Search results for: cardiovascular disease risk
1782 Etiology and Postnatal Management of Prenatal Hydronephrosis: A Study of Two Teaching Hospitals of Khyber Pakhtunkhwa
Authors: Saima Ali, Liaqat Ali, Nasir Orakzai
Abstract:
Background: Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with Ultrasonography. The prenatal hydronephrosis is a diagnostic dilemma in differentiating between obstructive variant versus physiologic hydronephrosis. The assessment and prompt diagnosis of prenatal hydronephrosis is important because of the fact that untreated obstructive hydronephrosis usually leads to recurrent UTI, Urosepsis, deterioration of renal functions, non-functioning kidneys, and even end-stage renal disease. Objectives: To determine the etiology and outcome of postnatal treatment of children with prenatal hydronephrosis in two teaching hospitals of Khyber Pakhtunkhwa (KPK) Methods: It is a multicentric descriptive study that was conducted in department of Paediatrics in Kuwait teaching hospital Peshawar and Department of Urology in Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from January 2008 till December 2010. Total numbers of 64 neonates were included in the study with the mean follow-up of 14.5 months. All the diagnostic data in prenatal, postnatal data, and operative and non-operative data were collected on structured Proforma and was analyzed on SPSS version 17. Results: Out of 64 patients, 39 (60.9 %) were male while 25 were female. 52 patients had unilateral while 12 patients had bilateral hydronephrosis. Based upon prenatal USG in term of AP diameter, 37 (57 %) patients had mild hydronephrosis (5-10 mm AP diameter), 14 patients had moderate hydronephrosis (10-15 mm AP diameter) while 13 patients had gross hydronephrosis (More than 15mm). Regarding etiology, 44(76 %) patients were labeled as physiologic hydronephrosis, 11 patients (9.3%) with PUJ obstruction, 5 patients with Vesicoureteric reflux (VUR) and 4 patients with posterior urethral valves. Surgery was performed in total of 15 (23.4%) patients that included open Pyeloplasty in 11 patients, Vesicostomy followed by posterior valve fulguration in 4 patients. All the patients of VUR treated medically. The severity in the grade of prenatal hydronephrosis is significantly associated with the need for definitive urological surgery p < 0.005. Ancillary procedures like percutaneous nephrostomy (PCN) were inserted 7 patients. Conclusions: Prenatal hydronephrosis is a common ailment associated with significant morbidity. Physiological Hydronephrosis and VUR can be successfully treated with medical treatment. However obstructive PUJ obstructions and posterior urethral valves require surgical correction with a good success rate.Keywords: prenatal hydronephrosis, Pelviureteric Junction (PUJ) Obstruction, vesicoureteric reflux, posterior urethral valve, renography
Procedia PDF Downloads 2461781 Transformation in Palliative Care Delivery in Surgery
Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau
Abstract:
Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care
Procedia PDF Downloads 2571780 Deregulation of Turkish State Railways Based on Public-Private Partnership Approaches
Authors: S. Shakibaei, P. Alpkokin
Abstract:
The railway network is one of the major components of a transportation system in a country which may be an indicator of the country’s level of economic improvement. Since 2000s on, revival of national railways and development of High Speed Rail (HSR) lines are one of the most remarkable policies of Turkish government in railway sector. Within this trend, the railway age is to be revived and coming decades will be a golden opportunity. Indubitably, major infrastructures such as road and railway networks require sizeable investment capital, precise maintenance and reparation. Traditionally, governments are held responsible for funding, operating and maintaining these infrastructures. However, lack or shortage of financial resources, risk responsibilities (particularly cost and time overrun), and in some cases inefficacy in constructional, operational and management phases persuade governments to find alternative options. Financial power, efficient experiences and background of private sector are the factors convincing the governments to make a collaboration with private parties to develop infrastructures. Public-Private Partnerships (PPP or 3P or P3) and related regulatory issues are born considering these collaborations. In Turkey, PPP approaches have attracted attention particularly during last decade and these types of investments have been accelerated by government to overcome budget limitations and cope with inefficacy of public sector in improving transportation network and its operation. This study mainly tends to present a comprehensive overview of PPP concept, evaluate the regulatory procedure in Europe and propose a general framework for Turkish State Railways (TCDD) as an outlook on privatization, liberalization and deregulation of railway network.Keywords: deregulation, high-speed railway, liberalization, privatization, public-private partnership
Procedia PDF Downloads 1711779 Depression among University Students an Epidemiological Study on a Sample of University Students
Authors: Laid Fekih
Abstract:
Background: Depression affects people in all communities across the world and in all aspects of their lives. Its spread varies from one country to another, can happen at any age and get rid of it is not easy. There is no clear policy in Algeria's higher education institutions to detect and treat these disorders or pay particular attention to those at risk. Identifying the prevalence of depression among Algerian students, its correlation with different variables, and studying gender differences in the light of a range of variables is necessary to develop an appropriate plan to raise the level of hope and love of life among students. Method: Random samples of 1500 University of Tlemcen students (967 girls and 533 boys), aged 19 to 24 years completed a self-administered questionnaire that included Beck's Depression Inventory ®-II (BDI®-II), (School Health Promotion: The Mood part), Other questions included in this survey focused on demographic characteristics including gender, age and year of study, academic performance (Annual Average Score (0-20) AAS), were examined. Results: The rate of depression (moderate, severe and extreme) varied from 03% to 13% among university students in Tlemcen University. There was no difference in the rates of depression in male and female students, which means that male and female students do have similar rates of depression. The rate of depression in the first-year of the study shows a higher score relative to students of other years. Depression has a negative relationship with academic performance, which means that depressed students have many difficulties in academic tasks at university. Conclusion: Depression among university students is an important center of interest in the world, not only because of the ease with which they can be followed, or the difficulties encountered during their studies and their technical courses but for the link between the level of depression and the quality of care of mental health services, especially if many students with mood and emotional problems don't meet the criteria for psychotherapy.Keywords: depression, epidemiology, university students, academic performance
Procedia PDF Downloads 1441778 Disparities Versus Similarities; WHO Good Practices for Pharmaceutical Quality Control Laboratories and ISO/IEC 17025:2017: International Standards for Quality Management Systems in Pharmaceutical Laboratories
Authors: Mercy Okezue, Kari Clase, Stephen Byrn, Paddy Shivanand
Abstract:
Medicines regulatory authorities expect pharmaceutical companies and contract research organizations to seek ways to certify that their laboratory control measurements are reliable. Establishing and maintaining laboratory quality standards are essential in ensuring the accuracy of test results. ‘ISO/IEC 17025:2017’ and ‘WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL)’ are two quality standards commonly employed in developing laboratory quality systems. A review was conducted on the two standards to elaborate on areas on convergence and divergence. The goal was to understand how differences in each standard's requirements may influence laboratories' choices as to which document is easier to adopt for quality systems. A qualitative review method compared similar items in the two standards while mapping out areas where there were specific differences in the requirements of the two documents. The review also provided a detailed description of the clauses and parts covering management and technical requirements in these laboratory standards. The review showed that both documents share requirements for over ten critical areas covering objectives, infrastructure, management systems, and laboratory processes. There were, however, differences in standard expectations where GPPQCL emphasizes system procedures for planning and future budgets that will ensure continuity. Conversely, ISO 17025 was more focused on the risk management approach to establish laboratory quality systems. Elements in the two documents form common standard requirements to assure the validity of laboratory test results that promote mutual recognition. The ISO standard currently has more global patronage than GPPQCL.Keywords: ISO/IEC 17025:2017, laboratory standards, quality control, WHO GPPQCL
Procedia PDF Downloads 1971777 Application of the Critical Decision Method for Monitoring and Improving Safety in the Construction Industry
Authors: Juan Carlos Rubio Romero, Francico Salguero Caparros, Virginia Herrera-Pérez
Abstract:
No one is in the slightest doubt about the high levels of risk involved in work in the construction industry. They are even higher in structural construction work. The Critical Decision Method (CDM) is a semi-structured interview technique that uses cognitive tests to identify the different disturbances that workers have to deal with in their work activity. At present, the vision of safety focused on daily performance and things that go well for safety and health management is facing the new paradigm known as Resilience Engineering. The aim of this study has been to describe the variability in formwork labour on concrete structures in the construction industry and, from there, to find out the resilient attitude of workers to unexpected events that they have experienced during their working lives. For this purpose, a series of semi-structured interviews were carried out with construction employees with extensive experience in formwork labour in Spain by applying the Critical Decision Method. This work has been the first application of the Critical Decision Method in the field of construction and, more specifically, in the execution of structures. The results obtained show that situations categorised as unthought-of are identified to a greater extent than potentially unexpected situations. The identification during these interviews of both expected and unexpected events provides insight into the critical decisions made and actions taken to improve resilience in daily practice in this construction work. From this study, it is clear that it is essential to gain more knowledge about the nature of the human cognitive process in work situations within complex socio-technical systems such as construction sites. This could lead to a more effective design of workplaces in the search for improved human performance.Keywords: resilience engineering, construction industry, unthought-of situations, critical decision method
Procedia PDF Downloads 1481776 Palladium/Platinum Complexes of Tridentate 4-Acylpyrazolone Thiosemicarbazone with Antioxidant Properties
Authors: Omoruyi G. Idemudia, Alexander P. Sadimenko
Abstract:
The need for the development of new sustainable bioactive compounds with unique properties that can become potential replacement for commonly used medicinal drugs has continued to gain tremendous research concerns because of the problems of disease resistant to these medicinal drugs and their toxicity effects. NOS-donor heterocycles are particularly of interest as they have showed good pharmacological activities in the midst of their interesting chelating properties towards metal ions, an important characteristic for transition metal based drugs design. These new compounds have also gained application as dye sensitizers in solar cell panels for the generation of renewable solar energy, as greener water purification polymer for supply and management of clean water and as catalysts which are used to reduce the amount of pollutants from industrial reaction processes amongst others, because of their versatile properties. Di-ketone acylpyrazolones and their azomethine schiff bases have been employed as pharmaceuticals as well as analytical reagents, and their application as transition metal complexes have being well established. In this research work, a new 4-propyl-3-methyl-1-phenyl-2-pyrazolin-5-one-thiosemicarbazone was synthesized from the reaction of 4-propyl-3-methyl-1-phenyl-2-pyrazolin-5-one and thiosemicarbazide in methanol. The pure isolate of the thiosemicarbazone was further reacted with aqueous solutions of palladium and platinum salts to obtain their metal complexes, in an effort towards the discovery of transition metal based synthetic drugs. These compounds were characterized by means of analytical, spectroscopic, thermogravimetric analysis TGA, as well as x-ray crystallography. 4-propyl-3-methyl-1-phenyl-2-pyrazolin-5-one thiosemicarbazone crystallizes in a triclinic crystal system with a P-1 (No. 2) space group according to x-ray crystallography. The tridentate NOS ligand formed a tetrahedral geometry on coordinating with metal ions. Reported compounds showed varying antioxidant free radical scavenging activities against 2, 2-diphenyl-1-picrylhydrazyl DPPH radical at 100, 200, 300, 400 and 500 µg/ml concentrations. The platinum complex have shown a very good antioxidant property against DPPH with an IC50 of 76.03 µg/ml compared with standard ascorbic acid (IC50 of 74.66 µg/ml) and as such have been identified as a potential anticancer candidate.Keywords: acylpyrazolone, free radical scavenging activities, tridentate ligand, x-ray crystallography
Procedia PDF Downloads 1851775 The Role and Tasks of a Social Worker in the Care of a Terminally Ill Child with Regard to the Malopolska Hospice for Children
Authors: Ewelina Zdebska
Abstract:
A social worker is an integral part of an interdisciplinary team working with the child and his family in a terminal state. Social support is an integral part of the medical procedure in the care of hospice. This is the basis and prerequisite of full treatment and good care of the child - patient, whose illness often finds at least the expected period of his life when his personal and legal issues are not regulated, and the family burdened with the problem requires care and support specialists - professionals. Hospice for Children in Krakow: a palliative care team operating in the province of Krakow and Malopolska, conducts specialized care for terminally ill children in place of their residence from the time when parents and doctors decided to end of treatment in hospital, allows parents to carry out medical care at home, provides parents social and legal assistance and provides care, psychological support and friendship to families throughout the life of the child's illness and after his death, as long as it is needed. The social worker in a hospice does not bear the burden of solving social problems, which is the responsibility of other authorities, but provides support possible and necessary at the moment. The most common form of assistance is to provide information on benefits, which for the child and his family may be subject to any treatment and fight for the life and health of a child. Employee assists in the preparation and completion of documents, requests to increase the degree of disability because of progressive disease or Allowance care because of the inability to live independently. It works in settling all the issues with the Department of Social Security, as well as with the Municipal and District Team Affairs of disability. Seeking help and support using multi-faceted childcare. With the Centres for Social Welfare contacts are also often on the organization of additional respite care for the sick at home (care), especially in the work of the other members of the family or if the family can not cope with the care and needs extra help. Hospice for Children in Cracow completing construction of Poland's first Respite Care Centre for chronically and terminally ill children, will be an open house where children suffering from chronic and incurable diseases and their families can get professional help, whenever - when they need it. The social worker has to pick up a very important role in caring for a terminally ill child. His presence gives a little patient and family the opportunity to be at this difficult time together while organizing assistance and support.Keywords: social worker, care, terminal care, hospice
Procedia PDF Downloads 2481774 A Rare Case of Metastatic Basal Cell Carcinoma
Authors: Nitesh Kumar, Eoin Twohig, jasparl cheema, Sadiq mawji, Yousif al najjar
Abstract:
Basal cell carcinoma (BCC) is the commonest cutaneous malignancy affecting humans. Despite this, distant spread is exceptionally rare. Metastatic BCC (mBCC) is estimated to occur in 0.0028 - 0.5%. it aim to illustrate with the aid of histological slides, a case of mBCC occurring in a fit and well 67-year-old. Initial diagnosis of desmoplastic BCC was made in 2006 from a scalp biopsy with the lesion then being excised. Re-excision of local recurrence was undertaken the following year. In 2014 the patient presented with an ipsilateral level 2a mass. Fine Needle Aspiration raised the suspicion of metastatic carcinoma. The patient had excision of two nodes from the left neck alongside pharyngeal tonsillectomy and tongue base biopsies. Histologically, the nodes closely resembled the immunophenotype of the initial scalp lesion. The patient subsequently had a modified radical neck dissection, and residual mBCC was excised from the left Sternocleidomastoid muscle. In 2023 the patient developed haematuria. On further investigation bilateral lung lesions on CT were noted with subsequent biopsy confirming mBCC. Spinal and renal lesions have also been found. Histopathology showed clear resemblance of the lung metastases to both those in the neck and the primary (scalp BCC) – with no squamous differentiation seen. The time span from primary to occurrence of lung metastasis (18 years) affirms the indolent and slow growing nature of BCC. This case fulfils Lattes and Kessler diagnostic criteria. High risk cases are described as those with advanced local presentation, primary tumour on the Head and Neck and locally recurrent lesions.Keywords: BCC, metastasis, rare, skin cancer
Procedia PDF Downloads 571773 Phytochemical Screening and Anti-Hypothyroidism Activity of Lepidium sativum Ethanolic Extract
Authors: Reham Hajomer, Ikram Elsiddig, Amna Hamad
Abstract:
Lepidium sativum (Garden Cress) belonging to Brassicaceae family is an annual herb locally known as El-rshad. In Ayurveda it is an important medicinal plant, traditionally used for the treatment of jaundice, liver problems, spleen diseases, gastrointestinal disorders, menstrual problems, fracture, arthritis, inflammatory conditions and for treatment of hypothyroidism. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones (Triiodithyronine T3 and Thyroxine T4) which are commonly caused by iodine deficiency. It’s divided into primary and secondary hypothyroidism, the primary caused by failure of thyroid function and secondary due to the failure of adequate thyroid-stimulating hormone (TSH) secretion from the pituitary gland or thyroid -releasing hormone (TRH) from the hypothalamus. The disease is most common in women over age 60. The objective regarding this study is to know whether Lepidium sativum would affect the level of thyroid hormones. The extract was prepared with 96% ethanol using Soxhlet apparatus. The anti-hypothyroidism activity was tested by using thirty male Wistar rats weighing (100-140 g) were used in the experiment. They were grouping into five groups, Group 1: Normal group= Administered only distilled water. Then 10 mg/kg Propylthiouracil was added to the drinking water of all other groups to induce hypothyroidism. Group 2: Negative control without any treatment; Group 3: Test group= treated with oral administration of 500mg/kg extract; Group 4: treated with oral administration of 250mg/kg of the extract; Group 5: Standard group (positive control) = treated with intraperitoneal Levothyroxine. All rats were incubated for 20 days at animal house with room temperature of proper ventilation provided with standard diet. The result show that the Lepidium sativum extract was found to increases the T3 and T4 in the propylthiouracil induced rats with values (0.29 ng/dl T3 and 0.57 U T4) for the 500mg/kg and (0.27 ng/dl T3 and 0.517 U T4) for the 250mg/kg in comparison with standard with values (0.241 ng/dl T3 and 0.516 U T4) so that Lepidium sativum can be stimulatory to thyroid function and possess significant anti-hypothyroidism effect with p-values ranges from (0.000006*-0.893472). In conclusion, from results obtained, Lepidium sativum plant extract was found to posses anti-hypothyroidism effects so its act as an agent that stimulates thyroid hormone secretion.Keywords: anti-hypothyroidism, extract, lepidium, sativum
Procedia PDF Downloads 2051772 Epidemiological Survey on Tick-Borne Pathogens with Zoonotic Potential in Dog Populations of Southern Ethiopia
Authors: Hana Tadesse, Marika Grillini, Giulia Simonato, Alessandra Mondin, Giorgia Dotto, Antonio Frangipane Di Regalbono, Bersissa Kumsa, Rudi Cassini, Maria Luisa Menandro
Abstract:
Dogs are known to host several tick-borne pathogens with zoonotic potential; however, scant information is available on the epidemiology of these pathogens in low-income tropical coun- tries and in particular in sub-Saharan Africa. With the aim of investigating a wide range of tick- borne pathogens (i.e., Rickettsia spp., Anaplasma spp., Erhlichia spp., Borrelia spp., Hepatozoon spp. and Babesia spp.), 273 blood samples were collected from dogs in selected districts of Ethiopia and analyzed by real-time and/or end-point PCR. The results of the study showed that Hepatozoon canis was the most prevalent pathogen (53.8%), followed by Anaplasma phagocythophilum (7.0%), Babesia canis rossi (3.3%), Ehrlichia canis (2.6%) and Anaplasma platys (2.2%). Furthermore, five samples tested positive for Borrelia spp., identified as Borrelia afzelii (n = 3) and Borrelia burgdorferi (n = 2), and two samples for Rickettsia spp., identified as Rickettsia conorii (n = 1) and Rickettsia monacensis (n = 1). The finding of Anaplasma phagocythophilum and different species of the genera Borrelia and Rickettsia with zoonotic potential was unexpected and alarming, and calls for further investigation on the roles of dogs and on the tick, species acting as vector in this specific context. Other pathogens (Hepatozoon canis, Babaesia canis rossi, Anaplasma platys, Ehrlichia canis) are already known to have an important impact on the dogs’ health but have minor zoonotic potential as they were rarely or never reported in humans. Dogs from rural areas were found to be at higher risk for different pathogens, probably due to the presence of other wild canids in the same environment. The findings of the present study contribute to a better knowledge of the epidemiology of tick-borne pathogens, which is relevant to human and animal health.Keywords: Dogs, Tick-borne pathogens, Africa, Ethiopia
Procedia PDF Downloads 921771 Deltamethrin-Induces Oxidative Stress to the Freshwater Ciliate Model: Paramecium tetraurelia
Authors: Amamra Ryma, Djebar Mohamed Reda, Moumeni Ouissem, Otmani Hadjer, Berrebbah Houria
Abstract:
The problem of environmental contamination by the excessive use of organics cannot be neglected. Extensive application is usually companied with serious problems and health risk. It is established that many chemicals, in common use, can produce some toxic effects on biological systems through their mode of action or by production of free radicals that damage all cell compounds. Deltamethrin, a widely used type II pyrethroid pesticide, is one of the most common contaminants in freshwater aquatic system. In this study, we investigate the effects of deltamethrin exposure on the induction of oxidative stress to the freshwater ciliate Paramecium tetraurelia. After the treatment of paramecium cells with increasing concentrations of insecticide, we followed up the growth kinetics, generation time and the percentage response. Also, we studied the variation in biomarkers of stress such as: GSH content, GST, GPX and CAT activities. Our results showed a significant decrease in the proliferation of cells correlated by the decrease in generation number and the increase in generation time. Also, we noted an inhibition in the percentage response. The monitoring of biomarkers revealed depletion in GSH content in a proportional and dose dependent manner accompanied by an increase in the GST activity. In parallel, a strong induction in the CAT and GPX activities was noted specially for the highest dose. In summary, under the current experimental conditions, deltamethrin is highly toxic to the freshwater ciliate Paramecium tetraurelia. Exposure to low concentrations showed significant adverse on growth accompanied with the induction of oxidative damage supported by the decrease in GSH content and the intensification of the antioxidant enzymes.Keywords: deltamethrin, Paramecium tetraurelia, growth, oxidative stress, biomarkers, antioxidant
Procedia PDF Downloads 4671770 Research on Old Community Planning Strategy in Mountainous City from The Perspective of Physical Activity: A Case Study of Daxigou Street Community, Chongqing
Authors: Yang Liandong
Abstract:
The rapid development of cities has triggered a series of urban health problems. Residents' daily lives have generally changed to long-term unhealthy work and rest, and the prevalence of chronic diseases in the population is on the rise. Promoting physical activity is an effective way to enhance the population's health and reduce the risk of various chronic diseases. As the most basic unit of the city, the community is the living space where residents use the highest frequency of daily activities and also the best space carrier for people to carry out all kinds of physical activities, and its planning research is of great significance for promoting physical activities. Under special conditions, the old communities in mountainous cities present compact and three-dimensional spatial characteristics, and there are problems such as disordered spatial organization, scattered distribution, and low utilization rates. This paper selects four communities in Daxigou Street, Yuzhong District, Chongqing as the research object, analyzes the current situation of the research cases through literature combing and field investigation and interviews, and puts forward the planning strategies for promoting physical activity in old communities in mountain cities from four aspects: building a convenient and smooth public space system, creating a diversified and shared activity space, creating a beautiful and healing community landscape, and providing convenient and perfect supporting facilities, to provide a certain reference for the healthy development of old communities in mountain cities.Keywords: physical activity, community planning, old communities in mountain cities, public space optimization, spatial fairness
Procedia PDF Downloads 261769 Investigating Acute and Chronic Pain after Bariatric Surgery
Authors: Patti Kastanias, Wei Wang, Karyn Mackenzie, Sandra Robinson, Susan Wnuk
Abstract:
Obesity is a worldwide epidemic and is recognized as a chronic disease. Pain in the obese individual is a multidimensional issue. An increase in BMI is positively correlated with pain incidence and severity, especially in central obesity where individuals are twice as likely to have chronic pain. Both obesity and chronic pain are also associated with mood disorders. Pain is worse among obese individuals with depression and anxiety. Bariatric surgery provides patients with an effective solution for long-term weight loss and associated health problems. However, not much is known about acute and chronic pain after bariatric surgery and its contributing factors, including mood disorders. Nurse practitioners (NPs) at one large multidisciplinary bariatric surgery centre led two studies to examine acute and chronic pain and pain management over time after bariatric surgery. The purpose of the initial study was to examine the incidence and severity of acute and chronic pain after bariatric surgery. The aim of the secondary study was to further examine chronic pain, specifically looking at psychological factors that influence severity or incidence of both neuropathic and somatic pain as well as changes in opioid use. The initial study was a prospective, longitudinal study where patients having bariatric surgery at one surgical center were followed up to 6 months postop. Data was collected at 7 time points using validated instruments for pain severity, pain interference, and patient satisfaction. In the second study, subjects were followed longitudinally starting preoperatively and then at 6 months and 1 year postoperatively to capture changes in chronic pain and influencing variables over time. Valid and reliable instruments were utilized for all major study outcomes. In the first study, there was a trend towards decreased acute post-operative pain over time. The incidence and severity of chronic pain was found to be significantly reduced at 6 months post bariatric surgery. Interestingly, interference of chronic pain in daily life such as normal work, mood, and walking ability was significantly improved at 6 months postop however; this was not the case with sleep. Preliminary results of the secondary study indicate that pain severity, pain interference, anxiety and depression are significantly improved at 6 months postoperatively. In addition, preoperative anxiety, depression and emotional regulation were predictive of pain interference, but not pain severity. The results of our regression analyses provide evidence for the impact of pre-existing psychological factors on pain, particularly anxiety in obese populations.Keywords: bariatric surgery, mood disorders, obesity, pain
Procedia PDF Downloads 3041768 Antioxidant Activity and Microbiological Quality of Functional Bread Enriched with Morus Alba Leaf Extract during Storage
Authors: Joanna Kobus-Cisowska, Daria Szymanowska, Piotr Szulc, Oskar Szczepaniak, Marcin Dziedzinski, Szymon Byczkiewicz
Abstract:
A wide range of food products is offered on the market. However, increasing consumer awareness of the impact of food on health causes a growing interest in enriched products. Cereal products are an important element of the daily diet of man. In the literature, no data was found on the impact of Morus alba preparations on the content of active ingredients and properties of wholemeal bread. Mulberry leaves (Morus alba L) are a rich source of bioactive compounds with multidirectional antioxidant activity, which means that they can be a component of new foods that prevent disease or support therapy and improve the patient's health. The aim of the study was to assess the impact of the addition of white mulberry leaf extract on the antioxidant activity of bread. It has been shown that bread can be a carrier of biologically active substances from mulberry leaves, because the addition of mulberry at a sensory acceptable level and meeting microbiological requirements significantly influenced the increase in the content of bioactive ingredients and the antioxidant activity of bread. The addition of mulberry leaf water extract to bread increased the level of flavonols and phenolic acids, in particular protocatechic, chlorogenic gallic and caffeic acid and isoquercetin and rutine, and also increased the antioxidant potential, which were microbiological stable during 5 days storage. It has been shown also that the addition of Morus alba preparations has a statistically significant effect on anti-radical activity. In addition, there were no differences in activity in DPPH · and ABTS · + tests between post-storage samples. This means that the compounds responsible for the anti-radical activity present in the bread were not inactivated during storage. It was found that the tested bread was characterized by high microbiological purity, which is indicated by the obtained results of analyzes performed for the titers of indicator microorganisms and the absence of pathogens. In the tested products from the moment of production throughout the entire storage period, no undesirable microflora was found, which proves their safety and guarantees microbiological stability during the storage period.Keywords: antioxidants, bread, extract, quality
Procedia PDF Downloads 1741767 Phenotypic Characterisation of Bapedi Sheep Breed
Authors: Fhulufhelo Ramukhithi, Kgothatso Masethe, Tlou Chokoe, Ayanda Maqhashu, Julius Sebei, Tshililo Raphulu, Joseph Mugwabana
Abstract:
Phenotypic characterisation ensures that the physical appearance of an animal is well documented. The information provided by this phenotypic characterisation study is important for planning management and the use of animal genetic resources. The aim of this study was to characterise the phenotypic characteristics of Bapedi sheep. Bapedi sheep are at risk of extinction like most of the indigenous breeds. As a result, a total of 196 Bapedi ewes and 35 rams were used. Phenotypic-qualitative characteristics were evaluated through visual appraisal. Phenotypic-quantitative characteristics such as body parts measurements were obtained using a flexible tape (cm), while body weight were obtained by using a weighing scale (kg). Bapedi rams (97 %) had higher satisfactory body condition when compared to ewes (75 %). A higher proportion of Bapedi sheep that did not have ticks observed (ewes = 87 % and rams = 91 %). Brown and white colour combination (head x body) was dominating in Bapedi sheep (80 % ewes and 91 % rams). Bapedi ewes did not have any horns; however, 3 % of rams had them. Bapedi sheep had a higher proportion of brown eyes, moderate neck, stiff sideways ears and normal front legs. Bapedi rams had a higher proportion of well-balanced and good attached testicles. Bapedi ewes had average (45 %), small (40 %) and big udders (15 %). Bapedi rams had a significantly higher body weight, height, depth, hearth girth circumference, rump width, hind leg width and length compared to ewes. However, both Bapedi rams and ewes had similar age, body condition score, tail length, length below hock and knee. In conclusion, Bapedi sheep had a higher satisfactory body condition and brown and white colour combination. Some of Bapedi rams’ quantitative characteristics were higher compared to ewes.Keywords: extinction, indigenous, phenotypic, smallstock
Procedia PDF Downloads 2131766 Effects of Climate Change on Floods of Pakistan, and Gap Analysis of Existing Policies with Vision 2025
Authors: Saima Akbar, Tahseen Ullah Khan
Abstract:
The analysis of the climate change impact on flood frequency represents an important issue for water resource management and flood risk mitigation. This research was conducted to address the effects of climate change on flood incidents of Pakistan and find out gaps in existing policies to reducing the environmental aspects on floods and effects of global warming. The main objective of this research was to critically analyses the National Climate Change Policy (NCCP), National Disaster Management Authority (NDMA), Federal Flood Commission (FFC) and Vision 2025, as an effective policy document which is not only hitting the target of a climate resilient Pakistan but provides room for efficient and flexible policy implementation. The methodology integrates projected changes in monsoon patterns (since last 20 years and overall change in rainfall pattern since 1901 to 2015 from Pakistan Metrological Department), glacier melting, decreasing dam capacity and lacks in existing policies by using SWOT (Strength, Weakness, Opportunities, Threats) model in order to explore the relative impacts of global warming on the system performance. Results indicate the impacts of climate change are significant, but probably not large enough to justify a major effort for adapting the physical infrastructure to expected climatic conditions in Vision 2025 which is our shared destination to progress, ultimate aspiration to see Pakistan among the ten largest economies of the world by 2047– the centennial year of our independence. The conclusion of this research was to adapt sustainable measures to reduce flood impacts and make policies as neighboring countries are adapting for their sustainability.Keywords: climatic factors, monsoon, Pakistan, sustainability
Procedia PDF Downloads 1401765 Design and Analysis of Semi-Active Isolation System in Low Frequency Excitation Region for Vehicle Seat to Reduce Discomfort
Authors: Andrea Tonoli, Nicola Amati, Maria Cavatorta, Reza Mirsanei, Behzad Mozaffari, Hamed Ahani, Akbar Karamihafshejani, Mohammad Ghazivakili, Mohammad Abuabiah
Abstract:
The vibrations transmitted to the drivers and passengers through vehicle seat seriously effect on the level of their attention, fatigue and physical health and reduce the comfort and efficiency of the occupants. Recently, some researchers have focused on vibrations at low excitation frequency(0.5-5 Hz) which are considered to be the main risk factors for lumbar part of the backbone but they were not applicable to A and B-segment cars regarding to the size and weight. A semi-active system with two symmetric negative stiffness structures (NSS) in parallel to a positive stiffness structure and actuators has been proposed to attenuate low frequency excitation and makes system flexible regarding to different weight of passengers which is applicable for A and B-Segment cars. Here, the 3 degree of freedom system is considered, dynamic equation clearly is presented, then simulated in MATLAB in order to analysis of performance of the system. The design procedure is derived so that the resonance peak of frequency–response curve shift to the left, the isolating range is increased and especially, the peak of the frequency–response curve is minimized. According to ISO standard different class of road profile as an input is applied to the system to evaluate the performance of the system. To evaluate comfort issues, we extract the RMS value of the vertical acceleration acting on the passenger's body. Then apply the band-pass filter, which takes into account the human sensitivity to acceleration. According to ISO, this weighted acceleration is lower than 0.315 m/s^2, so the ride is considered as comfortable.Keywords: low frequency excitation, negative stiffness, seat vehicle, vibration isolation
Procedia PDF Downloads 4361764 Sentiment Analysis of Fake Health News Using Naive Bayes Classification Models
Authors: Danielle Shackley, Yetunde Folajimi
Abstract:
As more people turn to the internet seeking health-related information, there is more risk of finding false, inaccurate, or dangerous information. Sentiment analysis is a natural language processing technique that assigns polarity scores to text, ranging from positive, neutral, and negative. In this research, we evaluate the weight of a sentiment analysis feature added to fake health news classification models. The dataset consists of existing reliably labeled health article headlines that were supplemented with health information collected about COVID-19 from social media sources. We started with data preprocessing and tested out various vectorization methods such as Count and TFIDF vectorization. We implemented 3 Naive Bayes classifier models, including Bernoulli, Multinomial, and Complement. To test the weight of the sentiment analysis feature on the dataset, we created benchmark Naive Bayes classification models without sentiment analysis, and those same models were reproduced, and the feature was added. We evaluated using the precision and accuracy scores. The Bernoulli initial model performed with 90% precision and 75.2% accuracy, while the model supplemented with sentiment labels performed with 90.4% precision and stayed constant at 75.2% accuracy. Our results show that the addition of sentiment analysis did not improve model precision by a wide margin; while there was no evidence of improvement in accuracy, we had a 1.9% improvement margin of the precision score with the Complement model. Future expansion of this work could include replicating the experiment process and substituting the Naive Bayes for a deep learning neural network model.Keywords: sentiment analysis, Naive Bayes model, natural language processing, topic analysis, fake health news classification model
Procedia PDF Downloads 971763 Status of Hazardous Waste Generation and Its Impacts on Environment and Human Health: A Study in West Bengal
Authors: Sk Ajim Ali
Abstract:
The present study is an attempt to overview on the major environmental and health impacts due to hazardous waste generation and poor management. In present scenario, not only hazardous waste, but as a common term ‘Waste’ is one of the acceptable and thinkable environmental issues. With excessive increasing population, industrialization and standardization of human’s life style heap in extra waste generation which is directly or indirectly related with hazardous waste generation. Urbanization and population growth are solely responsible for establishing industrial sector and generating various Hazardous Waste (HW) and concomitantly poor management practice arising adverse effect on environment and human health. As compare to other Indian state, West Bengal is not too much former in HW generation. West Bengal makes a rank of 7th in HW generation followed by Maharashtra, Gujarat, Tamil Nadu, U.P, Punjab and Andhra Pradesh. During the last 30 years, the industrial sectors in W.B have quadrupled in size, during 1995 there were only 440 HW generating Units in West Bengal which produced 129826 MTA hazardous waste but in 2011, it rose up into 609 units and it produced about 259777 MTA hazardous waste. So, the notable thing is that during a 15 year interval there increased 169 waste generating units but it produced about 129951 MTA of hazardous waste. Major chemical industries are the main sources of HW and causes of adverse effect on the environment and human health. HW from industrial sectors contains heavy metals, cyanides, pesticides, complex aromatic compounds (i.e. PCB) and other chemical which are toxic, flammable, reactive, and corrosive and have explosive properties which highly affect the surrounding environment and human health in and around he disposal sites. The main objective of present study is to highlight on the sources and components of hazardous waste in West Bengal and impacts of improper HW management on health and environment. This study is carried out based on a secondary source of data and qualitative method of research. The secondary data has been collected annual report of WBPCB, WHO’s report, research paper, article, books and so on. It has been found that excessive HW generation from various sources and communities has serious health hazards that lead to the spreading of infectious disease and environmental change.Keywords: environmental impacts, existing HW generation and management practice, hazardous waste (HW), health impacts, recommendation and planning
Procedia PDF Downloads 2841762 Identification and Management of Septic Arthritis of the Untouched Glenohumeral Joint
Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot
Abstract:
Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder
Procedia PDF Downloads 4221761 Risk Management and Resiliency: Evaluating Walmart’s Global Supply Chain Leadership Using the Supply Chain Resilience Assessment and Management Framework
Authors: Meghan Biallas, Amanda Hoffman, Tamara Miller, Kimmy Schnibben, Janaina Siegler
Abstract:
This paper assesses Walmart’s supply chain resiliency amidst continuous supply chain disruptions. It aims to evaluate how Walmart can use supply chain resiliency theory to retain its status as a global supply chain leader. The Bloomberg terminal was used to organize Walmart’s 754 Tier-1 suppliers by the size of their relationship to Walmart. Additional data from IBISWorld and Statista was also used in the analysis. This research focused on the top ten Tier-1 suppliers, with the greatest percentage of their revenue attributed to Walmart. This paper also applied the firm’s information to the Supply Chain Resilience Assessment and Management (SCRAM) framework for supply chain resiliency to evaluate the firm’s capabilities, vulnerabilities, and gaps. A rubric was created to quantify Walmart’s risks using four pillars: flexibility, velocity, visibility, and collaboration. Information and examples were reported from Walmart’s 10k filing. For each example, a rating of 1 indicated “high” resiliency, 0 indicated “medium” resiliency, and -1 indicated “low” resiliency. Findings from this study include the following: (1) Walmart has maintained its leadership through its ability to remain resilient with regard to visibility, efficiency, capacity, and collaboration. (2) Walmart is experiencing increases in supply chain costs due to internal factors affecting the company and external factors affecting its suppliers. (3) There are a number of emerging supply chain risks with Walmart’s suppliers, which could cause issues for Walmart to remain a supply chain leader in the future. Using the SCRAM framework, this paper assesses how Walmart measures up to the Supply Chain Resiliency Theory, identifying areas of strength as well as areas where Walmart can improve in order to remain a global supply chain leader.Keywords: supply chain resiliency, zone of balanced resilience, supply chain resilience assessment and management, supply chain theory.
Procedia PDF Downloads 1261760 Insight into the Visual Attentional Correlates Underpinning Autistic-Like Traits in Fragile X and Down Syndrome
Authors: Jennifer M. Glennon, Hana D'Souza, Luke Mason, Annette Karmiloff-Smith, Michael S. C. Thomas
Abstract:
Genetic syndrome groups that feature high rates of autism comorbidity, like Down syndrome (DS) and fragile X syndrome (FXS), have been presented as useful models for understanding risk and protective factors involved in the emergence of autistic traits. Yet despite reaching clinical thresholds, these ‘syndromic’ forms of autism appear to differ in important ways from the idiopathic or ‘non-syndromic’ autism phenotype. To uncover the true nature of these comorbidities, it is necessary to extend definitions of autism to include the cognitive characteristics of the disorder and to then apply this broadened conceptualisation to the study of syndromic autism profiles. The current study employs a variety of well-established eye-tracking paradigms to assess visual attentional performance in children with DS and FXS who reach thresholds for autism on the Social Communication Questionnaire. It investigates whether autism profiles in these children are accompanied by visual orienting difficulties (‘sticky attention’), decreased social attention, and enhanced visual search performance, all of which are characteristic of the idiopathic autism phenotype. Data is collected from children with DS and FXS aged between 6 and 10 years, in addition to two control groups matched on age and intellectual ability (i.e., children with idiopathic autism and neurotypical controls). Cross-sectional developmental trajectory analyses are conducted to enable visuo-attentional profile comparisons. Significant differences in the visuo-attentional processes underpinning autism presentations in children with FXS and DS are hypothesised, supporting notions of syndrome specificity. The study provides insight into the complex heterogeneity associated with syndromic autism presentations and autism per se, with clinical implications for the utility of autism intervention programmes in DS and FXS populations.Keywords: autism, down syndrome, fragile X syndrome, eye tracking
Procedia PDF Downloads 2391759 Melatonin Improved Vase Quality by Delaying Oxidation Reaction and Supplying More Energies in Cut Peony (Paeonia Lactiflora cv. Sarah)
Authors: Tai Chen, Caihuan Tian, Xiuxia Ren, Jingqi Xue, Xiuxin Zhang
Abstract:
The herbaceous peony has become increasingly popular worldwide in recent years, especially as a cut flower with great economic value. However, peony has a very short vase life, only 3-5 d usually, which seriously affects its commodity value. In this study, we used the cut peony (Paeonia lactiflora cv. Sarah) as a material and found that melatonin treatment significantly improved its postharvest performance. In the control group, its vase life was 4.8 d, accompanied by petal dropping at last; melatonin treatment (40 μM) increased this time to 6.9 d without petal dropping at the end. Further study showed that melatonin treatment significantly increased the activity of antioxidant enzymes as well as reduced sugar content in petals, whereas the starch content in petals decreased. These results indicated that melatonin treatment may delay the oxidation reaction caused by aging, which also provides extra energy for maintaining flowering. Through full-length transcriptome sequencing, a total of 2819 differentially expressed genes (DEGs) between control and melatonin treatment groups were identified. KEGG enrichment analysis showed that these DEGs were mainly involved in three pathways, including melatonin synthesis, starch and sucrose conversion, and plant disease resistance. After the RT-qPCR verification, we identified three DEGs, named PlBAM3, PlWRKY22 and PlTIP1, and they should play major roles in melatonin-improved postharvest performance. One possible reason is that PlBAM3 caused maltose production (by starch degradation), maintained the proline biosynthesis, and then alleviated oxidative stress. Another reason is that both PlBAM3 and PlWRKY22 are key drought resistance regulators, which have the ability to alleviate osmotic stress and improve water absorption, which may also help to improve the postharvest quality of cut peony. In addition, PlTIP1 is involved in the sugar signal pathway, indicating sugar may also as a signal substance during this process. Our work may give new ideas for developing new ways to prolong the vase life of cut peony and improve its commodity value eventually.Keywords: cut peony, melatonin, vase life, oxidation reaction, energy supply, differentially expressed genes
Procedia PDF Downloads 501758 Influence of Geologic and Geotechnical Dataset Resolution on Regional Liquefaction Assessment of the Lower Wairau Plains
Authors: Omer Altaf, Liam Wotherspoon, Rolando Orense
Abstract:
The Wairau Plains are located in the northeast of the South Island of New Zealand, with alluvial deposits of fine-grained silts and sands combined with low-lying topography suggesting the presence of liquefiable deposits over significant portions of the region. Liquefaction manifestations were observed in past earthquakes, including the 1848 Marlborough and 1855 Wairarapa earthquakes, and more recently during the 2013 Lake Grassmere and 2016 Kaikōura earthquakes. Therefore, a good understanding of the deposits that may be susceptible to liquefaction is important for land use planning in the region and to allow developers and asset owners to appropriately address their risk. For this purpose, multiple approaches have been employed to develop regional-scale maps showing the liquefaction vulnerability categories for the region. After applying semi-qualitative criteria linked to geologic age and deposit type, the higher resolution surface mapping of geomorphologic characteristics encompassing the Wairau River and the Opaoa River was used for screening. A detailed basin geologic model developed for groundwater modelling was analysed to provide a higher level of resolution than the surface-geology based classification. This is used to identify the thickness of near-surface gravel deposits, providing an improved understanding of the presence or lack of potentially non-liquefiable crust deposits. This paper describes the methodology adopted for this project and focuses on the influence of geomorphic characteristics and analysis of the detailed geologic basin model on the liquefaction classification of the Lower Wairau Plains.Keywords: liquefaction, earthquake, cone penetration test, mapping, liquefaction-induced damage
Procedia PDF Downloads 1761757 Assessment of Knowledge, Awareness about Hemorrhoids Causes and Stages among the General Public of Saudi Arabia
Authors: Asaiel Mubark Al Hadi
Abstract:
Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding
Procedia PDF Downloads 971756 Implementing a Hospitalist Co-Management Service in Orthopaedic Surgery
Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq
Abstract:
Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement
Procedia PDF Downloads 881755 Efficacy of Different Soil-Applied Fungicides to Manage Phytophthora Root Rot of Chili (Solanum annum) in Pakistan
Authors: Kiran Nawaz, Ahmad Ali Shahid, Sehrish Iftikhar, Waheed Anwar, Muhammad Nasir Subhani
Abstract:
Chili (Solanum annum L.) attacks by many fungal pathogens, including members of Oomycetes which are responsible for root rot in different chili growing areas of the world. Oomycetes pathogens cause economic losses in different regions of the Pakistan. Most of the plant tissues, including roots, crowns, fruit, and leaves, are vulnerable to Phytophthora capsici. It is very difficult to manage the Phytophthora root rot of chili as many commercial varieties are tremendously vulnerable to P. capsici. The causal agent of the disease was isolated on corn meal agar (CMA) and identified on a morphological basis by using available taxonomic keys. The pathogen was also confirmed on the molecular basis through internal transcribed spacer region and with other molecular markers.The Blastn results showed 100% homology with already reported sequences of P. capsici in NCBI database. Most of the farmers have conventionally relied on foliar fungicide applications to control Phytophthora root rot in spite of their incomplete effectiveness. In this study, in vitro plate assay, seed soaking and foliar applications of 6 fungicides were evaluated against root rot of chili. In vitro assay revealed that significant inhibition of linear growth was obtained with Triflumizole at 7.0%, followed by Thiophanate methyl (8.9%), Etridiazole (6.0%), Propamocarb (5.9%) and 7.5% with Mefenoxam and Iprodione for P. capsici. The promising treatments of in vitro plate bioassay were evaluated in pot experiments under controlled conditions in the greenhouse. All fungicides were applied after at 6-day intervals. Results of pot experiment showed that all treatments considerably inhibited the percentage of P. capsici root rot incidence. In addition, application of seed soaking with all six fungicides combined with the foliar spray of the same components showed the significant reduction in root rot incidence. The combine treatments of all fungicides as in vitro bioassay, seed soaking followed by foliar spray is considered non-harmful control methods which have advantages and limitation. Hence, these applications proved effective and harmless for the management of soil-borne plant pathogens.Keywords: blastn, bioassay, corn meal agar(CMA), oomycetes
Procedia PDF Downloads 2421754 Screening for Diabetes in Patients with Chronic Pancreatitis: The Belfast Trust Experience
Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston
Abstract:
Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience
Procedia PDF Downloads 1591753 Psychological Alarm among Individuals Suffering from Irritable Bowel Syndrome
Authors: Selim A., Albasher N., Bakrmom G., Alanzi S.
Abstract:
Irritable bowel syndrome (IBS) is a chronic functional bowel disorder characterized by abdominal discomfort or pain and associated with alteration in frequency and/or form of bowel habit among other symptoms. This diagnosis is associated with increased levels of psychological distress, maladaptive coping, genetic risk factors, abnormal small and colonic intestine transit, change in stool frequency or form and abdominal discomfort or pain. Aim: The aim of the study was to assess psychological alarm among individuals suffering from Irritable Bowel Syndrome (IBS). Methods: A cross-sectional correlational research design was used to conduct the current study. A convenience sample of 504 participants was included in the present study. Data were collected using a self-report questionnaire. The questionnaire included socio-demographic data, ROME III to identify Irritable Bowel Syndrome (IBS) and Psychological Alarm Questionnaire. Results: Out of 504 participants who reported abdominal discomfort, 297 (58.9 %) participants met the diagnostic criteria of IBS. The mean age of the IBS participants was 30.16 years, females composed 75.1% of the IBS participants, and 55.2% did not seek medical help. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals when compared to individuals not suffering from IBS. Psychological alarms such as feeling anxious, feeling depressed, having suicidal ideations, bodily pain, having impaired functioning due to pain and feeling unable to cope with pain were significantly high among IBS individuals compared to individuals not suffering from IBS. Conclusion: IBS is highly associated with significant psychological alarms including depression, anxiety and suicidal ideas.Keywords: abdominal pain , irritable bowel syndrome, distress, psychological alarms
Procedia PDF Downloads 189