Search results for: year one students

Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

Procedia PDF Downloads 93

Authors: Cory A. Logston

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It is imperative researchers continue to explore every transformative strategy to increase empathy and awareness of racial bias. Racism is a social and political concept that uses stereotypical ideology to highlight racial inequities. Everyone has biases they may not be aware of toward disparate out-groups. There is some form of racism in every profession; doctors, lawyers, and teachers are not immune. There have been numerous successful and unsuccessful strategies to motivate and transform an individual’s unconscious biased attitudes. One method designed to induce a transformative experience and identify implicit bias is virtual reality (VR). VR is a technology designed to transport the user to a three-dimensional environment. In a virtual reality simulation, the viewer is immersed in a realistic interactive video taking on the perspective of a Black man. The viewer as the character experiences discrimination in various life circumstances growing up as a child into adulthood. For instance, the prejudice felt in school, as an adolescent encountering the police and false accusations in the workplace. Current research suggests that an immersive VR simulation can enhance self-awareness and become a transformative learning experience. This study uses virtual reality immersion and transformative learning theory to create empathy and identify any unintentional racial bias. Participants, White teachers, will experience a VR immersion to create awareness and identify implicit biases regarding Black students. The desired outcome provides a springboard to reconceptualize their own implicit bias. Virtual reality is gaining traction in the research world and promises to be an effective tool in the transformative learning process.

Keywords: empathy, implicit bias, transformative learning, virtual reality

Procedia PDF Downloads 193

Authors: Babak Mirzashahi, Arvin Najafi, Pejman Mansouri, Mahmoud Farzan

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Background: The most effective treatment of posterior cruciate ligament (PCL) tears and the consequence of untreated PCL injuries remain controversial. Objectives: The aim of this study is to assess outcomes of fixation of tibial posterior cruciate ligament (PCL) avulsion fractures via a modified technique. Patients and Methods: From January, 2009 to March, 2012, there were 45 cases of PCL tibial avulsion fractures that were referred to our hospital and were managed through a modified open posterior approach. Fixation of Tibial PCL avulsion fractures were fixed by means of a lag screw and washer placed through our modified open posterior approach. Range of motion was begun on the first postoperative day. Clinical stability, range of motion, gastrocnemius muscle strength, radiographic investigation, and patient’s overall quality of life was analyzed at final follow up visit. Results: The average of overall musculoskeletal functional evaluation scores was 15 (range 3–35). All patients achieved union of their fracture and had clinically stable knees at the latest follow-up. The mean preoperative Lysholm score for 15 knees was 62 ± 8 (range, 50-75); the mean postoperative Lysholm score was 92± 7 (range, 75-101). A significant difference in Lysholm scores between preoperative and final follow-up evaluations was found (P < .05). At first-year follow-up, 42 (93%) patients revealed a difference of less than 10 mm in thigh circumference between their injured and healthy knees. Conclusions: The management of displaced large PCL avulsion fractures with placement of a cancellous lag screw with washer by means of the modified open posterior approach leads to satisfactory clinical, radiographic, and functional results and reduces the operation time and less blood loss. Level of evidence: IV.

Keywords: posterior cruciate ligament, tibial fracture, lysholm knee score, patient outcome assessment

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Authors: Alla Mariseva, Ilze Beitane

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Daily intake of products rich in antioxidants that scavenge free radicals in cell membranes is an effective way to combat oxidative stress. Last year there was noticed higher interest towards the identification and utilization of plants rich in antioxidant compounds as they may behave as preventive medicine. Amaranth seeds due to polyphenols, anthocyanins, flavonoids, and tocopherols are characterized by high antioxidant activity. The study aimed to evaluate the total phenolic content and radical scavenging activity of amaranth seeds cultivated in 2020 in two farms in Latvia. One sample of amaranth seeds came from an organic farm, the other – from a conventional farm. The total phenol content of amaranth seed extracts was measured with the Folin-Ciocalte spectrophotometric method. The total phenols were expressed as gallic acid equivalents (GAE) per 100 g dry weight (DW) of the samples. The antioxidant activity of amaranth seed extracts was calculated based on scavenging activities of the stable 2.2-diphenyl-1-picrylhydrazyl (DPPH˙) radical, the radical scavenging capacity (ABTS) was demonstrated as Trolox mM equivalents (TE) per 100 g-1 dry weight. Three parallel measurements were performed on all samples. There were significant differences between organic and conventional amaranth seeds in terms of total phenolic content and antioxidant activity. Organic amaranth seeds showed higher total phenolic content compared to conventional amaranth seeds, 65.4±6.0 mg GAE 100 g⁻¹ DW and 43.4±7.8 mg GAE 100 g⁻¹ DW respectively. Organic amaranth seeds were also characterized by higher DPPH radical scavenging activity (7.9±0.4 mM TE 100 g⁻¹ of dry matter) and ABTS radical scavenging capacity (13.2±1.5 mM TE 100 g⁻¹ of dry matter). The results obtained on total phenolic content and antioxidant activity of amaranth seeds grown in Latvia confirmed that the samples have a high biological value; therefore, it would be necessary to promote their consumption by including them in various food products, including vegan products, increasing their nutritional value.

Keywords: ABTS, amaranth seeds, antioxidant activity, DPPH, total phenolic content

Procedia PDF Downloads 220

Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

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Medical, social, and economic relevance of osteoporosis is caused by reducing quality of life, increasing disability and mortality of the patients as a result of fractures due to the low-energy trauma. This study is aimed to examine the associations of metabolic syndrome components, bone mineral density (BMD) and trabecular bone score (TBS) in menopausal women with non-vertebral fractures. 1161 menopausal women aged 50-79 year-old were examined and divided into three groups: A included 419 women with increased body weight (BMI - 25.0-29.9 kg/m²), B – 442 females with obesity (BMI >29.9 kg/m²)i and C – 300 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). BMD of lumbar spine (L1-L4), femoral neck, total body and forearm was investigated with usage of dual-energy X-ray absorptiometry. The bone quality indexes were measured according to Med-Imaps installation. All analyses were performed using Statistical Package 6.0. BMD of lumbar spine (L1-L4), femoral neck, total body, and ultradistal radius was significant higher in women with obesity and metabolic syndrome compared to the pre-obese ones (p<0.001). TBS was significantly higher in women with increased body weight compared to obese and metabolic syndrome patients. Analysis showed significant positive correlation between waist circumference, triglycerides level and BMD of lumbar spine and femur. Significant negative association between serum HDL level and BMD of investigated sites was established. The TBS (L1-L4) indexes positively correlated with HDL (high-density lipoprotein) level. Despite the fact that BMD indexes were better in women with metabolic syndrome, the frequency of non-vertebral fractures was significantly higher in this group of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

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Authors: Hutomo Abdurrohman, Muhammad Latief, Waridatun Nida, Ranta Dwi Irawati

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Yogyakarta Kembali Monument (Monjali) is one of the most popular tourist attraction in Yogyakarta. Yogyakarta is known as ‘Student City’, and Monjali is a right place to learn and explore more about Yogyakarta, especially for students in elementary and junior high school to do the study tour. Monjali is located in North Ringroad, Jongkang, Sariharjo village, Ngaglik Subdistrict, Sleman Regency, Yogyakarta. Monjali offers many historical replicas, and also the story behind them. That is about the war between Indonesia's fighter, called TNI (Indonesian national army) and the colonizer of Netherlands in Yogyakarta, on March, 1st 1949. That event could open the eyes of the whole of Indonesia, because at that time the TNI was placed by the invaders. This research is an effort to evaluate the visitor's interest in Monjali as a special tourist attraction. The substance that we use in this research is the Monjali's visitors whom up to 17 years old by taking a respondent in every 15 persons who visit Monjali, and we need 200 respondents to know the condition and facilities of Monjali. This research has been collected since January 2017 until October 2017. We do the interview and spread the questionnaire which has been tested all of its validity and reliability. This data analysis is descriptive statistic analysis by using the qualitative data, which is converted into the quantitative data, use the Linkert Scale. The result of this research shows that the interest of Monjali's visitors is higher 75,6%. Based on the result, we know that Monjali is being an attractiveness for people which always experience its improvements and the development. Monjali is the success to be a place which combines the entertainment with its education as a vision of Yogyakarta as a Student City.

Keywords: descriptive statistical analysis, Jogja Kembali monument, Linkert scale, sensation

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Authors: Sandeep Vasaikar, Lary Obi

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Rapid and discriminative genotyping methods are useful for determining the clonality of the isolates in nosocomial or household outbreaks. Multilocus sequence typing (MLST) is a nucleotide sequence-based approach for characterising bacterial isolates. The genetic diversity and the clinical relevance of the drug-resistant Klebsiella isolates from Mthatha are largely unknown. For this reason, prospective, experimental study of the molecular epidemiology of Klebsiella isolates from patients being treated in Mthatha over a three-year period was analysed. Methodology: PCR amplification and sequencing of the drug-resistance-associated genes, and multilocus sequence typing (MLST) using 7 housekeeping genes mdh, pgi, infB, FusAR, phoE, gapA and rpoB were conducted. A total of 32 isolates were analysed. Results: The percentages of multidrug-resistant (MDR), extensively drug-resistance (XDR) and pandrug-resistant (PDR) isolates were; MDR 65.6 % (21) and XDR and PDR with 0 % each. In this study, K. pneumoniae was 19/32 (59.4 %). MLST results showed 22 sequence types (STs) were identified, which were further separated by Maximum Parsimony into 10 clonal complexes and 12 singletons. The most dominant group was Klebsiella pneumoniae with 23/32 (71.8 %) isolates, Klebsiella oxytoca as a second group with 2/32 (6.25 %) isolates, and a single (3.1 %) K. varricola as a third group while 6 isolates were of unknown sequences. Conclusions/significance: A phylogenetic analysis of the concatenated sequences of the 7 housekeeping genes showed that strains of K. pneumoniae form a distinct lineage within the genus Klebsiella, with K. oxytoca and K. varricola its nearest phylogenetic neighbours. With the analysis of 7 genes were determined 1 K. variicola, which was mistakenly identified as K. pneumoniae by phenotypic methods. Two misidentifications of K. oxytoca were found when phenotypic methods were used. No significant differences were observed between ESBL blaCTX-M, blaTEM and blaSHV groups in the distribution of Sequence types (STs) or Clonal complexes (CCs).

Keywords: phylogenetic analysis, phylogeny, klebsiella phylogenetic, klebsiella

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Authors: K. Sridhar Reddy, M. Amaranatha Reddy, Nilanjan Mitra

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Short paneled concrete pavement (SPCP) with shorter panel size can be an alternative to the conventional jointed plain concrete pavements (JPCP) at the same cost as the asphalt pavements with all the advantages of concrete pavement with reduced thickness, less chance of mid-slab cracking and or dowel bar locking so common in JPCP. Cast-in-situ short concrete panels (short slabs) laid on a strong foundation consisting of a dry lean concrete base (DLC), and cement treated subbase (CTSB) will reduce the thickness of the concrete slab to the order of 180 mm to 220 mm, whereas JPCP was with 280 mm for the same traffic. During the construction of SPCP test sections on two Indian National Highways (NH), it was observed that the joints remain uncracked after a year of traffic. The undoweled and uncracked joints load transfer variability and joint behavior are of interest with anticipation on its long-term performance of the SPCP. To investigate the effects of undoweled and uncracked joints on short slabs, the present study was conducted. A multilayer linear elastic analysis using 3D finite element package for different panel sizes with different thicknesses resting on different types of solid elastic foundation with and without temperature gradient was developed. Surface deflections were obtained from 3D FE model and validated with measured field deflections from falling weight deflectometer (FWD) test. Stress analysis indicates that flexural stresses in short slabs are decreased with a decrease in panel size and increase in thickness. Detailed evaluation of stress analysis with the effects of curling behavior, the stiffness of the base layer and a variable degree of load transfer, is underway.

Keywords: joint behavior, short slabs, uncracked joints, undoweled joints, 3D numerical simulation

Procedia PDF Downloads 179

Authors: Jinhoa Lee

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The relationships between environmental quality, energy use and economic output have created growing attention over the past decades among researchers and policy makers. Focusing on the empirical aspects of the role of CO2 emissions and energy use in affecting the economic output, this paper is an effort to fulfill the gap in a comprehensive case study at a country level using modern econometric techniques. To achieve the goal, this country-specific study examines the short-run and long-run relationships among energy consumption (using disaggregated energy sources: crude oil, coal, natural gas, electricity), carbon dioxide (CO2) emissions and gross domestic product (GDP) for Israel using time series analysis from the year 1980-2010. To investigate the relationships between the variables, this paper employs the Phillips–Perron (PP) test for stationarity, Johansen maximum likelihood method for cointegration and a Vector Error Correction Model (VECM) for both short- and long-run causality among the research variables for the sample. The long-run equilibrium in the VECM suggests significant positive impacts of coal and natural gas consumptions on GDP in Israel. In the short run, GDP positively affects coal consumption. While there exists a positive unidirectional causality running from coal consumption to consumption of petroleum products and the direct combustion of crude oil, there exists a negative unidirectional causality running from natural gas consumption to consumption of petroleum products and the direct combustion of crude oil in the short run. Overall, the results support arguments that there are relationships among environmental quality, energy use and economic output but the associations can to be differed by the sources of energy in the case of Israel over of period 1980-2010.

Keywords: CO2 emissions, energy consumption, GDP, Israel, time series analysis

Procedia PDF Downloads 647

Authors: M. Bolacalı, Y. Öztürk, O. Yılmaz, M. Küçük, M. A. Karslı

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The aim of the study was to determine various body measurements from the birth to the 30-day age of Boer x Hair goats F1 crossbred kids and pure Hair goat kids raised in Van in Eastern Anatolia region, and reveal factors such as the effects of year, dame body weight, genotype, dame age, birth type and sex on this parameter. 49 kids born in 2012 and 76 kids born in 2014 were utilized in the study. In the statistical analysis of various body measurements data was performed using the General Lineer Model procedure in SPSS software. Duncan's multiple range test was used for multiple comparisons. Boer x Hair goats F1 crossbred kids and pure Hair goat kids from various body measurements cidago height, body length, chest length, chest depth, chest circumference, circumference of leg, cannon bone circumference, chest width were determinated in general respectively 29.90 and 27.88 cm; 29.49 and 27.93 cm; 17.28 and 16.68 cm; 13.34 and 12.82 cm; 31.74 and 29.85 cm; 28.43 and 23.95 cm; 5.41 and 5.15 cm; 8.71 and 7.63 cm at birth, respectively; 35.01 and 32.98 cm; 35.20 and 33.30 cm; 18.82 and 18.17 cm; 15.64 and 14.83 cm; 39.08 and 37.30 cm; 34.29 and 29.25 cm; 5.80 and 5.42 cm; 9.87 and 8.85 cm at 30 days age, respectively. Among factors affecting cidago height in this study, the effect of dame body weight and sex were not significant, but genotype, dame age and birth type were significant (P < 0,05 and P < 0,01) at birth; dame body weight effect of the cidago height was not significant, but the effect of genotype, birth type, of dame age and sex were significant (P < 0.05, P < 0.05 and P<0.001) at 30-day age. The effect of genotype and sex of body length were not significant, but dam age, dame body weight and birth type were significant (P < 0.05, P < 0.05 and P<0.001, respectively) at birth; the effect of sex to body length was not significant, but genotype, dame age, dame body weight and birth type were significant (P < 0.01, P < 0.05, P < 0.05 and P < 0.001, respectively) at 30-day age. While circumference of leg was insignificant the effect of dame age and sex, genotype, dame body weight and type of the birth were significant (P < 0.001, P < 0.05 and P < 0.001) at birth; the circumstance of leg at 30-day age was found to be important the effect of examined other factors except for sex (P < 0.05 and P < 0.001). The obtained results, when considered in terms of a variety of body sizes, from birth to 30-day age growth period, showed that the kids of Boer x Hair Goat F1 hybrids have higher values than the kids of Hair Goats.

Keywords: Boer x hair goat F1 crossbred, hair goat, body measurements, cidago height

Procedia PDF Downloads 346

Authors: Aikaterini Amanatidou

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

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

Procedia PDF Downloads 93

Authors: Katsumi Mera

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The purpose of this study was to clarify the relationship between strengths/weaknesses on studying and subjective well-being among Japanese working adults. We conducted an online questionnaire survey of Japanese working adults (aged 20-69) and obtained 1,063 valid responses. Subjective well-being was evaluated using the Cantril Self-Anchoring Striving Scale, the method used in the World Happiness Survey, in which the highest possible life is set at 10, and the lowest possible life is set at 0. The mean subjective well-being of all 1,063 respondents was 5.87, which is a very similar value that was obtained in the Japanese World Happiness Survey in 2023. First, we investigated the respondents' strengths/weaknesses in studying and their subjective well-being. The results showed that the subjective well-being of the group who answered that they were good at studying (6.62) was significantly higher than that of the group who answered that they were poor at studying (5.15). Next, we investigated the subjective well-being of students who answered that they were good at Japanese, Math, English, Social studies, and Science, the major subjects in Japan, and found that the subjective well-being of the group that answered that they were good at these subjects was higher than that of the group that answered that they were poor at these subjects. When the correlation between the score of "strengths/weaknesses on studying" and the score of "subjective well-being" was examined, those who answered that they were good at studying had higher subjective well-being (correlation coefficient r = 0.26, p < 0.001). The correlation between the subjective well-being score and the score of "strengths/weaknesses on studying each subject” was examined. Among the subjects, the subjective well-being score was the highest for those who answered that they were good at English (correlation coefficient r = 0.17, p < 0.001). These results indicate a relationship between strengths/weaknesses on studying and subjective well-being among workers in Japan. These findings may provide an important basis for considering what kind of education should be focused on in order to nurture working adults with high levels of well-being.

Keywords: subject well-being, strengths/weaknesses, studying, Japanese working adults

Procedia PDF Downloads 76

Authors: A. M. Taleb, A. G. Tail, A. F. Kara, B. B. Djedouani, C. T. Moussa

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Forensic entomology is the use of insects to aid legal investigations. The main purpose of forensic entomology is to establish the postmortem interval (PMI). In order to estimate the PMI, a forensic entomologist compares the case data with certain reference information relevant to the particular location and time of year. This reference information, including the local distribution of species, are not available in Algeria. Therefore, experiments need to be conducted to provide references for entomological evidence. The objective of this study was to identify the necrophagous flies species which arrive first to carrion using liver baits in Ghardaia, South Algeria. The study was carried out during the spring season in the palmeral of Beni Isguen, Ghardaia which is well known by its hot arid climate. The experiment site (32°28’0’’ N, 3°42’0’’ E), is situated at an altitude of about 526 metres above mean sea level. On April the 4th, 2014, a number of three replicates of liver baited traps were placed in the shade and other three baits were exposed to the sun. Flying insects and larvae were captured and identified. After few minutes, flies invaded the traps which were exposed to the sun. In contrast, no flies were observed in the other traps. A total number of fourty five (45) adult specimens belonging to three taxa were identified: Calliphora vicina (Robineau-Desvoidy, 1830) (Diptera, Calliphoridae) (51.11 %), Lucilia sericata (Meigen, 1826) (Diptera, Calliphoridae) (33.33 %) and Sarcophaga africa (Wiedemann, 1824) (Diptera: Sarcophagidae) (15.55 %). Six hundred and three (603) maggots belonging to two taxa were identified: Calliphora vicina (76.28 %) and Lucilia sericata (23.71 %). The data obtained from this study provides baseline information regarding the carrion fauna of this area. It will also form a basis for similar studies in different geographical and climatological regions of Algeria.

Keywords: forensic entomology, liver baits, necrophagous fly, Ghardaia, South Algeria

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Authors: Mbuso Siwela

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Background: The Sub-Saharan Africa region has the greatest number of people eligible to receive antiretroviral treatment (ART). Multi-month Drug dispensing (MMD) of antiretroviral treatment (ART) aims to reduce patient-related barriers to access long-term treatment and improve health system efficiency. In Eswatini, however, few children and adolescents are on MMD. Young Heroes is implementing an HIV program that aims to avert new HIV infections in children and youth and improve treatment outcomes for children and adolescents living with HIV (C/ALHIV: 0-19 Years) and OVC caregivers with HIV prevention and impact mitigation interventions that prevent new HIV infections and reduce vulnerability. Aim of the study: The study aimed to ascertain factors that are associated with the assignment of the MMD model on C/ALHIVs. Methodology: The project provides treatment adherence support through well-trained community cadres (Home Visitors - HVs) at both community and health facility levels. During door-to-door visits, HVs track all C/ALHIV enrolled in the project monthly and refer any who might have stopped or interrupted treatment. C/ALHIV with unsuppressed viral load is supported through case conferencing and teen clubs. A quantitative cross-sectional analysis was conducted using STATA for children and adolescents living with HIV enrolled in the project. Bivariate analysis was conducted, and the Logistic Regression model was used to ascertain the effects of duration on ART on the choice of MMD model. Results: Data for 544 C/ALHIV (0-19 Years) was analyzed in STATA. Results show a strong association between (duration on ART, Age, being in teen club) and enrolment in an MMD model. Duration on ART is a major predictor for the choice of MMD model at (95% CI: 0.0012905 – 0.0039812; P = <0.0001). C/ALHIV who have been on ART for less than a year are less likely to be on MMD. C/ALHIVs who are 1 or more years on ART are more likely to be in 3 months dispensing, while those who are 5 years or more are most likely to be in 6 months model.

Keywords: C/ALHIV, OVC, HIV, treatment

Procedia PDF Downloads 38

Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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Authors: Mark Andrew

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Geopolitical tensions are at a thirty-year high, and the pace of technological innovation is driving asymmetry in force capabilities between nation states and between non-state actors. Technology futures are a vital component of defence capability growth, and investments in technology futures need to be informed by accurate and reliable forecasts of the options for ‘systems of systems’ innovation, development, and deployment. This paper describes a method for forecasting technology futures developed through an analysis of four key systems’ development stages, namely: technology domain categorisation, scanning results examining novel systems’ signals and signs, potential system-of systems’ implications in warfare theatres, and political ramifications in terms of funding and development priorities. The method has been applied to several technology domains, including physical systems (e.g., nano weapons, loitering munitions, inflight charging, and hypersonic missiles), biological systems (e.g., molecular virus weaponry, genetic engineering, brain-computer interfaces, and trans-human augmentation), and information systems (e.g., sensor technologies supporting situation awareness, cyber-driven social attacks, and goal-specification challenges to proliferation and alliance testing). Although the current application of the method has been team-centred using paper-based rapid prototyping and iteration, the application of autonomous language models (such as GPT-3) is anticipated as a next-stage operating platform. The importance of forecasting accuracy and reliability is considered a vital element in guiding technology development to afford stronger contingencies as ideological changes are forecast to expand threats to ecology and earth systems, possibly eclipsing the traditional vulnerabilities of nation states. The early results from the method will be subjected to ground truthing using longitudinal investigation.

Keywords: forecasting, technology futures, uncertainty, complexity

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Authors: Antonello Durante, James Duff, Kevin Kelly

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The visual needs of people in modern work based buildings are changing. Self-illuminated screens of computers, televisions, tablets and smart phones have changed the relationship between people and the lit environment. In the past, lighting design practice was primarily based on providing uniform horizontal illuminance on the working plane, but this has failed to ensure good quality lit environments. Lighting standards of today continue to be set based upon a 100 year old approach that at its core, considers the task illuminance of the utmost importance, with this task typically being located on a horizontal plane. An alternative method focused on appearance has been proposed, as opposed to the traditional performance based approach. Mean Room Surface Exitance (MRSE) and Target-Ambient Illuminance Ratio (TAIR) are two new metrics proposed to assess illumination adequacy in interiors. The hypothesis is that these factors will be superior to the existing metrics used, which are horizontal illuminance led. For the six past years, research has examined this, within the Dublin Institute of Technology, with a view to determining the suitability of this approach for application to general lighting practice. Since the start of this research, a number of key findings have been produced that centered on how occupants will react to various levels of MRSE. This paper provides a broad update on how this research has progressed. More specifically, this paper will: i) Demonstrate how MRSE can be measured using HDR images technology, ii) Illustrate how MRSE can be calculated using scripting and an open source lighting computation engine, iii) Describe experimental results that demonstrate how occupants have reacted to various levels of MRSE within experimental office environments.

Keywords: illumination hierarchy (IH), mean room surface exitance (MRSE), perceived adequacy of illumination (PAI), target-ambient illumination ratio (TAIR)

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Authors: Harriet Kebirungi, Majaliwa Jackson-Gilbert Mwanjalolo, S. Livingstone Luboobi, Richard Joseph Kimwaga, Consolata Kabonesa

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This paper assessed gender responsiveness of water and sanitation policies and legal frameworks at Makerere University, Uganda. The objectives of the study were to i) examine the gender responsiveness of water and sanitation related policies and frameworks implemented at Makerere University; and ii) assess the challenges faced by the University in customizing national water and sanitation policies and legal frameworks into University policies. A cross-sectional gender-focused study design was adopted. A checklist was developed to analyze national water and sanitation policies and legal frameworks and University based policies. In addition, primary data was obtained from Key informants at the Ministry of Water and Environment and Makerere University. A gender responsive five-step analytical framework was used to analyze the collected data. Key findings indicated that the policies did not adequately address issues of gender, water and sanitation and the policies were gender neutral consistently. The national policy formulation process was found to be gender blind and not backed by situation analysis of different stakeholders including higher education institutions like Universities. At Makerere University, due to lack of customized and gender responsive water and sanitation policy and implementation framework, there were gender differences and deficiencies in access to and utilization of water and sanitation facilities. The University should take advantage of existing expertise within them to customize existing national water policies and gender, and water and sanitation sub-sector strategy. This will help the University to design gender responsive, culturally acceptable and environmental friendly water and sanitation systems that provide adequate water and sanitation facilities that address the needs and interests of male and female students.

Keywords: gender, Makerere University, policies, water, sanitation

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Todor Nickolov Stoyanov

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Cooperatives are present in all countries and in almost all sectors, including agriculture, forestry, food, finance, health, marketing, insurance and credit. Strong cooperatives are able to overcome many of the difficulties faced by private owners. Cooperatives use seven principles, including the 'Community Concern" principle, which enables cooperatives to work for the sustainable development of the community. The members of cooperatives may use different systems for generating year-round employment and for receiving sustainable income through performing different forestry activities. Various methods are used during the preparation of the report. These include literature reviews, statistics, secondary data and expert interviews. The members of the cooperatives are benefits exclusively from increasing the efficiency of the various products and from the overall yield of the harvest, and ultimately from achieving better profit through cooperative efforts. Cooperatives also use other types of activities that are an additional opportunity for cooperative income. There are many heterogeneous activities in the production and service sectors of the forest cooperatives under consideration. Some cooperatives serve dairies, distilleries, woodworking enterprises, tourist homes, hotels and motels, shops, ski slopes, sheep breeding, etc. Through the revenue generated by the activity, cooperatives have the opportunity to carry out various environmental and protective activities - recreation, water protection, protection of endangered and endemic species, etc., which in the case of small-scale forests cannot be achieved and the management is not sustainable. The conclusions indicate the results received in the analysis. Cooperative management of forests and forest lands gives higher incomes to individual owners. The management of forests and forest lands through cooperatives helps to carry out different environmental and protective activities. Cooperative forest management provides additional means of subsistence to the owners of poor forest lands. Cooperative management of forests and forest lands support owners to implement the forest management plans and to apply sustainable management of these territories.

Keywords: cooperative, forestry, forest owners, principles of cooperation

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Authors: Eric Tardif, Nicolas Meylan

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Recent studies suggest that the consolidation of episodic memory is better achieved through repeated retrieval than with the use of concept mapping or repeated study. Although such laboratory results highly appeal to educationalists, it remains to be shown whether they can be directly used in a classroom setting. Forty-five college students (42 girls; mean age 16.1 y/o) were asked to remember pairs of biology-related words (e.g. mitochondria-energy) in two configurations. The first configuration consisted of a three-minute study of pairs of words followed by a final one-minute test in which the first word of a pair was shown and the subject asked to write down the second associated word. This procedure was repeated three times. The second configuration consisted of a one-minute study of a list of pairs of words, which was immediately followed by a one-minute test. This procedure was repeated 6 times. Subjects filled out a small questionnaire assessing their general mood, level of fatigue, stress and motivation to do the exercise. One week later, subjects were given a final test using the same words. A total of 8 lists of words were studied and tested during the semester. Results showed that subjects recalled more correct words when using the second configuration, both within the study period and one week later, confirming laboratory findings. However, the general performance (mean items recalled) as well as the motivation to do the exercise gradually decreased during the semester. Motivation was positively correlated with performance (r=0.77, p<0.05). The results suggest that laboratory findings may provide some applications in education but other variables inherent to the classroom setting must also be considered.

Keywords: long-term, episodic memory, consolidation, retrieval, school setting

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Authors: Rui Li, Min Wen, Kim Bang Salling

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For the modern railways, maintenance is critical for ensuring safety, train punctuality and overall capacity utilization. The cost of railway maintenance in Europe is high, on average between 30,000 – 100,000 Euros per kilometer per year. In order to reduce such maintenance expenditures, this paper presents a mixed 0-1 linear mathematical model designed to optimize the predictive railway tamping activities for ballast track in the planning horizon of three to four years. The objective function is to minimize the tamping machine actual costs. The approach of the research is using the simple dynamic model for modelling condition-based tamping process and the solution method for finding optimal condition-based tamping schedule. Seven technical and practical aspects are taken into account to schedule tamping: (1) track degradation of the standard deviation of the longitudinal level over time; (2) track geometrical alignment; (3) track quality thresholds based on the train speed limits; (4) the dependency of the track quality recovery on the track quality after tamping operation; (5) Tamping machine operation practices (6) tamping budgets and (7) differentiating the open track from the station sections. A Danish railway track between Odense and Fredericia with 42.6 km of length is applied for a time period of three and four years in the proposed maintenance model. The generated tamping schedule is reasonable and robust. Based on the result from the Danish railway corridor, the total costs can be reduced significantly (50%) than the previous model which is based on optimizing the number of tamping. The different maintenance strategies have been discussed in the paper. The analysis from the results obtained from the model also shows a longer period of predictive tamping planning has more optimal scheduling of maintenance actions than continuous short term preventive maintenance, namely yearly condition-based planning.

Keywords: integer programming, railway tamping, predictive maintenance model, preventive condition-based maintenance

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Authors: Klara Smith-Etxeberria

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main goal of this study was to analyze the predictive ability of some variables associated with the parental divorce process alongside attachment history with parents on both, mother-child and father-child relationship quality. Our sample consisted of 173 undergraduate and vocational school students from the Autonomous Community of the Basque Country. All of them belonged to a divorced family. Results showed that adequate maternal strategies during the divorce process (e.g.: stable, continuous and positive role as a mother) was the variable with greater predictive ability on mother-child relationships quality. In addition, secure attachment history with mother also predicted positive mother-child relationships. On the other hand, father-child relationship quality was predicted by adequate paternal strategies during the divorce process, such as his stable, continuous and positive role as a father, along with not badmouthing the mother and promoting good mother-child relationships. Furthermore, paternal negative emotional state due to divorce was positively associated with father-child relationships quality, and both, history of attachment with mother and with father predicted father-child relationships quality. In conclusion, our data indicate that both, paternal and maternal strategies for children´s adequate adjustment during the divorce process influence on mother-child and father-child relationships quality. However, these results suggest that paternal strategies during the divorce process have a greater predictive ability on father-child relationships quality, whereas maternal positive strategies during divorce determine positive mother-child relationships among young adults.

Keywords: father-child relationships quality, mother-child relationships quality, parental divorce process, young adulthood

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Authors: Alireza Jalilifar, Nadia Mayahi

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An oral defense is the examination of a doctoral program in which the candidates display their academic capacity through sharing and disseminating the findings of their study and defending their position. In this challenging criticism-generating context, the examiners evaluate the PhD dissertation critically so as to confirm its scholarly merit or lack of it. To identify the examiners’ expectations of the viva, this study used a conversation analytic approach for analyzing the data. The research is inductive in that it seeks to develop theory that is grounded in the data. The data comprised transcripts of the question and answer section of two applied linguistics doctoral defense sessions from two accredited Iranian state universities in 2019, both of which are among the top Iranian universities on the list of Times Higher Education World University Rankings. In spite of the similar shortcomings and deficiencies, for instance, in terms of innovation, development, sampling, and treatment, raised by the examiners, one of these defenses passed with distinction while the other was referred for re-submission. It seems that the outcome of a viva, in an EFL context, not only depends on adherence to the rules and regulations of doctoral research but is also influenced to a certain extent by the strictness of the examiners and the candidates’ language proficiency and effective negotiation and communication skills in this confrontational communicative event. The findings of this study provide evidence for the issues determining the success or failure of PhD candidates in displaying their claims of scholarship during their defense sessions. This study has implications for both applied linguistics doctoral students and academics in EFL contexts who try to prove and authenticate the doctorateness of a dissertation.

Keywords: academic discourse, conversation analysis, doctoral defense, doctorateness, EFL

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Authors: Manuela Gamba, Niki Mandolesi

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Teenagers today have little knowledge about how to move or play together. The adults who are part of sports culture must find an effective way to foster this essential ability. Our research in Italy uses a 'holistic model' based on fantasy literature to explore the relationships between the game identities and self-identities of young people and the achievement of psycho-motor, emotional and social well-being in the realms of sport and education. Physical activity projects were carried out in schools and extra-curricular associations in Rome, combining outdoor activities and distance learning. This holistic and malleable game model is inspired by fantasy accounts of the journeys taken in The Lord of Rings and Harry Potter books. We know that many have a lot of resistance to the idea of using fantasy and play as a pedagogical tool, but the results obtained in this experience are surprising. Our interventions and investigations focused on promoting self-esteem, awareness, a sense of belonging, social integration, cooperation, well-being, and informed decision making: a basis for healthy and effective citizenship. For teenagers, creative thinking is the right stimulus to involve and compare the story of characters to their own journey through social and self-reflective identity analysis. We observed how important it is to engage students emotionally as well as cognitively and that enabling them to play with identity through relationships with peers. There is a need today for a multidisciplinary synthesis of analog and digital values, especially in response to recent distance-living experiences. There is a need for a global reconceptualization of free time and nature in the human experience.

Keywords: awareness, creativity, identity, play

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Authors: Maham Leeza Adil, Mahrukh Alvi, Muhammad Osman

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Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum hemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries, due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management. Case Presentation: A 40-year-old female presented with acute abdomen symptoms and was initially diagnosed with acalculous cholecystitis. However, a detailed history revealed a history of postpartum hemorrhage 18 years prior, leading to a provisional diagnosis of SS. Further investigations confirmed panhypopituitarism, including hypothyroidism, hypocortisolism, and hypogonadism. Notably, the patient also exhibited pancytopenia, a rarely reported hematological manifestation of SS. Discussion: SS often presents with nonspecific symptoms, leading to delayed or missed diagnoses. In this case, the patient's initial presentation of acute abdomen symptoms was attributed to secondary adrenal insufficiency due to panhypopituitarism. The presence of pancytopenia, along with hyponatremia, further complicated the clinical picture. Hormone replacement therapy led to a remarkable improvement in the patient's condition, emphasizing the importance of early diagnosis and intervention. Conclusion: SS is a common cause of panhypopituitarism in developing countries, but its atypical presentations, such as pancytopenia, are rare and often overlooked. This case highlights the need for increased awareness among clinicians to consider SS in patients with unexplained hematological abnormalities, particularly in regions with high rates of postpartum hemorrhage. Early recognition and appropriate hormone replacement therapy can significantly improve patients' outcomes and prevent long-term complications associated with this underdiagnosed syndrome.

Keywords: Sheehan syndrome, panhypopituitarism, pancytopenia, delayed diagnosis

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Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

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Authors: Hai Zeng, Yisheng Li, Jincheng Huang, Chenghui Huang, Ying Zhang

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Children are strong; the country strong, the development of children Basketball is a strategic advantage. Common forms of basketball equipment has been difficult to meet the needs of young children teaching the game of basketball, basketball development for 3-6 years old children in the form of appropriate teaching aids is a breakthrough basketball game teaching children bottlenecks, improve teaching critical path pleasure, but also the development of early childhood basketball a necessary requirement. In this study, literature, questionnaires, focus group interviews, comparative analysis, for domestic and foreign use of 12 kinds of basketball teaching aids (cloud computing MINI basketball, adjustable basketball MINI, MINI basketball court, shooting assist paw print ball, dribble goggles, dribbling machine, machine cartoon shooting, rebounding machine, against the mat, elastic belt, ladder, fitness ball), from fun and improve early childhood shooting technique, dribbling technology, as well as offensive and defensive rebounding against technology conduct research on conversion technology. The results show that by using appropriate forms of teaching children basketball aids, can effectively improve children's fun basketball game, targeted to improve a technology, different types of aids from different perspectives enrich the connotation of children basketball game. Recommended for children of color psychology, cartoon and environmentally friendly material production aids, and increase research efforts basketball aids children, encourage children to sports teachers aids applications.

Keywords: health and physical education field of curriculum outline, health fitness, sports and health curriculum reform, Taiwan, twelve years basic education

Procedia PDF Downloads 391

Authors: Liliane Ventura, Mauro Masili

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Ultraviolet (UV) protection is critical for sunglasses, and mydriasis, as well as miosis, are relevant parameters to consider. The literature reports that for sunglasses, ultraviolet protection is critical because sunglasses can cause the opposite effect if the lenses do not provide adequate UV protection due to the greater dilation of the pupil when wearing sunglasses. However, the scientific literature does not properly quantify to support this rationale. The reasoning may be misleading by ignoring not only the inherent absorption of UV by the sunglass lens materials but also by ignoring the absorption of the anterior structures of the eye, i.e., the cornea and aqueous humor. Therefore, we estimate the pupil diameter and calculate the solar ultraviolet influx through the pupil of the human eye for two situations of an individual wearing and not wearing sunglasses. We quantify the dilation of the pupil as a function of the luminance of the surrounding. Therefore, we calculate the influx of solar UV through the pupil of the eye for two situations for an individual wearing sunglass and for the eyes free of shade. A typical boundary condition for the calculation is an individual in an upright position wearing sunglasses, staring at the horizon as if the sun is in the zenith. The calculation was done for the latitude of the geographic center of the state of São Paulo (-22º04'11.8'' S) from sunrise to sunset. A model from the literature is used for determining the sky luminance. The initial approach is to obtain pupil diameter as a function of luminance. Therefore, as a preliminary result, we calculate the pupil diameter as a function of the time of day, as the sun moves, for a particular day of the year. The working range for luminance is daylight (10⁻⁴ – 10⁵ cd/m²). We are able to show how the pupil adjusts to brightness change (~2 - ~7.8 mm). At noon, with the sun higher, the direct incidence of light on the pupil is lower if compared to mid-morning or mid-afternoon, when the sun strikes more directly into the eye. Thus, the pupil is larger at midday. As expected, the two situations have opposite behaviors since higher luminance implies a smaller pupil. With these results, we can progress in the short term to obtain the transmittance spectra of sunglasses samples and quantify how light attenuation provided by the spectacles affects pupil diameter.

Keywords: sunglasses, UV protection, pupil diameter, solar irradiance, luminance

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Authors: Dike Ibegbulem

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This paper interrogates the chances of Nigeria achieving its target of making the list of the first 70 countries in World Bank’s Ease of Doing Business (EoDB) rankings by the year 2023. That is, in light of existing conflicts in policies relating to the door-to-door carriage of goods and multimodal transport operations (MTOs) in the country. Drawing on the famed Legal Origins theory plus data from World Bank; and using Singapore as a touchstone, the paper unveils how amongst the top-ranked Commonwealth jurisdictions, positive correlations have been recorded over the past years between certainty in their policies on MTOs on the one hand; and their Enforcing Contracts (EC) and Doing Business (DB) indices on the other. The paper postulates that to increase Nigeria’s chances of achieving her DB2023 objective, legislative and curial policies on MTOs and door-to-door carriage of goods have to be realigned in line with prevailing policies in highly-ranked Commonwealth jurisdictions of the Global North. Her appellate courts, in particular, will need some unshackling from English pedigrees which still delimit admiralty jurisdiction to port-to-port shipping, to the exclusion of door-to-door carriage of goods beyond navigable waters. The paper identifies continental and domestic instruments, plus judicial precedents, which provide bases for expanding admiralty jurisdiction to adjudication of claims derived from door-to-door or multimodal transport contracts and other allied maritime-plus contracts. It prescribes synergy between legislative and curial policies on MTOs and door-to-door carriage of goods as species of admiralty – an emerging trend in top-ranked Commonwealth jurisdictions of the Global North.

Keywords: admiralty jurisdiction, legal origins, world bank, ease of doing business, enforcing contracts, multimodal transport operation, door-to-door, carriage of goods by sea, combined transport shipping

Procedia PDF Downloads 78