Search results for: stress response
Commenced in January 2007
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Edition: International
Paper Count: 8580

Search results for: stress response

750 Risk and Protective Factors for the Health of Primary Care-Givers of Children with Autism Spectrum Disorders or Intellectual Disability: A Narrative Review and Discussion

Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard

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Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.

Keywords: autism, caregivers, health, intellectual disability, mothers, review

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749 Cartographic Depiction and Visualization of Wetlands Changes in the North-Western States of India

Authors: Bansal Ashwani

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Cartographic depiction and visualization of wetland changes is an important tool to map spatial-temporal information about the wetland dynamics effectively and to comprehend the response of these water bodies in maintaining the groundwater and surrounding ecosystem. This is true for the states of North Western India, i.e., J&K, Himachal, Punjab, and Haryana that are bestowed upon with several natural wetlands in the flood plains or on the courses of its rivers. Thus, the present study documents, analyses and reconstructs the lost wetlands, which existed in the flood plains of the major river basins of these states, i.e., Chenab, Jhelum, Satluj, Beas, Ravi, and Ghagar, in the beginning of the 20th century. To achieve the objective, the study has used multi-temporal datasets since the 1960s using high to medium resolution satellite datasets, e.g., Corona (1960s/70s), Landsat (1990s-2017) and Sentinel (2017). The Sentinel (2017) satellite image has been used for making the wetland inventory owing to its comparatively higher spatial resolution with multi-spectral bands. In addition, historical records, repeated photographs, historical maps, field observations including geomorphological evidence were also used. The water index techniques, i.e., band rationing, normalized difference water index (NDWI), modified NDWI (MNDWI) have been compared and used to map the wetlands. The wetland types found in the north-western states have been categorized under 19 classes suggested by Space Application Centre, India. These enable the researcher to provide with the wetlands inventory and a series of cartographic representation that includes overlaying multiple temporal wetlands extent vectors. A preliminary result shows the general state of wetland shrinkage since the 1960s with varying area shrinkage rate from one wetland to another. In addition, it is observed that majority of wetlands have not been documented so far and even do not have names. Moreover, the purpose is to emphasize their elimination in addition to establishing a baseline dataset that can be a tool for wetland planning and management. Finally, the applicability of cartographic depiction and visualization, historical map sources, repeated photographs and remote sensing data for reconstruction of long term wetlands fluctuations, especially in the northern part of India, will be addressed.

Keywords: cartographic depiction and visualization, wetland changes, NDWI/MDWI, geomorphological evidence and remote sensing

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748 Building the Professional Readiness of Graduates from Day One: An Empirical Approach to Curriculum Continuous Improvement

Authors: Fiona Wahr, Sitalakshmi Venkatraman

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Industry employers require new graduates to bring with them a range of knowledge, skills and abilities which mean these new employees can immediately make valuable work contributions. These will be a combination of discipline and professional knowledge, skills and abilities which give graduates the technical capabilities to solve practical problems whilst interacting with a range of stakeholders. Underpinning the development of these disciplines and professional knowledge, skills and abilities, are “enabling” knowledge, skills and abilities which assist students to engage in learning. These are academic and learning skills which are essential to common starting points for both the learning process of students entering the course as well as forming the foundation for the fully developed graduate knowledge, skills and abilities. This paper reports on a project created to introduce and strengthen these enabling skills into the first semester of a Bachelor of Information Technology degree in an Australian polytechnic. The project uses an action research approach in the context of ongoing continuous improvement for the course to enhance the overall learning experience, learning sequencing, graduate outcomes, and most importantly, in the first semester, student engagement and retention. The focus of this is implementing the new curriculum in first semester subjects of the course with the aim of developing the “enabling” learning skills, such as literacy, research and numeracy based knowledge, skills and abilities (KSAs). The approach used for the introduction and embedding of these KSAs, (as both enablers of learning and to underpin graduate attribute development), is presented. Building on previous publications which reported different aspects of this longitudinal study, this paper recaps on the rationale for the curriculum redevelopment and then presents the quantitative findings of entering students’ reading literacy and numeracy knowledge and skills degree as well as their perceived research ability. The paper presents the methodology and findings for this stage of the research. Overall, the cohort exhibits mixed KSA levels in these areas, with a relatively low aggregated score. In addition, the paper describes the considerations for adjusting the design and delivery of the new subjects with a targeted learning experience, in response to the feedback gained through continuous monitoring. Such a strategy is aimed at accommodating the changing learning needs of the students and serves to support them towards achieving the enabling learning goals starting from day one of their higher education studies.

Keywords: enabling skills, student retention, embedded learning support, continuous improvement

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747 Study of Open Spaces in Urban Residential Clusters in India

Authors: Renuka G. Oka

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From chowks to streets to verandahs to courtyards; residential open spaces are very significantly placed in traditional urban neighborhoods of India. At various levels of intersection, the open spaces with their attributes like juxtaposition with the built fabric, scale, climate sensitivity and response, multi-functionality, etc. reflect and respond to the patterns of human interactions. Also, these spaces tend to be quite well utilized. On the other hand, it is a common specter to see an imbalanced utilization of open spaces in newly/recently planned residential clusters. This is maybe due to lack of activity generators around or wrong locations or excess provisions or improper incorporation of aforementioned design attributes. These casual observations suggest the necessity for a systematic study of current residential open spaces. The exploratory study thus attempts to draw lessons through a structured inspection of residential open spaces to understand the effective environment as revealed through their use patterns. Here, residential open spaces are considered in a wider sense to incorporate all the un-built fabric around. These thus, include both use spaces and access space. For the study, open spaces in ten exemplary housing clusters/societies built during the last ten years across India are studied. A threefold inquiry is attempted in this direction. The first relates to identifying and determining the effects of various physical functions like space organization, size, hierarchy, thermal and optical comfort, etc. on the performance of residential open spaces. The second part sets out to understand socio-cultural variations in values, lifestyle, and beliefs which determine activity choices and behavioral preferences of users for respective residential open spaces. The third inquiry further observes the application of these research findings to the design process to derive meaningful and qualitative design advice. However, the study also emphasizes to develop a suitable framework of analysis and to carve out appropriate methods and approaches to probe into these aspects of the inquiry. Given this emphasis, a considerable portion of the research details out the conceptual framework for the study. This framework is supported by an in-depth search of available literature. The findings are worked out for design solutions which integrate the open space systems with the overall design process for residential clusters. The open spaces in residential areas present great complexities both in terms of their use patterns and determinants of their functional responses. The broad aim of the study is, therefore, to arrive at reconsideration of standards and qualitative parameters used by designers – on the basis of more substantial inquiry into the use patterns of open spaces in residential areas.

Keywords: open spaces, physical and social determinants, residential clusters, use patterns

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746 Psychological Distress and Associated Factors among Patients Attending Orthopedic Unit of at Dilla University Referral Hospital in Ethiopia, 2022

Authors: Chalachew Kassaw, Henok Ababu, Bethelhem Sileshy, Lulu Abebe, Birhanie Mekuriaw

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Background: Psychological discomfort is a state of emotional distress caused by everyday stressors and obligations that are difficult to manage. Orthopedic trauma has a wide range of effects on survivors' physical health, as well as a variety of mental health concerns that impede recovery. Psychiatric and behavioral conditions are 3-5 times more common in people who have undergone physical trauma, and they are a predictor of poor outcomes. Despite the above facts, there is a shortage of research done on the subject. Therefore, this study aimed to determine the magnitude of psychological distress and associated factor among patients attending orthopedic treatment at Gedeo zone, South Ethiopia 2022. Methods: A cross-sectional study was undertaken at Dilla University Referral Hospital from October –November 2022. The data was collected via a face-to-face interview, and the Kessler psychological distress scale (K-10) was used to assess psychological distress. A total of 386 patients receiving outpatient and inpatient services at the orthopedic unit were chosen using a simple random selection technique. A Statistical Package for the Social Science version 21 (SPSS-21) was used to enter and evaluate the data. To find related factors, bivariate, and multivariate logistic regressions were used. Variables having a p-value of less than 0.05 were deemed statistically significant. Result: A total of 386 participants with a response rate of 94.8% were included in the study. Out of all respondents, 114 (31.4%) of the individuals have experienced psychological distress. Independent variables such as Females [Adjusted odds ratio (AOR)=5.8, 95%CI=(4.6-15.6)], Average monthly income of <3500 birrs [Adjusted odds ratio (AOR) =4.8, 95% CI=(2.4-9.8) ], Current history of substance use [Adjusted odds ratio (AOR) =2.6, 95% CI=(1.66-4.7)], Strong social support [Adjusted odds ratio (AOR)=0.4, 95% CI= 0.4(0.2-0.8)], and Poor sleep quality (PSQI score>5) [Adjusted odds ratio (AOR)=2.0, 95%CI= 2.0(1.2-2.8)] were significantly associated with psychological distress. Conclusion: The prevalence of psychological distress was high. Being female, having poor social support, and having a high PSQI score were significantly associated factors with psychological distress. It is good if clinicians emphasize orthopedic patients, especially females and those having poor social support and low sleep quality symptoms.

Keywords: psychological distress, orthopedic unit, Dilla University hospital, Dilla Town, Southern Ethiopia

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745 The Role of Glyceryl Trinitrate (GTN) in 99mTc-HIDA with Morphine Provocation Scan for the Investigation of Type III Sphincter of Oddi Dysfunction (SOD)

Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland

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Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.

Keywords: GTN, HIDA, MORPHINE, SOD

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744 Efficacy of DAPG Producing Fluorescent Pseudomonas for Enhancing Nutrient Use Efficacy, Bio-Control of Soil-Borne Diseases and Yield of Groundnut

Authors: Basavaraj Yenagi, P. Nagaraju, C. R. Patil

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Groundnut (Arachis hypohaea L.) is called as “King of oilseeds” and one of the most important food and cash crops in Indian subcontinent. Yield and quality of oil are negatively correlated with poor or imbalanced nutrition and constant exposure to both biotic and abiotic stress factors. Variety of diseases affect groundnut plant, most of them are caused by fungi and lead to severe yield loss. Imbalanced nutrition increases the concerns of environmental deterioration which includes soil fertility. Among different microbial antagonists, Pseudomonas is common member of the plant growth promoting rhizobacteria microflora present in the rhizosphere of groundnut. These are known to produce a beneficial effect on groundnut due to their high metabolic activity leading to the production of enzymes, exopolysaccharides, secondary metabolites, and antibiotics. The ability of pseudomonas lies on their ability to produce antibiotic metabolites such as 2, 4-diacetylphloroglucinol (DAPG). DAPG can inhibit the growth of fungal pathogens namely collar rot and stem rot and also increase the availability of plant nutrients through increased solubilization and uptake of nutrients. Hence, the present study was conducted for three consecutive years (2014 to 2016) in vertisol during the rainy season to assess the efficacy of DAPG producing fluorescent pseudomonas for enhancing nutrient use efficacy, bio-control of soil-borne diseases and yield of groundnut at University of Agricultural Sciences, Dharwad farm. The experiment was laid out in an RCBD with three replications and seven treatments. The mean of three years data revealed that the effect of DAPG-producing producing fluorescent pseudomonas enhanced groundnut yield, uptake of nitrogen and phosphorus and nutrient use efficiency and also found to be effective in bio-control of collar rot and stem rot incidence leading to increase pod yield of groundnut. Higher dry pod yield of groundnut was obtained with DAPG 2(3535 kg ha-1) closely followed by DAPG 4(3492 kg ha-1), FP 98(3443 kg ha-1), DAPG 1(3414 kg ha-1), FP 86(3361 kg ha-1) and Trichoderma spp. (3380 kg ha-1) over control(3173 kg ha-1). A similar trend was obtained with other growth and yield attributing parameters. N uptake ranged from 8.21 percent to FP 86 to 17.91 percent with DAPG 2 and P uptake ranged between 5.56 percent with FP 86 to 16.67 percent with DAPG 2 over control. The first year, there was no incidence of collar rot. During the second year, the control plot recorded 2.51 percent incidence and it ranged from 0.82 percent to 1.43 percent in different DAPG-producing fluorescent pseudomonas treatments. The similar trend was noticed in the third year with lower incidence. The stem rot incidence was recorded during all the three years. Mean data indicated that the control plot recorded 2.65 percent incidence and it ranged from 0.71 percent to 1.23 percent in different DAPG-producing fluorescent pseudomonas treatments. The increase in net monetary benefits ranged from Rs.5975 ha-1 to Rs.11407 ha 1 in different treatments. Hence, as a low-cost technology, seed treatment with available DAPG-producing fluorescent pseudomonas has a beneficial effect on groundnut for enhancing groundnut yield, nutrient use efficiency and bio-control of soil-borne diseases.

Keywords: groundnut, DAPG, fluorescent pseudomonas, nutrient use efficiency, collar rot, stem rot

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743 Decentralized Peak-Shaving Strategies for Integrated Domestic Batteries

Authors: Corentin Jankowiak, Aggelos Zacharopoulos, Caterina Brandoni

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In a context of increasing stress put on the electricity network by the decarbonization of many sectors, energy storage is likely to be the key mitigating element, by acting as a buffer between production and demand. In particular, the highest potential for storage is when connected closer to the loads. Yet, low voltage storage struggles to penetrate the market at a large scale due to the novelty and complexity of the solution, and the competitive advantage of fossil fuel-based technologies regarding regulations. Strong and reliable numerical simulations are required to show the benefits of storage located near loads and promote its development. The present study was restrained from excluding aggregated control of storage: it is assumed that the storage units operate independently to one another without exchanging information – as is currently mostly the case. A computationally light battery model is presented in detail and validated by direct comparison with a domestic battery operating in real conditions. This model is then used to develop Peak-Shaving (PS) control strategies as it is the decentralized service from which beneficial impacts are most likely to emerge. The aggregation of flatter, peak- shaved consumption profiles is likely to lead to flatter and arbitraged profile at higher voltage layers. Furthermore, voltage fluctuations can be expected to decrease if spikes of individual consumption are reduced. The crucial part to achieve PS lies in the charging pattern: peaks depend on the switching on and off of appliances in the dwelling by the occupants and are therefore impossible to predict accurately. A performant PS strategy must, therefore, include a smart charge recovery algorithm that can ensure enough energy is present in the battery in case it is needed without generating new peaks by charging the unit. Three categories of PS algorithms are introduced in detail. First, using a constant threshold or power rate for charge recovery, followed by algorithms using the State Of Charge (SOC) as a decision variable. Finally, using a load forecast – of which the impact of the accuracy is discussed – to generate PS. A performance metrics was defined in order to quantitatively evaluate their operating regarding peak reduction, total energy consumption, and self-consumption of domestic photovoltaic generation. The algorithms were tested on load profiles with a 1-minute granularity over a 1-year period, and their performance was assessed regarding these metrics. The results show that constant charging threshold or power are far from optimal: a certain value is not likely to fit the variability of a residential profile. As could be expected, forecast-based algorithms show the highest performance. However, these depend on the accuracy of the forecast. On the other hand, SOC based algorithms also present satisfying performance, making them a strong alternative when the reliable forecast is not available.

Keywords: decentralised control, domestic integrated batteries, electricity network performance, peak-shaving algorithm

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742 Relationship between Glycated Hemoglobin in Adolescents with Type 1 Diabetes Mellitus and Parental Anxiety and Depression

Authors: Evija Silina, Maris Taube, Maksims Zolovs

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Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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741 Parental Education on Early Childhood Development Using Mobile App and Website in China

Authors: Margo O'Sullivan, Xuefeng Chen, Qi Zhao, J. Jiang, Ning Fu

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Early childhood development, or ECD, is about the 'whole child' – the physical, social and emotional, cognitive thinking and language progression of each young individual. Overwhelming evidence is now available to support investment in Early Childhood Development internationally, attendance at ECD leads to: improved learning outcomes; improved completion and reduced less dropout rates; and most notably, Professor Heckman, Nobel Laureate’s, findings that for every dollar invested, there is an economic return of up to 17%. Notably, ECD has been included in the 2015-2030 Sustainable Development Goals. The Government of China (GOC) has embraced this research and in 2010, State Council, announced focus on ECD setting a target to provide access to ECD for 85% of 3-6 year olds by 2020; to date, the target has surpassed expectations and reached 70.4%. GoC is also increasingly focusing on the even more critical 0-3 age group, when the plasticity of the brain is at its peak and neurons form connections as fast as 1,000 per second. Key to ECD are parents and caregivers of young children, with parental education critical to fully exploiting the significant potential of the early years of children. In China, with such vast numbers, one in seven pre-school age children in the world live in China, the Ministry of Education (MoE) and the National Centre for Education Technology, explored how to best provide parental education and provide key child developmental related knowledge to parents and caregivers. In response, MoE and UNICEF created a resource for parenting information that began with a computer website in 2012, followed by piloting a kiosk service in 2013 for parents in remote areas without access to the internet, and then a mobile phone application in 2014. The resource includes 269 ECD messages and 200 micro-videos covering critical issues of early childhood development from birth to age 6 years: daily care, nutrition and feeding, disease prevention, immunization, development and education, and safety and protection. To date, there have been 397,599 unique views on the website, and data for the mobile app currently being analysed (Links: http://yuer.cbern.gov.cn/; App: https://appsto.re/cn/OiKPZ.i). This paper will explore the development of this resource, its use by parents and the public, efforts to assess the effectiveness in improving parenting and child development, and future plans to roll an updated version in 2016 to all parents.

Keywords: early childhood development, mobile apps for education, parental education, China

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740 Implementing a Structured, yet Flexible Tool for Critical Information Handover

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

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739 Feasibility and Acceptability of Mindfulness-Based Cognitive Therapy in People with Depression and Cardiovascular Disorders: A Feasibility Randomised Controlled Trial

Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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738 Nonlinear Interaction of Free Surface Sloshing of Gaussian Hump with Its Container

Authors: Mohammad R. Jalali

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Movement of liquid with a free surface in a container is known as slosh. For instance, slosh occurs when water in a closed tank is set in motion by a free surface displacement, or when liquid natural gas in a container is vibrated by an external driving force, such as an earthquake or movement induced by transport. Slosh is also derived from resonant switching of a natural basin. During sloshing, different types of motion are produced by energy exchange between the liquid and its container. In present study, a numerical model is developed to simulate the nonlinear even harmonic oscillations of free surface sloshing of an initial disturbance to the free surface of a liquid in a closed square basin. The response of the liquid free surface is affected by amplitude and motion frequencies of its container; therefore, sloshing involves complex fluid-structure interactions. In the present study, nonlinear interaction of free surface sloshing of an initial Gaussian hump with its uneven container is predicted numerically. For this purpose, Green-Naghdi (GN) equations are applied as governing equation of fluid field to produce nonlinear second-order and higher-order wave interactions. These equations reduce the dimensions from three to two, yielding equations that can be solved efficiently. The GN approach assumes a particular flow kinematic structure in the vertical direction for shallow and deep-water problems. The fluid velocity profile is finite sum of coefficients depending on space and time multiplied by a weighting function. It should be noted that in GN theory, the flow is rotational. In this study, GN numerical simulations of initial Gaussian hump are compared with Fourier series semi-analytical solutions of the linearized shallow water equations. The comparison reveals that satisfactory agreement exists between the numerical simulation and the analytical solution of the overall free surface sloshing patterns. The resonant free surface motions driven by an initial Gaussian disturbance are obtained by Fast Fourier Transform (FFT) of the free surface elevation time history components. Numerically predicted velocity vectors and magnitude contours for the free surface patterns indicate that interaction of Gaussian hump with its container has localized effect. The result of this sloshing is applicable to the design of stable liquefied oil containers in tankers and offshore platforms.

Keywords: fluid-structure interactions, free surface sloshing, Gaussian hump, Green-Naghdi equations, numerical predictions

Procedia PDF Downloads 397
737 Risk Factors Associated with Increased Emergency Department Visits and Hospital Admissions Among Child and Adolescent Patients

Authors: Lalanthica Yogendran, Manassa Hany, Saira Pasha, Benjamin Chaucer, Simarpreet Kaur, Christopher Janusz

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Children and adolescent patients visit the Psychiatric Emergency Department (ED) for multiple reasons. Visiting the Psychiatric ED itself can be a traumatic experience that can affect an adolescents mental well-being, regardless of a history of mental illness. Despite this, limited research exists in this domain. Prospective studies have correlated adverse psychosocial determinants among adolescents to risk factors for poor well-being and unfavorable behavior outcomes. Studies have also shown that physiological stress is a contributor in the development of health problems and an increase in substance abuse in adolescents. This study aimed to retrospectively determine which psychosocial factors are associated with an increase in psychiatric ED visits. 600 charts of patients who had a psychiatric ED and inpatient admission visit from January 2014 through December 2014 were reviewed. Sociodemographics, diagnoses, ED visits and inpatient admissions were collected. Descriptive statistics, chi-square tests and independent t-test analyses were utilized to examine differences in the sample to determine which factors affected ED visits and admissions. The sample was 50% female, 35.2% self-identified black, and had a mean age of 13 years. The majority, 85%, went to public school and 17% were in special education. Attention Deficit Hyperactivity Disorder was the most common admitting diagnosis, found in 132(23%) responders. Most patients came from single parent household 305 (53%). The mean ages of patients that were sexually active, with legal issues, and reporting marijuana substance abuse were 15, 14.35, and 15 years respectively. Patients from two biological parent households had significantly fewer ED visits (1.2 vs. 1.7, p < 0.01) and admissions (0.09 vs. 0.26, p < 0.01). Among social factors, those who reported sexual, physical or emotional abuse had a significantly greater number of ED visits (2.1 vs. 1.5, p < 0.01) and admissions (0.61 vs. 0.14, p < 0.01) than those who did not. Patients that were sexually active or had legal issues or substance abuse with marijuana had a significantly greater number of admissions (0.43 vs. 0.17, p < 0.01), (0.54 vs. .18, p < 0.01) and (0.46 vs. 0.18, p < 0.01) respectively. This data supports the theory of the stability of a two parent home. Dual parenting plays a role in creating a safe space where a child can develop; this is shown by subsequent decreases in psychiatric ED visits and admissions. This may highlight the psychological protective role of a two parent household. Abuse can exacerbate existing psychiatric illness or initiate the onset of new disease. Substance abuse and legal issues result in early induction to the criminal system. Results show that this causes an increase in frequency of visits and severity of symptoms. Only marijuana, but not other illicit substances, correlated with higher incidence of psychiatric ED visits. This may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. This study demonstrates the array of psychosocial factors that lead to increased ED visits and admissions in children and adolescents.

Keywords: adolescent, child psychiatry, emergency department, substance abuse

Procedia PDF Downloads 331
736 Investigating the Role of Organizational Politics in Human Resource Management: Effects on Performance Appraisal and Downsizing Decisions

Authors: Ibrahim Elshaer, Samar Kamel

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Organizational politics (OP) has received a great deal of attention in the management literature due to its popularity, mystery, and potential advantages for those how can use it. It involves the use of power and social networks within an organization to promote interests and gain potential benefits. Its implication for human resource (HR) management decisions is heretofore one of its least studied aspects, and awaits further investigation. Therefore, it is our intention to investigate certain relations between organizational politics and the validity of HR decisions in addition to the expected dysfunctional consequences. The study is undertaken on two HR management practices- Performance appraisal (measured by the distributive justice scale) and downsizing- depending on data gathered from the hotel industry in Egypt; a developing Non-Western country, in which Political practices of HR management are common in public and private organizations. Data was obtained from a survey of 600 employees in the Egyptian hotel industry. A total of 500 responses were attained. 100 uncompleted questionnaires were excluded leaving 400 usable with response rate of around 80%. Structural equation modeling (SEM) was employed to test the causal relationship between the research variables. The analysis of the current study data reveals that organizational politics is negatively linked to the perception of distributive justice of performance appraisal, additionally, the perception of distributive justice in performance appraisal is positively linked to the perception of validity in the downsizing decisions and finally the perception of OP is negatively linked to the perception of downsizing decisions validity. This study makes three important contributions. First although there have been several studies on OP, the majority of these studies have focused on examining its effect on employees’ attitudes in workplace. This empirical study helps in identifying the influence of OP on the effectiveness and success of HR decisions and accordingly the organizational system. Second, it draws attention to OP as an important phenomenon that influence HR management in hospitality industry, since empirical evidences concerning OP in the hospitality management literature are meager. Third, this study contributes to the existing downsizing literature by examining OP and low distributive justice as challenges of the effectiveness of the downsizing process. Finally, to the best of the authors’ knowledge, no empirical study in the tourism and hospitality management literature has examined the effect of OP and distributive justice on the workplace using data gathered from the hotel industry in Egypt; a developing non-Western setting.

Keywords: organizational politics, performance appraisal, downsizing, structural equation modeling, hotel industry

Procedia PDF Downloads 408
735 Volunteered Geographic Information Coupled with Wildfire Fire Progression Maps: A Spatial and Temporal Tool for Incident Storytelling

Authors: Cassandra Hansen, Paul Doherty, Chris Ferner, German Whitley, Holly Torpey

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Wildfire is a natural and inevitable occurrence, yet changing climatic conditions have increased the severity, frequency, and risk to human populations in the wildland/urban interface (WUI) of the Western United States. Rapid dissemination of accurate wildfire information is critical to both the Incident Management Team (IMT) and the affected community. With the advent of increasingly sophisticated information systems, GIS can now be used as a web platform for sharing geographic information in new and innovative ways, such as virtual story map applications. Crowdsourced information can be extraordinarily useful when coupled with authoritative information. Information abounds in the form of social media, emergency alerts, radio, and news outlets, yet many of these resources lack a spatial component when first distributed. In this study, we describe how twenty-eight volunteer GIS professionals across nine Geographic Area Coordination Centers (GACC) sourced, curated, and distributed Volunteered Geographic Information (VGI) from authoritative social media accounts focused on disseminating information about wildfires and public safety. The combination of fire progression maps with VGI incident information helps answer three critical questions about an incident, such as: where the first started. How and why the fire behaved in an extreme manner and how we can learn from the fire incident's story to respond and prepare for future fires in this area. By adding a spatial component to that shared information, this team has been able to visualize shared information about wildfire starts in an interactive map that answers three critical questions in a more intuitive way. Additionally, long-term social and technical impacts on communities are examined in relation to situational awareness of the disaster through map layers and agency links, the number of views in a particular region of a disaster, community involvement and sharing of this critical resource. Combined with a GIS platform and disaster VGI applications, this workflow and information become invaluable to communities within the WUI and bring spatial awareness for disaster preparedness, response, mitigation, and recovery. This study highlights progression maps as the ultimate storytelling mechanism through incident case studies and demonstrates the impact of VGI and sophisticated applied cartographic methodology make this an indispensable resource for authoritative information sharing.

Keywords: storytelling, wildfire progression maps, volunteered geographic information, spatial and temporal

Procedia PDF Downloads 170
734 Short and Long Crack Growth Behavior in Ferrite Bainite Dual Phase Steels

Authors: Ashok Kumar, Shiv Brat Singh, Kalyan Kumar Ray

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There is growing awareness to design steels against fatigue damage Ferrite martensite dual-phase steels are known to exhibit favourable mechanical properties like good strength, ductility, toughness, continuous yielding, and high work hardening rate. However, dual-phase steels containing bainite as second phase are potential alternatives for ferrite martensite steels for certain applications where good fatigue property is required. Fatigue properties of dual phase steels are popularly assessed by the nature of variation of crack growth rate (da/dN) with stress intensity factor range (∆K), and the magnitude of fatigue threshold (∆Kth) for long cracks. There exists an increased emphasis to understand not only the long crack fatigue behavior but also short crack growth behavior of ferrite bainite dual phase steels. The major objective of this report is to examine the influence of microstructures on the short and long crack growth behavior of a series of developed dual-phase steels with varying amounts of bainite and. Three low carbon steels containing Nb, Cr and Mo as microalloying elements steels were selected for making ferrite-bainite dual-phase microstructures by suitable heat treatments. The heat treatment consisted of austenitizing the steel at 1100°C for 20 min, cooling at different rates in air prior to soaking these in a salt bath at 500°C for one hour, and finally quenching in water. Tensile tests were carried out on 25 mm gauge length specimens with 5 mm diameter using nominal strain rate 0.6x10⁻³ s⁻¹ at room temperature. Fatigue crack growth studies were made on a recently developed specimen configuration using a rotating bending machine. The crack growth was monitored by interrupting the test and observing the specimens under an optical microscope connected to an Image analyzer. The estimated crack lengths (a) at varying number of cycles (N) in different fatigue experiments were analyzed to obtain log da/dN vs. log °∆K curves for determining ∆Kthsc. The microstructural features of these steels have been characterized and their influence on the near threshold crack growth has been examined. This investigation, in brief, involves (i) the estimation of ∆Kthsc and (ii) the examination of the influence of microstructure on short and long crack fatigue threshold. The maximum fatigue threshold values obtained from short crack growth experiments on various specimens of dual-phase steels containing different amounts of bainite are found to increase with increasing bainite content in all the investigated steels. The variations of fatigue behavior of the selected steel samples have been explained with the consideration of varying amounts of the constituent phases and their interactions with the generated microstructures during cyclic loading. Quantitative estimation of the different types of fatigue crack paths indicates that the propensity of a crack to pass through the interfaces depends on the relative amount of the microstructural constituents. The fatigue crack path is found to be predominantly intra-granular except for the ones containing > 70% bainite in which it is predominantly inter-granular.

Keywords: bainite, dual phase steel, fatigue crack growth rate, long crack fatigue threshold, short crack fatigue threshold

Procedia PDF Downloads 201
733 Robust Processing of Antenna Array Signals under Local Scattering Environments

Authors: Ju-Hong Lee, Ching-Wei Liao

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An adaptive array beamformer is designed for automatically preserving the desired signals while cancelling interference and noise. Providing robustness against model mismatches and tracking possible environment changes calls for robust adaptive beamforming techniques. The design criterion yields the well-known generalized sidelobe canceller (GSC) beamformer. In practice, the knowledge of the desired steering vector can be imprecise, which often occurs due to estimation errors in the DOA of the desired signal or imperfect array calibration. In these situations, the SOI is considered as interference, and the performance of the GSC beamformer is known to degrade. This undesired behavior results in a reduction of the array output signal-to-interference plus-noise-ratio (SINR). Therefore, it is worth developing robust techniques to deal with the problem due to local scattering environments. As to the implementation of adaptive beamforming, the required computational complexity is enormous when the array beamformer is equipped with massive antenna array sensors. To alleviate this difficulty, a generalized sidelobe canceller (GSC) with partially adaptivity for less adaptive degrees of freedom and faster adaptive response has been proposed in the literature. Unfortunately, it has been shown that the conventional GSC-based adaptive beamformers are usually very sensitive to the mismatch problems due to local scattering situations. In this paper, we present an effective GSC-based beamformer against the mismatch problems mentioned above. The proposed GSC-based array beamformer adaptively estimates the actual direction of the desired signal by using the presumed steering vector and the received array data snapshots. We utilize the predefined steering vector and a presumed angle tolerance range to carry out the required estimation for obtaining an appropriate steering vector. A matrix associated with the direction vector of signal sources is first created. Then projection matrices related to the matrix are generated and are utilized to iteratively estimate the actual direction vector of the desired signal. As a result, the quiescent weight vector and the required signal blocking matrix required for performing adaptive beamforming can be easily found. By utilizing the proposed GSC-based beamformer, we find that the performance degradation due to the considered local scattering environments can be effectively mitigated. To further enhance the beamforming performance, a signal subspace projection matrix is also introduced into the proposed GSC-based beamformer. Several computer simulation examples show that the proposed GSC-based beamformer outperforms the existing robust techniques.

Keywords: adaptive antenna beamforming, local scattering, signal blocking, steering mismatch

Procedia PDF Downloads 108
732 Artificial Intelligence in Management Simulators

Authors: Nuno Biga

Abstract:

Artificial Intelligence (AI) allows machines to interpret information and learn from context analysis, giving them the ability to make predictions adjusted to each specific situation. In addition to learning by performing deterministic and probabilistic calculations, the 'artificial brain' also learns through information and data provided by those who train it, namely its users. The "Assisted-BIGAMES" version of the Accident & Emergency (A&E) simulator introduces the concept of a "Virtual Assistant" (VA) that provides users with useful suggestions, namely to pursue the following operations: a) to relocate workstations in order to shorten travelled distances and minimize the stress of those involved; b) to identify in real time the bottleneck(s) in the operations system so that it is possible to quickly act upon them; c) to identify resources that should be polyvalent so that the system can be more efficient; d) to identify in which specific processes it may be advantageous to establish partnership with other teams; and e) to assess possible solutions based on the suggested KPIs allowing action monitoring to guide the (re)definition of future strategies. This paper is built on the BIGAMES© simulator and presents the conceptual AI model developed in a pilot project. Each Virtual Assisted BIGAME is a management simulator developed by the author that guides operational and strategic decision making, providing users with useful information in the form of management recommendations that make it possible to predict the actual outcome of different alternative management strategic actions. The pilot project developed incorporates results from 12 editions of the BIGAME A&E that took place between 2017 and 2022 at AESE Business School, based on the compilation of data that allows establishing causal relationships between decisions taken and results obtained. The systemic analysis and interpretation of this information is materialised in the Assisted-BIGAMES through a computer application called "BIGAMES Virtual Assistant" that players can use during the Game. Each participant in the Virtual Assisted-BIGAMES permanently asks himself about the decisions he should make during the game in order to win the competition. To this end, the role of the VA of each team consists in guiding the players to be more effective in their decision making through presenting recommendations based on AI methods. It is important to note that the VA's suggestions for action can be accepted or rejected by the managers of each team, and as the participants gain a better understanding of the game, they will more easily dispense with the VA's recommendations and rely more on their own experience, capability, and knowledge to support their own decisions. Preliminary results show that the introduction of the VA provides a faster learning of the decision-making process. The facilitator (Serious Game Controller) is responsible for supporting the players with further analysis and the recommended action may be (or not) aligned with the previous recommendations of the VA. All the information should be jointly analysed and assessed by each player, who are expected to add “Emotional Intelligence”, a component absent from the machine learning process.

Keywords: artificial intelligence (AI), gamification, key performance indicators (KPI), machine learning, management simulators, serious games, virtual assistant

Procedia PDF Downloads 100
731 Coupled Field Formulation – A Unified Method for Formulating Structural Mechanics Problems

Authors: Ramprasad Srinivasan

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Engineers create inventions and put their ideas in concrete terms to design new products. Design drivers must be established, which requires, among other things, a complete understanding of the product design, load paths, etc. For Aerospace Vehicles, weight/strength ratio, strength, stiffness and stability are the important design drivers. A complex built-up structure is made up of an assemblage of primitive structural forms of arbitrary shape, which include 1D structures like beams and frames, 2D structures like membranes, plate and shell structures, and 3D solid structures. Justification through simulation involves a check for all the quantities of interest, namely stresses, deformation, frequencies, and buckling loads and is normally achieved through the finite element (FE) method. Over the past few decades, Fiber-reinforced composites are fast replacing the traditional metallic structures in the weight-sensitive aerospace and aircraft industries due to their high specific strength, high specific stiffness, anisotropic properties, design freedom for tailoring etc. Composite panel constructions are used in aircraft to design primary structure components like wings, empennage, ailerons, etc., while thin-walled composite beams (TWCB) are used to model slender structures like stiffened panels, helicopter, and wind turbine rotor blades, etc. The TWCB demonstrates many non-classical effects like torsional and constrained warping, transverse shear, coupling effects, heterogeneity, etc., which makes the analysis of composite structures far more complex. Conventional FE formulations to model 1D structures suffer from many limitations like shear locking, particularly in slender beams, lower convergence rates due to material coupling in composites, inability to satisfy, equilibrium in the domain and natural boundary conditions (NBC) etc. For 2D structures, the limitations of conventional displacement-based FE formulations include the inability to satisfy NBC explicitly and many pathological problems such as shear and membrane locking, spurious modes, stress oscillations, lower convergence due to mesh distortion etc. This mandates frequent re-meshing to even achieve an acceptable mesh (satisfy stringent quality metrics) for analysis leading to significant cycle time. Besides, currently, there is a need for separate formulations (u/p) to model incompressible materials, and a single unified formulation is missing in the literature. Hence coupled field formulation (CFF) is a unified formulation proposed by the author for the solution of complex 1D and 2D structures addressing the gaps in the literature mentioned above. The salient features of CFF and its many advantages over other conventional methods shall be presented in this paper.

Keywords: coupled field formulation, kinematic and material coupling, natural boundary condition, locking free formulation

Procedia PDF Downloads 63
730 Dynamic Changes in NT-proBNP Levels in Unrelated Donors during Hematopoietic Stem Cells Mobilization

Authors: Natalia V. Minaeva, Natalia A. Zorina, Marina N. Khorobrikh, Philipp S. Sherstnev, Tatiana V. Krivokorytova, Alexander S. Luchinin, Maksim S. Minaev, Igor V. Paramonov

Abstract:

Background. Over the last few decades, the Center for International Blood and Marrow Transplant Research (CIBMTR) and the World Marrow Donor Association (WMDA) have been actively working to ensure the safety of the hematopoietic stem cell (HSC) donation process. Registration of adverse events that may occur during the donation period and establishing a relationship between donation and side effects are included in the WMDA international standards. The level of blood serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is an early marker of myocardial stress. Due to the high analytical sensitivity and specificity, laboratory assessment of NT-proBNP makes it possible to objectively diagnose myocardial dysfunction. It is well known that the main stimulus for proBNP synthesis and secretion from atrial and ventricular cardiac myocytes is myocyte stretch and increasement of myocardial extensibility and pressure in the heart chambers. Аim. The aim of the study was to assess the dynamic changes in the levels of blood serum N-terminal pro-brain natriuretic peptide of unrelated donors at various stages of hematopoietic stem cell mobilization. Materials. We have examined 133 unrelated donors, including 92 men and 41 women, that have been included into the study. The NT-proBNP levels were measured before the start of mobilization, then on the day of apheresis, and after the donation of allogeneic HSC. The relationship between NT-proBNP levels and body mass index (BMI), ferritin, hemoglobin, and white blood cells (WBC) levels was assessed on the day of apheresis. The median age of donors was 34 years. Mobilization of HSCs was managed with filgrastim administration at a dose of 10 μg/kg daily for 4-5 days. The first leukocytapheresis was performed on day 4 from the start of filgrastim administration. Quantitative values of the blood serum NT-proBNP level are presented as a median (Me), first and third quartiles (Q1-Q3). Comparative analysis was carried out using the t-test and correlation analysis as well by Spearman method. Results. The baseline blood serum NT-proBNP levels in all 133 donors were within the reference values (<125 pg/ml) and equaled 21,6 (10,0; 43,3) pg/ml. At the same time, the level of NT-proBNP in women was significantly higher than that of men. On the day of the HSC apheresis, a significant increase of blood serum NT-proBNP levels was detected and equald 131,2 (72,6; 165,3) pg/ml (p<0,001), with higher rates in female donors. A statistically significant weak inverse correleation was established between the level of NT-proBNP and the BMI of donors (-0.18, p = 0,03), as well as the level of hemoglobin (-0.33, p <0,001), and ferritin levels (-0.19, p = 0,03). No relationship has been established between the magnitude of WBC levels achieved as a result of the mobilization of HSC on the day of leukocytapheresis. A day after the apheresis, the blood serum NT-proBNP levels still exceeded the reference values, but there was a decreasing tendency. Conclusion. An increase of the blood serum NT-proBNP level in unrelated donors during the mobilization of HSC was established. Future studies should clarify the reason for this phenomenon, as well as its effects on donors' long-term health.

Keywords: unrelated donors, mobilization, hematopoietic stem cells, N-terminal pro-brain natriuretic peptide

Procedia PDF Downloads 98
729 Mechanical Behavior of Sandwiches with Various Glass Fiber/Epoxy Skins under Bending Load

Authors: Emre Kara, Metehan Demir, Şura Karakuzu, Kadir Koç, Ahmet F. Geylan, Halil Aykul

Abstract:

While the polymeric foam cored sandwiches have been realized for many years, recently there is a growing and outstanding interest on the use of sandwiches consisting of aluminum foam core because of their some of the distinct mechanical properties such as high bending stiffness, high load carrying and energy absorption capacities. These properties make them very useful in the transportation industry (automotive, aerospace, shipbuilding industry), where the "lightweight design" philosophy and the safety of vehicles are very important aspects. Therefore, in this study, the sandwich panels with aluminum alloy foam core and various types and thicknesses of glass fiber reinforced polymer (GFRP) skins produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique were obtained by using a commercial toughened epoxy based adhesive with two components. The aim of this contribution was the analysis of the bending response of sandwiches with various glass fiber reinforced polymer skins. The three point bending tests were performed on sandwich panels at different values of support span distance using a universal static testing machine in order to clarify the effects of the type and thickness of the GFRP skins in terms of peak load, energy efficiency and absorbed energy values. The GFRP skins were easily bonded to the aluminum alloy foam core under press machine with a very low pressure. The main results of the bending tests are: force-displacement curves, peak force values, absorbed energy, collapse mechanisms and the influence of the support span length and GFRP skins. The obtained results of the experimental investigation presented that the sandwich with the skin made of thicker S-Glass fabric failed at the highest load and absorbed the highest amount of energy compared to the other sandwich specimens. The increment of the support span distance made the decrease of the peak force and absorbed energy values for each type of panels. The common collapse mechanism of the panels was obtained as core shear failure which was not affected by the skin materials and the support span distance.

Keywords: aluminum foam, collapse mechanisms, light-weight structures, transport application

Procedia PDF Downloads 396
728 Atypical Intoxication Due to Fluoxetine Abuse with Symptoms of Amnesia

Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

Procedia PDF Downloads 195
727 Nation Building versus Self Determination: Thai State’s Response to Insurgency in South

Authors: Sunaina Sunaina

Abstract:

The emergence of Thailand as a modern nation was amalgamation of several minority groups. Eventually, the nation tried to mitigate these diversities in the name of nationalism in the backdrop of colonial powers presence in neighboring nations. However, the continued imposition of modern nation building processes (which is a western concept) in the post-colonial era deepen the feelings of alienation among the minority groups and leads to separatist conflicts. It is significant that whatever form these conflicts take, will impact the security of nation as well as the region of Southeast Asia. This paper tries to explore the possible factors behind the state policies adopted by the government of Thailand to manage the insurgency in Southern provinces in the south. The protracted insurgency in the South has historical roots as Pattani kingdom had glorious period whether it was trade or commerce or education and its assimilation was never accepted by the leaders of these areas. But after assimilation of southern provinces in the state, it has been the state policy as an important factor in promoting or mitigating the insurgency. Initial protests from the elite class of southern provinces inflated into a more organized and violent uprising after Second World War. It was only the decade of 1990s that a relative peace could prevail for some time. The violence reemerged in 2004 with more intensity and till today this area is suffering with violence. Period of different Prime Ministers dealt this insurgency in different ways sometimes very hard line approach had been adopted especially under Primeminstership of Thaksin Shinawatra. Recently, the peace talks which were started during the period of Yinglunck Shinawatra and were carried forward by Junta government also halted. And again, the region stays in a very volatile state. Violence in these provinces not only questions the capability of government to provide political solution to the problem, but also emerges as a major threat to the internal security of the state. The current era where global terrorism is spreading fast, such vulnerable areas may work as a new ground for its proliferation in Southeast Asia. The paper attempts to understand how Thailand’s historical experience of security determines a different approach to national unity which limits the prospects for autonomy in the South. In conjunction with this experience it is nature of national politics and leadership that influences the nature of policies on the ground in Southern Thailand. The paper also tries to bring out conflict between state sovereignty and self-determination as demanded by many in the southern provinces.

Keywords: insurgency, southern Thailand, security, nation building

Procedia PDF Downloads 123
726 Mothers’ Experiences of Continuing Their Pregnancy after Prenatally Receiving a Diagnosis of Down Syndrome

Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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725 Moringa olifera Curate The Toxic Potential of CuO Nanoparticles in Oreochromis mossambicus

Authors: Farhat Jabeen, Muhammad Asad

Abstract:

The study assessed the curative potential of Moringa olifera seeds against copper oxide nanoparticles induced toxicity in Oreochromis mossambicus. In order to investigate the curative potential of M. olifera seeds, firstly we examine its chemical composition, secondary metabolites, and bioactive compounds including hydroxyl-cinnamic acids, flavanols and hydroxybenzoic acids through standard methods and high performance liquid chromatography. In current study, the potential sub-lethal toxic dose of CuO-NPs (0.12 mg/l) was investigated through pilot experiment and three non-lethal doses (low=32, medium=48 and high=96 mg/l) of M. olifera were selected on the basis of its LC50 value for O. mossambicus. The experimental fish, O. mossambicus (n=100 of approximately 20 g each) were procured from Manawan Fisheries Complex, Lahore, and acclimatized for two weeks in glass aquaria. Experiment was conducted in accordance with the guidelines of Institutional Animal Ethics Committee, Government College University Faisalabad, Pakistan. During acclimatization and experimental period, fish received the commercial fish feed at 2.5% body weight daily. In order to assess the curative effect of M. olifera against CuO NPs induced toxicity, O. mossambicus were randomly divided into five groups and were designated as control (C) without any treatment, positive control (G*) exposed to potential toxic dose of CuO-NPs at 0.12 mg/l, and three treated groups namely G1, G2, and G3 co-treated with 0.12 mg/l of CuO-NPs plus different doses of M. olifera seed extract at 32, 48, and 96 mg/l, respectively for 56 days. Fish were exposed to waterborne CuO NPs and M. olifera seed extract. CuO-NPs treatment was ceased after 28 days but the doses of M. olifera were continued for 56 days. Blood was taken after 28 and 56 days through caudal venipuncture. Liver and intestine were taken for oxidative stress and histological studies after 56 days. In M. olifera seeds, moisture contents, crude protein, lipids, carbohydrates and ash were recorded as 3.8, 37.83, 32.52, 46.12, and 7.75%, respectively on dry weight basis. Total energy was recorded as 627.36 kcal/100g. Qualitative analysis of M. olifera seeds showed the presence of terpenoids, saponins, flavonoids, alkaloids and phenolics, while its quantitative analysis showed the considerable amount of total phenolics, flavonoids, saponins, and alkaloids as 134.75, 170.15, 1.57, and 0.4 µg/mg, respectively. Analysis of bioactive compounds in M. olifera seeds showed the presence of hydroxy-cinnamic acids (6.07 µg/ml), flavanols (71.72 µg/ml), and hydroxyl benzoic acids (97.82 µg/ml). The results showed that M. oliefera seed extract at 48 and 56 mg/l was able to cure against the toxic effects of CuO-NPs. The significant changes were observed in G* and G1 for sero-hepatic enzymes, anti-oxidants and histological profile. The investigations of this study showed that M. olifera is a good curative agent against potential induced toxicity of CuO-NPs in O. mossambicus. The curative effect of M. olifera is attributed to the presence of higher amount of secondary metabolites and bioactive compounds. This study suggested the use of M. olifera to curate different ailments in fish and other organisms.

Keywords: CuO nanoparticles, curative, Moringa olifera, Oreochromis mossambicus

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724 The Impact of a Leadership Change on Individuals' Behaviour and Incentives: Evidence from the Top Tier Italian Football League

Authors: Kaori Narita, Juan de Dios Tena Horrillo, Claudio Detotto

Abstract:

Decisions on replacement of leaders are of significance and high prevalence in any organization, and concerns many of its stakeholders, whether it is a leader in a political party or a CEO of a firm, as indicated by high media coverage of such events. This merits an investigation into the consequences and implications of a leadership change on the performances and behavior of organizations and their workers. Sport economics provides a fruitful field to explore these issues due to the high frequencies of managerial changes in professional sports clubs and the transparency and regularity of observations of team performance and players’ abilities. Much of the existing research on managerial change focuses on how this affects the performance of an organization. However, there is scarcely attention paid to the consequences of such events on the behavior of individuals within the organization. Changes in behavior and attitudes of a group of workers due to a managerial change could be of great interest in management science, psychology, and operational research. On the other hand, these changes cannot be observed in the final outcome of the organization, as this is affected by many other unobserved shocks, for example, the stress level of workers with the need to deal with a difficult situation. To fill this gap, this study shows the first attempt to evaluate the impact of managerial change on players’ behaviors such as attack intensity, aggressiveness, and efforts. The data used in this study is from the top tier Italian football league (“Serie A”), where an average of 13 within season replacements of head coaches were observed over the period of seasons from 2000/2001 to 2017/18. The preliminary estimation employs Pooled Ordinary Least Square (POLS) and club-season Fixed Effect (FE) in order to assess the marginal effect of having a new manager on the number of shots, corners and red/yellow cards after controlling for a home-field advantage, ex ante abilities and current positions in the league of a team and their opponent. The results from this preliminary estimation suggest that the teams do not show a significant difference in their behaviors before and after the managerial change. To build on these preliminary results, other methods, including propensity score matching and non-linear model estimates, will be used. Moreover, the study will further investigate these issues by considering other measurements of attack intensity, aggressiveness, and efforts, such as possessions, a number of fouls and the athletic performance of players, respectively. Finally, the study is going to investigate whether these results vary over the characteristics of a new head coach, for example, their age and experience as a manager and a player. Thus far, this study suggests that certain behaviours of individuals in an organisation are not immediately affected by a change in leadership. To confirm this preliminary finding and lead to a more solid conclusion, further investigation will be conducted in the aforementioned manner, and the results will be elaborated in the conference.

Keywords: behaviour, effort, manager characteristics, managerial change, sport economics

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723 Effects of Exposure to a Language on Perception of Non-Native Phonologically Contrastive Duration

Authors: Chuyu Huang, Itsuki Minemi, Kuanlin Chen, Yuki Hirose

Abstract:

It remains unclear how language speakers are able to perceive phonological contrasts that do not exist on their own. This experiment uses the vowel-length distinction in Japanese, which is phonologically contrastive and co-occurs with tonal change in some cases. For speakers whose first language does not distinguish vowel length, contrastive duration is usually misperceived, e.g., Mandarin speakers. Two alternative hypotheses for how Mandarin speakers would perceive a phonological contrast that does not exist in their language make different predictions. The stress parameter model does not have a clear prediction about the impact of tonal type. Mandarin speakers will likely be not able to perceive vowel length as well as Japanese native speakers do, but the performance might not correlate to tonal type because the prosody of their language is distinctive, which requires users to encode lexical prosody and notice subtle differences in word prosody. By contrast, cue-based phonetic models predict that Mandarin speakers may rely on pitch differences, a secondary cue, to perceive vowel length. Two groups of Mandarin speakers, including naive non-Japanese speakers and beginner learners, were recruited to participate in an AX discrimination task involving two Japanese sound stimuli that contain a phonologically contrastive environment. Participants were asked to indicate whether the two stimuli containing a vowel-length contrast (e.g., maapero vs. mapero) sound the same. The experiment was bifactorial. The first factor contrasted three syllabic positions (syllable position; initial/medial/final), as it would be likely to affect the perceptual difficulty, as seen in previous studies, and the second factor contrasted two pitch types (accent type): one with accentual change that could be distinguished with the lexical tones in Mandarin (the different condition), with the other group having no tonal distinction but only differing in vowel length (the same condition). The overall results showed that a significant main effect of accent type by applying a linear mixed-effects model (β = 1.48, SE = 0.35, p < 0.05), which implies that Mandarin speakers tend to more successfully recognize vowel-length differences when the long vowel counterpart takes on a tone that exists in Mandarin. The interaction between the accent type and the syllabic position is also significant (β = 2.30, SE = 0.91, p < 0.05), showing that vowel lengths in the different conditions are more difficult to recognize in the word-final case relative to the initial condition. The second statistical model, which compares naive speakers to beginners, was conducted with logistic regression to test the effects of the participant group. A significant difference was found between the two groups (β = 1.06, 95% CI = [0.36, 2.03], p < 0.05). This study shows that: (1) Mandarin speakers are likely to use pitch cues to perceive vowel length in a non-native language, which is consistent with the cue-based approaches; (2) an exposure effect was observed: the beginner group achieved a higher accuracy for long vowel perception, which implied the exposure effect despite the short period of language learning experience.

Keywords: cue-based perception, exposure effect, prosodic perception, vowel duration

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722 The Production of Reinforced Insulation Bricks out of the Concentration of Ganoderma lucidum Fungal Inoculums and Cement Paste

Authors: Jovie Esquivias Nicolas, Ron Aldrin Lontoc Austria, Crisabelle Belleza Bautista, Mariane Chiho Espinosa Bundalian, Owwen Kervy Del Rosario Castillo, Mary Angelyn Mercado Dela Cruz, Heinrich Theraja Recana De Luna, Chriscell Gipanao Eustaquio, Desiree Laine Lauz Gilbas, Jordan Ignacio Legaspi, Larah Denise David Madrid, Charles Linelle Malapote Mendoza, Hazel Maxine Manalad Reyes, Carl Justine Nabora Saberdo, Claire Mae Rendon Santos

Abstract:

In response to the global race in discovering the next advanced sustainable material that will reduce our ecological footprint, the researchers aimed to create a masonry unit which is competent in physical edifices and other constructional facets. From different proven researches, mycelium has been concluded that when dried can be used as a robust and waterproof building material that can be grown into explicit forms, thus reducing the processing requirements. Hypothesizing inclusive measures to attest fungi’s impressive structural qualities and absorbency, the researchers projected to perform comparative analyses in creating mycelium bricks from mushroom spores of G. lucidum. Three treatments were intended to classify the most ideal concentration of clay and substrate fixings. The substrate bags fixed with 30% clay and 70% mixings indicated highest numerical frequencies in terms of full occupation of fungal mycelia. Subsequently, sorted parts of white portions from the treatment were settled in a thermoplastic mold and burnt. Three proportional concentrations of cultivated substrate and cement were also prioritized to gather results of variation focused on the weights of the bricks in the Water Absorption Test and Durability Test. Fungal inoculums with solutions of cement showed small to moderate amounts of decrease and increase in load. This proves that the treatments did not show any significant difference when it comes to strength, efficiency and absorption capacity. Each of the concentration is equally valid and could be used in supporting the worldwide demands of creating numerous bricks while also taking into consideration the recovery of our nature.

Keywords: mycelium, fungi, fungal mycelia, durability test, water absorption test

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721 Study on Adding Story and Seismic Strengthening of Old Masonry Buildings

Authors: Youlu Huang, Huanjun Jiang

Abstract:

A large number of old masonry buildings built in the last century still remain in the city. It generates the problems of unsafety, obsolescence, and non-habitability. In recent years, many old buildings have been reconstructed through renovating façade, strengthening, and adding floors. However, most projects only provide a solution for a single problem. It is difficult to comprehensively solve problems of poor safety and lack of building functions. Therefore, a comprehensive functional renovation program of adding reinforced concrete frame story at the bottom via integrally lifting the building and then strengthening the building was put forward. Based on field measurement and YJK calculation software, the seismic performance of an actual three-story masonry structure in Shanghai was identified. The results show that the material strength of masonry is low, and the bearing capacity of some masonry walls could not meet the code requirements. The elastoplastic time history analysis of the structure was carried out by using SAP2000 software. The results show that under the 7 degrees rare earthquake, the seismic performance of the structure reaches 'serious damage' performance level. Based on the code requirements of the stiffness ration of the bottom frame (lateral stiffness ration of the transition masonry story and frame story), the bottom frame story was designed. The integral lifting process of the masonry building was introduced based on many engineering examples. The reinforced methods for the bottom frame structure strengthened by the steel-reinforced mesh mortar surface layer (SRMM) and base isolators, respectively, were proposed. The time history analysis of the two kinds of structures, under the frequent earthquake, the fortification earthquake, and the rare earthquake, was conducted by SAP2000 software. For the bottom frame structure, the results show that the seismic response of the masonry floor is significantly reduced after reinforced by the two methods compared to the masonry structure. The previous earthquake disaster indicated that the bottom frame is vulnerable to serious damage under a strong earthquake. The analysis results showed that under the rare earthquake, the inter-story displacement angle of the bottom frame floor meets the 1/100 limit value of the seismic code. The inter-story drift of the masonry floor for the base isolated structure under different levels of earthquakes is similar to that of structure with SRMM, while the base-isolated program is better to protect the bottom frame. Both reinforced methods could significantly improve the seismic performance of the bottom frame structure.

Keywords: old buildings, adding story, seismic strengthening, seismic performance

Procedia PDF Downloads 118