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

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9485 Improvement of Sleep Quality Through Manual and Non-Pharmacological Treatment

Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

Abstract:

As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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9484 Family Treatment Drug Court Cost Analysis: An In-depth Look At The Cost And Savings Of A Southeastern Family Treatment Drug Court

Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

Abstract:

This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

Procedia PDF Downloads 161
9483 Impact Modified Oil Palm Empty Fruit Bunch Fiber/Poly(Lactic) Acid Composite

Authors: Mohammad D. H. Beg, John O. Akindoyo, Suriati Ghazali, Abdullah A. Mamun

Abstract:

In this study, composites were fabricated from oil palm empty fruit bunch fiber and poly(lactic) acid by extrusion followed by injection moulding. Surface of the fiber was pre-treated by ultrasound in an alkali medium and treatment efficiency was investigated by scanning electron microscopy (SEM) analysis and Fourier transforms infrared spectrometer (FTIR). Effect of fiber treatment on composite was characterized by tensile strength (TS), tensile modulus (TM) and impact strength (IS). Furthermore, biostrong impact modifier was incorporated into the treated fiber composite to improve its impact properties. Mechanical testing showed an improvement of up to 23.5% and 33.6% respectively for TS and TM of treated fiber composite above untreated fiber composite. On the other hand incorporation of impact modifier led to enhancement of about 20% above the initial IS of the treated fiber composite.

Keywords: fiber treatment, impact modifier, natural fibers, ultrasound

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9482 Elucidating the Defensive Role of Silicon-Induced Biochemical Responses in Wheat Exposed to Drought and Diuraphis noxia Infestation

Authors: Lintle Mohase, Ninikoe Lebusa, Mpho Stephen Mafa

Abstract:

Wheat is an economically important cereal crop. However, the changing climatic conditions that intensify drought in production areas, and additional pest infestation, such as the Russian wheat aphid (RWA, Diuraphis noxia), severely hamper its production. Drought and pest management require an additional water supply through irrigation and applying inorganic nutrients (including silicon) as alternative strategies to mitigate the stress effects. Therefore, other approaches are needed to enhance wheat productivity during drought stress and aphid abundance. Two wheat cultivars were raised under greenhouse conditions, exposed to drought stress, and treated with silicon before infestation with the South African RWA biotype 2 (RWASA2). The morphological evaluations showed that severe drought or a combination of drought and infestation significantly reduced the plant height of wheat cultivars. Silicon treatment did not alleviate the growth reduction. The biochemical responses were measured using spectrophotometric assays with specific substrates. An evaluation of the enzyme activities associated with oxidative stress and defence responses indicated that drought stress increased NADPH oxidase activity, while silicon treatment significantly reduced it in drought-stressed and infested plants. At 48 and 72 hours sampling periods, a combination of silicon, drought and infestation treatment significantly increased peroxidase activity compared to drought and infestation treatment. The treatment also increased β-1,3-glucanase activity 72 hours after infestation. In addition, silicon and drought treatment increased glucose but reduced sucrose accumulation. Furthermore, silicon, drought, and infestation treatment combinations reduced the sucrose content. Finally, silicon significantly increased the trehalose content under severe drought and infestation, evident at 48 and 72-hour sampling periods. Our findings shed light on silicon’s ability to induce protective biochemical responses during drought and aphid infestation.

Keywords: drought, enzyme activity, silicon, soluble sugars, Russian wheat aphid, wheat

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9481 Assessment of Heavy Metals and Radionuclide Concentrations in Mafikeng Waste Water Treatment Plant

Authors: M. Mathuthu, N. N. Gaxela, R. Y. Olobatoke

Abstract:

A study was carried out to assess the heavy metal and radionuclide concentrations of water from the waste water treatment plant in Mafikeng Local Municipality to evaluate treatment efficiency. Ten water samples were collected from various stages of water treatment which included sewage delivered to the plant, the two treatment stages and the effluent and also the community. The samples were analyzed for heavy metal content using Inductive Coupled Plasma Mass Spectrometer. Gross α/β activity concentration in water samples was evaluated by Liquid Scintillation Counting whereas the concentration of individual radionuclides was measured by gamma spectroscopy. The results showed marked reduction in the levels of heavy metal concentration from 3 µg/L (As)–670 µg/L (Na) in sewage into the plant to 2 µg/L (As)–170 µg/L (Fe) in the effluent. Beta activity was not detected in water samples except in the in-coming sewage, the concentration of which was within reference limits. However, the gross α activity in all the water samples (7.7-8.02 Bq/L) exceeded the 0.1 Bq/L limit set by World Health Organization (WHO). Gamma spectroscopy analysis revealed very high concentrations of 235U and 226Ra in water samples, with the lowest concentrations (9.35 and 5.44 Bq/L respectively) in the in-coming sewage and highest concentrations (73.8 and 47 Bq/L respectively) in the community water suggesting contamination along water processing line. All the values were considerably higher than the limits of South Africa Target Water Quality Range and WHO. However, the estimated total doses of the two radionuclides for the analyzed water samples (10.62 - 45.40 µSv yr-1) were all well below the reference level of the committed effective dose of 100 µSv yr-1 recommended by WHO.

Keywords: gross α/β activity, heavy metals, radionuclides, 235U, 226Ra, water sample

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9480 The Role of Surgery to Remove the Primary Tumor in Patients with Metastatic Breast Cancer

Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

Abstract:

Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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9479 Free and Open Source Licences, Software Programmers, and the Social Norm of Reciprocity

Authors: Luke McDonagh

Abstract:

Over the past three decades, free and open source software (FOSS) programmers have developed new, innovative and legally binding licences that have in turn enabled the creation of innumerable pieces of everyday software, including Linux, Mozilla Firefox and Open Office. That FOSS has been highly successful in competing with 'closed source software' (e.g. Microsoft Office) is now undeniable, but in noting this success, it is important to examine in detail why this system of FOSS has been so successful. One key reason is the existence of networks or communities of programmers, who are bound together by a key shared social norm of 'reciprocity'. At the same time, these FOSS networks are not unitary – they are highly diverse and there are large divergences of opinion between members regarding which licences are generally preferable: some members favour the flexible ‘free’ or 'no copyleft' licences, such as BSD and MIT, while other members favour the ‘strong open’ or 'strong copyleft' licences such as GPL. This paper argues that without both the existence of the shared norm of reciprocity and the diversity of licences, it is unlikely that the innovative legal framework provided by FOSS would have succeeded to the extent that it has.

Keywords: open source, copyright, licensing, copyleft

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9478 Epidemiology and Jeopardy Aspect of Febrile Neutropenia Patients by Means of Infectious Maladies

Authors: Pouya Karimi, Ramin Ghasemi Shayan

Abstract:

Conclusions of the sort and setting of observational treatment for immunocompromised patients with fever are confused by the qualities of the hidden disease and the impacts of medications previously got, just as by changing microbiological examples and patterns in sedate obstruction at national and institutional levels. A few frameworks have been proposed to recognize patients who could profit by outpatient anti-infection treatment from patients who require hospitalization. Useful contemplations may choose whether the fundamental checking during the time of neutropenia can be accomplished.

Keywords: microbiology, infectious, neutropenia, epidemiology

Procedia PDF Downloads 147
9477 Treatment of Leaden Sludge of Algiers Refinery by Electrooxidation

Authors: K. Ighilahriz, M. Taleb Ahmed, R. Maachi

Abstract:

Oil industries are responsible for most cases of contamination of our ecosystem by oil and heavy metals. They are toxic and considered carcinogenic and dangerous even when they exist in trace amounts. At Algiers refinery, production, transportation, and refining of crude oil generate considerable waste in storage tanks; these residues result from the gravitational settling. The composition of these residues is essentially a mixture of hydrocarbon and lead. We propose in this work the application of electrooxidation treatment for the leachate of the leaden sludge. The effect of pH, current density and the electrolysis time were studied, the effectiveness of the processes is evaluated by measuring the chemical oxygen demand (COD). The dissolution is the best way to mobilize pollutants from leaden mud, so we conducted leaching before starting the electrochemical treatment. The process was carried out in batch mode using graphite anode and a stainless steel cathode. The results clearly demonstrate the compatibility of the technique used with the type of pollution studied. In fact, it allowed COD removal about 80%.

Keywords: electrooxidation, leaching, leaden sludge, oil industry

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9476 Study of the Physicochemical Characteristics of Liquid Effluents from the El Jadida Wastewater Treatment Plant

Authors: Aicha Assal, El Mostapha Lotfi

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Rapid industrialization and population growth are currently the main causes of energy and environmental problems associated with wastewater treatment. Wastewater treatment plants (WWTPs) aim to treat wastewater before discharging it into the environment, but they are not yet capable of treating non-biodegradable contaminants such as heavy metals. Toxic heavy metals can disrupt biological processes in WWTPs. Consequently, it is crucial to combine additional physico-chemical treatments with WWTPs to ensure effective wastewater treatment. In this study, the authors examined the pretreatment process for urban wastewater generated by the El Jadida WWTP in order to assess its treatment efficiency. Various physicochemical and spatiotemporal parameters of the WWTP's raw and treated water were studied, including temperature, pH, conductivity, biochemical oxygen demand (BOD5), chemical oxygen demand (COD), suspended solids (SS), total nitrogen, and total phosphorus. The results showed an improvement in treatment yields, with measured performance values of 77% for BOD5, 63% for COD, and 66% for TSS. However, spectroscopic analyses revealed persistent coloration in wastewater samples leaving the WWTP, as well as the presence of heavy metals such as Zn, cadmium, chromium, and cobalt, detected by inductively coupled plasma optical emission spectroscopy (ICP-OES). To remedy these staining problems and reduce the presence of heavy metals, a new low-cost, environmentally-friendly eggshell-based solution was proposed. This method eliminated most heavy metals such as cobalt, beryllium, silver, and copper and significantly reduced the amount of cadmium, lead, chromium, manganese, aluminium, and Zn. In addition, the bioadsorbent was able to decolorize wastewater by up to 84%. This adsorption process is, therefore, of great interest for ensuring the quality of wastewater and promoting its reuse in irrigation.

Keywords: WWTP, wastewater, heavy metals, decoloration, depollution, COD, BOD5

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