Search results for: pulmonary involvement

Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

Procedia PDF Downloads 237

Authors: Cheeze Janito, Crisly Dawang

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It is important to determine the personality traits that exist in the workplace and the contribution of these personality traits in the staff’s daily work routines; a sedentary lifestyle is harmful to one’s health. This study reports the personality traits of the University of Southern Mindanao, Kabacan, Philippines, non-teaching staff, the physical activity involvement of the non-teaching staff, and the big five personality traits that shape the relationship of university non-teaching staff in engaging physical activities. A quantitative method approach, which comprised a three-part questionnaire, was used to collect the data. The fifty non-teaching staff complete the survey. The results revealed that among the big five personality traits, the university non-teaching staff scored higher in agreeableness as revealed, that there was a commonality among the respondents’ traits of consideration to the feelings of the co-workers in observance to not being rude and vividly display of respect to co-workers and workplace and scored least in the personality trait of neuroticism. The study also reported that the university non-teaching staff's main physical activity was house chores as a prime physical exercise in which respondents reported a physical activity frequency of once to twice a week; thus, this study reported that the respondents are less engaged in doing physical activities. Further, the relationship of personality traits and the physical activity of the non-teaching staff gained a p-value of .596 that indicates there is no significant relationship between the two variables, the personality trait and physical activities. This study recommends the tight promotion of staff in engaging in physical activity of at least one hundred fifty minutes of moderate-intensity activity each week. Added to this, the use of different platforms containing physical exercise literacy and the benefits of physical exercise for the holistic development of the university community.

Keywords: university staff, physical fitness, personality traits, physical activity

Procedia PDF Downloads 195

Authors: Restuning Widiasih, Katherine Nelson, Joan Skinner

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Muslim husbands have significant roles in the family including their roles in women’s health and illness. However, studies that explore Muslim husbands’ participation in women’s health is limited. The objective of this study was to uncover Muslim husbands’ participation in women’ health and illness including cancer prevention and screening. A descriptive exploratory approach was used involving 20 Muslim women from urban and rural areas of West Java Province, Indonesia. Muslim women shared experience related to their husbands support and activities in women’s health and illness. The data from the interviews were analyzed using the Comparative Analysis for Interview (CAI). Women perceived that husbands fully supported their health by providing opportunities for activities, and reminding them about healthy food, their workloads, and family planning. Husbands actively involved when women faced health issues including sharing knowledge and experience, discussing any health problems, advising for medical check-ups, and accompanying them for treatments. The analysis also found that husbands were less active and offered less advice regarding prevention and early detection of cancer. This study highlights the significant involvement of Muslim husbands in women’s health and illness, yet a lack of support from husbands related to screening and cancer prevention. This condition could be a burden for Muslim women to participate in health programs related to cancer prevention and early detection. Health education programs to improve Muslim husbands’ understanding of women’s health is needed.

Keywords: descriptive exploratory study, Muslim husbands, Muslim women, women's health and illness

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Authors: Chibuzo Okoye Daniels, Gillian Glegg, Lynda Rodwell

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Marine debris from fishing nets to medical equipment to food packaging that play major roles in boosting the economy and protecting human health is now more than an environmental problem that can be solved by legislation, law enforcement and technical solutions. It has also been identified as a cultural problem that can only be addressed by identifying instruments that can be used to change human attitudes and behaviors. This may be through management approaches, education and involvement of all sectors/interests, including the public. To contribute to the sustainable development of coastal Nigeria, two case study areas (Ikoyi and Victoria Islands of Lagos State) were used to evaluate the socio-economic impacts of marine debris problem in coastal Nigeria. The following methods were used: (1) semi-structured interviews with key stakeholders and businesses on beaches, waterfronts and waterways within the study areas and (2) observational study of beaches, waterfronts and waterways within the study areas. The results of the study have shown that marine debris is a cultural and multi-sectoral problem that poses great threat not only to the environmental sustainability of the study areas but also to the wellbeing of its citizens and the economy of coastal Nigeria. Current solid waste and marine debris management practices are inefficient due to inadequate knowledge of how to tackle the problem. To ensure environmental sustainability in coastal Nigeria and avoid waste of scarce financial resources, adequate, appropriate and cost effective solutions to the marine debris problem need to be identified and effectively transferred for implementation in the study areas.

Keywords: sustainability, coastal Nigeria, study areas, aquaculture

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Authors: Samedin Mehmeti

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The rationale behind this study is considering combating and preventing the phenomenon of trafficking in human beings from a multidisciplinary perspective that involves many layers of the society. Trafficking in human beings is an abhorrent phenomenon highly affecting negatively the victims and their families in both human and material aspect, sometimes causing irreversible damages. The longer term effects of this phenomenon, in countries with a weak economic development and extremely young and dynamic population, such as Kosovo, without proper measures to prevented and control can cause tremendous damages in the society. Given the fact that a complete eradication of this phenomenon is almost impossible, efforts should be concentrated at least on the prevention and controlling aspects. Treating trafficking in human beings based on traditional police tactics, methods and proceedings cannot bring satisfactory results. There is no doubt that a multi-disciplinary approach is an irreplaceable requirement, in other words, a combination of authentic and functional proactive and reactive methods, techniques and tactics. Obviously, police must exercise its role in preventing and combating trafficking in human beings, a role sanctioned by the law, however, police role and contribution cannot by any means considered complete if all segments of the society are not included in these efforts. Naturally, civil society should have an important share in these collaborative and interactive efforts especially in preventive activities such as: awareness on trafficking risks and damages, proactive engagement in drafting appropriate legislation and strategies, law enforcement monitoring and direct or indirect involvement in protective and supporting activities which benefit the victims of trafficking etc.

Keywords: civil society, cooperation, police, human trafficking

Procedia PDF Downloads 362

Authors: Martin Plener

Abstract:

Developmental and democratization research has a long tradition of focusing on the relationship between democratization and economic development. However, recent studies have shown that economic development is not adequate to measure the actual living conditions of civilian people. In consequence, it is unclear if a democratization process helps to improve people’s quality of life. This work addresses this issue by investigating the influence of democratization on the Human Development Index (HDI) created by the United Nations. The main objective is to study the relationship between democracy and human development and whether democratization positively impacts the living conditions of the population over time. The main mechanism which supports a positive impact is that democratic structures promote participation and political involvement of people from all social classes resulting in a better articulation of interests and thus accountability to the government. To study this issue, a panel regression with Fixed-Effects is conducted. By that, it is examined if democracy has a positive impact on the HDI (Hypothesis 1) and secondly if the same effect weakens in more developed democracies compared to less developed democracies (Hypothesis 2). The results do not reveal a direct positive relationship between the democratization of a country and its development of the HDI, not supporting H1 which denies the first hypothesis. In contrast to the assumption of H2, the effect of democratization on human development seems to be negatively correlated in countries in which democracy is barely developed. Therefore, both hypotheses must be discarded. The results indicate rather a positive correlation between economic development on human development. Therefore, the impact of democracy on the well-being of countries’ citizens needs to be reinvestigated in order to create a better understanding of how improved human development can be achieved.

Keywords: democracy, human development, modernization theory, HDI, TSCS

Procedia PDF Downloads 79

Authors: Usman A. Usman

Abstract:

Undeniably, unlike the Classical side, the Keynesian perspective of the aggregate demand side indeed has a significant position in the policy, growth, and welfare of Nigeria due to government involvement and ineffective demand of the population living with poor per capita income. This study seeks to investigate the effect of Government Final Consumption Expenditure, Financial Deepening on Households, and NPISHs Final consumption expenditure using data on Nigeria from 1981 to 2019. This study employed the ADF stationarity test, Johansen Cointegration test, and Vector Error Correction Model. The results of the study revealed that the coefficient of Government final consumption expenditure has a positive effect on household consumption expenditure in the long run. There is a long-run and short-run relationship between gross fixed capital formation and household consumption expenditure. The coefficients cpsgdp (financial deepening and gross fixed capital formation posit a negative impact on household final consumption expenditure. The coefficients money supply lm2gdp, which is another proxy for financial deepening, and the coefficient FDI have a positive effect on household final consumption expenditure in the long run. Therefore, this study recommends that Gross fixed capital formation stimulates household consumption expenditure; a legal framework to support investment is a panacea to increasing hoodmold income and consumption and reducing poverty in Nigeria. Therefore, this should be a key central component of policy.

Keywords: government final consumption expenditure, household consumption expenditure, vector error correction model, cointegration

Procedia PDF Downloads 52

Authors: Sharifah I. N. A. Syed Azmi, Nazarina Mohd Nasir

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The Billing & Customer Relationship Management (BCRM) project is an important enabler towards realizing customer experience transformation. It involves technological shifts for future scalability, revision of multiple business processes and adoption of change by the users and impacted employees. This massive transition, if not managed properly, may result in the decline of business performance due to productivity drop. Organizational change management is an essential element in BCRM project implementation to ensure the system is well understood and embraced by all stakeholders. In order to move impacted employees from unaware state or denial mode to full-acceptance mindset and committing themselves in using the new system, their involvement in the whole change process starting from the initial stage is imperative. Through the BCRM Change Management Plan, a holistic approach was taken whereby the strategy and program for five key components namely executive sponsorship, continuous communication, process change readiness, organizational readiness and individual readiness were all carefully established. Roles of the project sponsor, change agents, change ambassadors and community of practice (CoP) were clearly defined in gaining high commitment and support across the entire organization. Continuous communication and engagement initiatives throughout project implementation have been carried out to reach all stakeholders. The business readiness was constantly monitored and assessed including effectiveness of end-user training, thorough review of process documentation and completion of roles realignment exercise.

Keywords: BCRM, change management, organizational change, transformation project

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Jhabakhar Aryal, Kesh Bahadur Rana, Durga Prasad Neupane

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This research analyzes the nature and impacts of the 2015 unofficial blockade in Nepal, a significant event that triggered an economic and humanitarian crisis. While official channels denied claims of involvement, Nepal perceived the blockade as orchestrated by India due to concerns about the newly adopted constitution and Madheshi infringements. The study adopts a qualitative approach, utilizing semi-structured interviews, document analysis, and content analysis to gather data from various perspectives. Employing a "colonial hangover lens," it investigates if colonial legacies continue to influence postcolonial nation dynamics, focusing on India's potential attempt to exert influence over Nepal. The findings suggest that the 2015 blockade had profound consequences for Nepal, potentially reflecting lingering colonial power dynamics in the region. Despite India's denials, a significant portion of Nepalis perceived the blockade as an act of external pressure. Examining these perceptions offers valuable insights into postcolonial relations and their impact on regional stability. The 2015 unofficial blockade serves as a critical case study in understanding the complex interplay of internal dynamics, external influences, and historical legacies in shaping the geopolitics of the region. This research contributes to a deeper understanding of these factors and their ongoing implications for Nepal and its relationship with India.

Keywords: blockade, unofficial, constitution, Madhesis, India, Nepal, postcolonial, regional stability, geopolitics

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Authors: Mohd Iz'aan Paiz Bin Zamri, Anis Salwa Mohd Khairuddin, Norrima Mokhtar, Rubiyah Yusof

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Effective statistical feature extraction and classification are important in image-based automatic inspection and analysis. An automatic wood species recognition system is designed to perform wood inspection at custom checkpoints to avoid mislabeling of timber which will results to loss of income to the timber industry. The system focuses on analyzing the statistical pores properties of the wood images. This paper proposed a fuzzy-based feature extractor which mimics the experts’ knowledge on wood texture to extract the properties of pores distribution from the wood surface texture. The proposed feature extractor consists of two steps namely pores extraction and fuzzy pores management. The total number of statistical features extracted from each wood image is 38 features. Then, a backpropagation neural network is used to classify the wood species based on the statistical features. A comprehensive set of experiments on a database composed of 5200 macroscopic images from 52 tropical wood species was used to evaluate the performance of the proposed feature extractor. The advantage of the proposed feature extraction technique is that it mimics the experts’ interpretation on wood texture which allows human involvement when analyzing the wood texture. Experimental results show the efficiency of the proposed method.

Keywords: classification, feature extraction, fuzzy, inspection system, image analysis, macroscopic images

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Authors: Mohammed Bukar Maina, Mohammed Alhaji Bukar

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Flooding is a significant threat to human lives, particularly in low- and middle-income nations. This study focuses on the environmental implications of inadequate drainage systems in the Jere Local Government Area of Borno State, Nigeria. By examining community awareness, understanding, and perceived impacts of the absence of drainage systems, as well as exploring potential solutions, this research aims to address the existing knowledge gap. The study focuses on the Fori and 202/303 Quarters, chosen for their lack of drainage infrastructure and environmental challenges. Primary data was collected through questionnaires and observations supplemented by secondary sources. The findings highlight the need for increased awareness of drainage systems and the consequences of inadequate infrastructure. The community faces challenges like flooding, water-logging, contamination of drinking water, waterborne diseases, and property damage, necessitating the implementation of proper drainage systems. Recommendations include prioritizing new drainage systems, awareness campaigns, community participation, involvement of local government and leaders, and regular maintenance. Long-term planning is crucial for integrating drainage infrastructure into future development. Implementing these recommendations will establish sustainable and resilient drainage systems, mitigating environmental hazards. This research provides valuable insights for policymakers, stakeholders, and communities in addressing insufficient drainage systems and safeguarding the community's well-being.

Keywords: environment, drainage systems, flooding, lack

Procedia PDF Downloads 26

Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

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Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

Procedia PDF Downloads 437

Authors: Cristina Greco

Abstract:

The spread of the digital and we-based technologies has led to a transformation process, which has coincided with an increase in the number of cases who are beyond the mainstream storytelling and its codes on the interaction with the user. On the base of a previous research on i-docs and virtual museums, this study analyses interactive and immersive online Graphic Novel – one-page, animated, illustrated, and hybrid – to reflect on the transformational implications of this expressive form on the user perception, remembrance, and awareness. The way in which the user experiences a certain level of interaction with the story and immersion in the semantic and figurative universe would bring user’s attention, activating introspection and self-reflection processes, perception, imagination, and creativity. This would have to do with the involvement of different senses – visual, proprioceptive, tactile, auditory, and vestibular – and the activation of a phenomenon of synaesthesia (involuntary cross-modal sensory association) – where, for example, the aural reconnect the user to another sense, providing a multisensory experience. The case studies show specific forms of interactive and immersive graphic novel and reflect on application that has sought to engage innovative ways to communicate different messages and stimulate cultural memory and collective awareness. The visual semiotic and narrative analysis of the distinctive traits of such a complex textuality, along with a study of the user’s experience through observation in naturalistic settings and interviews, allows us to question the functioning of these configurations, with regard to the relationships between the figurative dimension, the perceptive activity, and their impact on the user’s engagement.

Keywords: collective awareness, cultural memory, graphic novel, interactive and immersive storytelling

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Authors: Tasneem Halawani, Yamen Khateeb

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With customers’ ever-increasing expectations for fast services provisioning for all their business needs, information technology (IT) organizations, as business partners, have to cope with this demanding environment and deliver their services in the most effective and efficient way. The purpose of this paper is to identify optimization and automation opportunities for the top requested IT services in a heterogenic digital environment and widely spread customer base. In collaboration with systems, processes, and subject matter experts (SMEs), the processes in scope were approached by analyzing four-year related historical data, identifying and surveying stakeholders, modeling the as-is processes, and studying systems integration/automation capabilities. This effort resulted in identifying several pain areas, including standardization, unnecessary customer and IT involvement, manual steps, systems integration, and performance measurement. These pain areas were addressed by standardizing the top five requested IT services, eliminating/automating 43 steps, and utilizing a single platform for end-to-end process execution. In conclusion, the optimization of IT service request processes in a heterogenic digital environment and widely spread customer base is challenging, yet achievable without compromising the service quality and customers’ added value. Further studies can focus on measuring the value of the eliminated/automated process steps to quantify the enhancement impact. Moreover, a similar approach can be utilized to optimize other IT service requests, with a focus on business criticality.

Keywords: automation, customer value, heterogenic, integration, IT services, optimization, processes

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Authors: Muhammad Umair, Yuri Nikolaev, Denis Artemov, Ighor Uzhinsky

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A flexible manufacturing system is an integral part of a smart factory of industry 4.0 in which every machine is interconnected and works autonomously. Robots are in the process of replacing humans in every industrial sector. As the cyber-physical-system (CPS) and artificial intelligence (AI) are advancing, the manufacturing industry is getting more dependent on computers than human brains. This modernization has boosted the production with high quality and accuracy and shifted from classic production to smart manufacturing systems. However, material handling for such automated productions is a challenge and needs to be addressed with the best possible solution. Conventional clamping systems are designed for manual work and not suitable for highly automated production systems. Researchers and engineers are trying to find the most economical solution for loading/unloading and transportation workpieces from a warehouse to a machine shop for machining operations and back to the warehouse without human involvement. This work aims to propose an advanced multi-shape tooling solution for highly automated manufacturing systems. The currently obtained result shows that it could function well with automated guided vehicles (AGVs) and modern conveyor belts. The proposed solution is following requirements to be automation-friendly, universal for different part geometry and production operations. We used a bottom-up approach in this work, starting with studying different case scenarios and their limitations and finishing with the general solution.

Keywords: artificial intelligence, cyber physics system, Industry 4.0, material handling, smart factory, flexible manufacturing system

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Authors: Jennifer A. Barrowclough, Caroline A. Crowther, Bridget Kool

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Fetal malposition in labour is associated with adverse maternal and infant health outcomes. Evidence for effective interventions for fetal malposition is inconclusive. The feasibility and design of a randomized controlled trial (RCT) of maternal posture to improve maternal and infant outcomes of malposition should be considered, based on the hypothesis that gravity corrects malposition. The aim was to assess pregnant women’s views on the acceptability of a future trial of maternal posture for fetal malposition in labour, and the enablers and barriers of participation. Method: An online anonymous survey of pregnant women was conducted in Auckland during 2020. Descriptive summaries of quantitative data used chi-square to assess differences in proportions. The influence of maternal characteristics on women’s responses was assessed using cross-tabulation. Free text responses were analysed thematically. Results: Respondents (n=206) were mostly aged26-35 years (75%), of 29-38 weeks gestation (71%), of European (40%) or Asian (36%) ethnicity, were evenly nulliparous or multiparous. Most women (76%) had heard of fetal malposition in labour however only 28% were aware of the use of maternal posture to correct this. Most women (86%) were interested in labour research. Although 37% indicated they would participate in a future RCT of posture for fetal malposition, nearly half (47%) were unsure and a further quarter (15%) indicated they would not participate. Comfort was the predominant concern (22%). Almost half of the respondents (49%) indicated they would consult their partner before deciding on participation in an RCT. Conclusions: Participation in a trial of maternal posture in labour can be enabled through measures to enhance maternal comfort, increased awareness of malposition and the role of posture, and the involvement of partners during trial counselling and recruitment.

Keywords: pregnant women, labour, presentation, posture, randomized controlled trial, survey

Procedia PDF Downloads 163

Authors: Muhammad Umair Mushtaq, Ameena Iqbal, Muhammad Aqib Hassan Ali Khan, Ismat Nawaz, Sohail Yousaf, Mazhar Iqbal

Abstract:

Heavy metals are one of the priority pollutants as they pose serious health and environmental threats. They can be removed by various physiochemical methods but are costly and responsible for additional environmental problems. Bioremediation that exploits plants and their associated microbes have been referred as cost effective and environmental friendly technique. In this study, a pot experiment was conducted in a greenhouse to evaluate the potential of Celosia cristata and effects of bacteria, Pseudomonas japonica, and organic amendment moss/compost on tolerating/accumulating heavy metals. Two weeks old seedlings were transferred to soil in pots, and after four weeks they were inoculated with bacterial strain, while after growth of six weeks they were watered with a metal containing synthetic wastewater and were harvested after a growth period of nine weeks. After harvesting, morphological and physiological parameters and metal content of plants were measured. The results showed highest plant growth and biomass production in case of organic amendments while highest metal uptake has been found in non-amended pots. Positive controls have shown highest Pb uptake of 2900 mg/kg DW, while P. japonica amended pots have shown highest Cd, Cr, Ni and Cu uptake of 963.53, 1481.17, 1022.01 and 602.17 mg/kg DW, respectively. In conclusion organic amendments have strong impacts on growth enhancement while P. japonica enhances metal translocation and accumulation to aerial parts with little significant involvement in plant growth.

Keywords: ornamental plants, plant microbe interaction, amendments, bacteria

Procedia PDF Downloads 294

Authors: Shiori Ishida, Hiromi Okuno, Hisato Igarashi, Akemi Yamazaki, Hiroko Takahashi

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The purpose of this study was to clarify the differences and similarities regarding the social support of fathers and mothers towards considering increased assistance for the paternity of children with developmental disabilities. Written questionnaires were completed by fathers (n=85) and mothers (n=101) of children using rehabilitation facilities between infancy and 5 years of age. The survey contained multiple-choice questions on four categories: information support (6 items), emotional support (7 items), evaluation support (3 items), and daily living support (3 items). Regarding information support, fathers answered ‘spouse’ as the provider in over 50% of cases for all 6 items, which was significantly different compared with mothers (all p < 0.001). For emotional support, fathers were significantly more likely to get support from the workplace (p < 0.001) and from spouse (p < 0.001). The ‘evaluation support’ did not have significant differences for fathers in all the items, but the most frequent support providers were ‘spouses’. ‘Daily living support’ was significantly different from fathers in the workplace (p < 0.000) in terms of make allowances for work and duties. Thus, it appeared that fathers had fewer social support sources as compared with mothers and limited non-spouse support. The understanding of developmental disabilities, acquisition of methods of rehabilitation, and sources of support might have been inadequately addressed among fathers, which could be a hindrance to the involvement of fathers in the rearing of children with developmental disabilities. On the other hand, we also observed that some fathers were involved in the care of developmentally troubled children while providing mental support for their spouse, cooperating with housework, and adjusting their work life. However, the results on the external and social backgrounds of fathers indicated a necessity for greater empowerment and peer support to improve the paternal care of children with developmental disabilities in the family survey.

Keywords: children with developmental disabilities, family support, father, social support

Procedia PDF Downloads 132

Authors: Cyrillus Prabandana

Abstract:

Supply chain optimisation requires multiple factors as consideration or constraints. These factors are including but not limited to demand forecasting, raw material fulfilment, production capacity, inventory level, facilities locations, transportation means, and manpower availability. By knowing all manageable factors involved and assuming the uncertainty with pre-defined percentage factors, an integrated supply chain model could be developed to manage various business scenarios. This paper analyse the utilisation of geographical point of view to develop an integrated supply chain network model to optimise the distribution of finished product appropriately according to forecasted demand and available supply. The supply chain optimisation model shows that small change in one supply chain constraint is possible to largely impact other constraints, and the new information from the model should be able to support the decision making process. The model was focused on three areas, i.e. raw material fulfilment, production capacity and finished products transportation. To validate the model suitability, it was implemented in a project aimed to optimise the concrete supply chain in a mining location. The high level of operations complexity and involvement of multiple stakeholders in the concrete supply chain is believed to be sufficient to give the illustration of the larger scope. The implementation of this geographical supply chain network modeling resulted an optimised concrete supply chain from raw material fulfilment until finished products distribution to each customer, which indicated by lower percentage of missed concrete order fulfilment to customer.

Keywords: decision making, geographical supply chain modeling, supply chain optimisation, supply chain

Procedia PDF Downloads 346

Authors: Usman A. Usman

Abstract:

Undeniably, unlike the Classical side, the Keynesian perspective of the aggregate demand side indeed has a significant position in the policy, growth, and welfare of Nigeria due to government involvement and ineffective demand of the population living with poor per capita income. This study seeks to investigate the effect of Government Final Consumption Expenditure, Financial Deepening on Households, and NPISHs Final consumption expenditure using data on Nigeria from 1981 to 2019. This study employed the ADF stationarity test, Johansen Cointegration test, and Vector Error Correction Model. The results of the study revealed that the coefficient of Government final consumption expenditure has a positive effect on household consumption expenditure in the long run. There is a long-run and short-run relationship between gross fixed capital formation and household consumption expenditure. The coefficients cpsgdp financial deepening and gross fixed capital formation posit a negative impact on household final consumption expenditure. The coefficients money supply lm2gdp, which is another proxy for financial deepening, and the coefficient FDI have a positive effect on household final consumption expenditure in the long run. Therefore, this study recommends that Gross fixed capital formation stimulates household consumption expenditure; a legal framework to support investment is a panacea to increasing hoodmold income and consumption and reducing poverty in Nigeria. Therefore, this should be a key central component of policy.

Keywords: household, government expenditures, vector error correction model, johansen test

Procedia PDF Downloads 61

Authors: Klazina T. Havinga, Hilde R. H. de Geus

Abstract:

Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

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Authors: Tejinder Pal Singh, Ravinder Kumar Malik, Gurpreet Kaur

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Adhesion is key factor for colonization of the gastrointestinal tract and the ability of probiotic strains to inhibit pathogens. Therefore, the adhesion ability is considered as a suitable biomarker for the selection of potential probiotic. In the present study, eight probiotic Lactobacillus reuteri strains were evaluated as viable, LiCl treated or heat-killed forms and compared with probiotic reference strains (L. reuteri ATCC55730). All strains investigated were able to adhere to Caco-2 cells. All probiotic L. reuteri strains tested were able to inhibit and displace (P < 0.05) the adhesion of Escherichia coli ATCC25922, Salmonella typhi NCDC113, Listeria monocytogenes ATCC53135 and Enterococcus faecalis NCDC115. The probiotic strain L. reuteri LR6 showed the strongest adhesion and pathogen inhibition ability among the eight L. reuteri strains tested. In addition, the abilities to inhibit and to displace adhered pathogens depended on both the probiotic and the pathogen strains tested suggesting the involvement of various mechanisms. The adhesion and antagonistic potential of the probiotic strains were significantly decreased upon exposure to 5M LiCl, showing that surface molecules, proteinaceous in nature, are involved. The heat-killed forms of the probiotic L. reuteri strains also inhibited the attachment of selected pathogens to Caco-2 cells. In conclusion, in vitro assays showed that L. reuteri strains, as viable or heat-killed forms, are adherent to Caco-2 cell line model and are highly antagonistic to selected pathogens in which surface molecules, proteinaceous molecules in particular, plays an important role.

Keywords: probiotics, Lactobacillus reuteri, adhesion, Caco-2 cells

Procedia PDF Downloads 251

Authors: Danjuma Moudu Momoh

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Participation in sports is of immense benefit to the soundness of individual mental and social wellness, particularly among youngsters. The 1980’s and 1990’s compared to 2000’s witnessed great involvement of youngsters in school games arising from the high administrative supports attached to sports. Previous studies in an attempt to increase youngster’s participation in sports had focused more on other factors rather than on administrative factors. This study, therefore, investigated the importance of administrative factors (availability of facilities, availability of equipment, funding, scheduling of sports programme and administrative style of school principals) on students’ sports participation in private and public secondary schools in Kwara State, Nigeria. Descriptive survey research design using validated and structured questionnaire, was adopted. Stratified random sampling technique was used to pick the students both male and female. A total of two thousand five hundred and sixty participants were involved in the study. A reliable coefficient of r=0.82 was obtained for the instruments using Cronbach Alpha. Data were analyzed using multiple regressions to test the hypotheses at 00.5 significant levels. At the end of the study, it was discovered that the relative contributions of administrative factors among the students were: availability of facilities (β=0.314), availability of equipment (β=0.444), funding (β=0.301), scheduling of sports programme (β=0.447), made relative contributions to the dependent variable, administrative style of school principal (β=0.077) did not make significant but minimal contribution to the student’s sports participation.

Keywords: administrative determinants, secondary school students, physical activity, sports participation

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Authors: J. Gochermann

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Due to complex markets and products, and increasing need to innovate, cooperation between small and medium size enterprises arose during the last decades, which are not prior driven by process optimization or sales enhancement. Especially small and medium sized enterprises (SME) collaborate increasingly in innovation and knowledge networks to enhance their knowledge and innovation potential, and to find strategic partners for product and market development. These networks are characterized by dual objectives, the superordinate goal of the total network, and the specific objectives of the network members, which can cause target conflicts. Moreover, most SMEs do not have structured innovation processes and they are not accustomed to collaborate in complex innovation projects in an open network structure. On the other hand, SMEs have suitable characteristics for promising networking. They are flexible and spontaneous, they have flat hierarchies, and the acting people are not anonymous. These characteristics indeed distinguish them from bigger concerns. Investigation of German SME networks have been done to identify success factors for SME innovation networks. The fundamental network principles, donation-return and confidence, could be confirmed and identified as basic success factors. Further factors are voluntariness, adequate number of network members, quality of communication, neutrality and competence of the network management, as well as reliability and obligingness of the network services. Innovation and knowledge networks with an appreciable number of members from science and technology institutions need also active sense-making to bring different disciplines into successful collaboration. It has also been investigated, whether and how the involvement in an innovation network impacts the innovation structure and culture inside the member companies. The degree of reaction grows with time and intensity of commitment.

Keywords: innovation and knowledge networks, SME, success factors, innovation structure and culture

Procedia PDF Downloads 283

Authors: Robinson, E. L., Freeman, E. E.

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Over the last few decades, the social movement of involved fatherhood has stimulated a research focus on fathers, leading to an increase in the body of evidence into the paternal contributions to child development. Past research has suggested that rough-and-tumble play, which involves wrestling, chasing and tumbling, is the preferred play type of western fathers. This type of play remains underutilized and underrepresented in child developmental research as it’s perceived to be dangerous or too aggressive. The limited research available has shown a relationship between high quality rough-and-tumble play interactions, lower childhood aggression and improved child emotional regulation. The aim of this study was to examine father-child rough-and-tumble play and assess the impact on cognitive development in children aged 4-7 years. Father-child dyads completed a 10-minute rough-and-tumble play interaction, which consisted of 2 games, at the University of Newcastle. Children then completed the Wechsler Preschool & Primary Scale of Intelligence - Fourth Edition Australian and New Zealand Standardized Edition (WPPSI-IV A&NZ). Fathers reported on their involvement in various caregiving activities and on their child’s development. Analyses revealed that fathers-child play quality was positively related to working memory outcomes in children. Furthermore, the amount of rough-and-tumble play father and child did together on a regular basis was also related to working memory outcomes. While father-child play interactions remain an understudied area of research, this study outlines the importance of examining the paternal play role in children’s cognitive development.

Keywords: children, development, father, executive function

Procedia PDF Downloads 204

Authors: Dhruv J. Limaye, Hanga Galfalvy, Cheick A. Sissoko, Yung-yu Huang, Chunanning Tang, Ying Liu, Shu-Chi Hsiung, Andrew J. Dwork, Gorazd B. Rosoklija, Victoria Arango, Lewis Brown, J. John Mann, Maura Boldrini

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Memory and emotion require hippocampal cell viability and connectivity and are disrupted in major depressive disorder (MDD). Applying shotgun proteomics and stereological quantification of neural progenitor cells (NPCs), intermediate neural progenitors (INPs), and mature granule neurons (GNs), to postmortem human hippocampus, identified differentially expressed proteins (DEPs), and fewer NPCs, INPs and GNs, in untreated MDD (uMDD) compared with non-psychiatric controls (CTRL) and antidepressant-treated MDD (MDDT). DEPs lower in uMDD vs. CTRL promote mitosis, differentiation, and prevent apoptosis. DEPs higher in uMDD vs. CTRL inhibit the cell cycle, and regulate cell adhesion, neurite outgrowth, and DNA repair. DEPs lower in MDDT vs. uMDD block cell proliferation. We observe group-specific correlations between numbers of NPCs, INPs, and GNs and an abundance of proteins regulating mitosis, differentiation, and apoptosis. Altered protein expression underlies hippocampus cellular and volume loss in uMDD, supports a trophic effect of antidepressants, and offers new treatment targets.

Keywords: proteomics, hippocampus, depression, mitosis, migration, differentiation, mitochondria, apoptosis, antidepressants, human brain

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

Procedia PDF Downloads 333

Authors: Manish Subedi, Bijay Bartaula, Ashok R. Pant, Purbesh Adhikari, Sanjib K. Sharma

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Background: The pattern of glomerular disease varies worldwide. In absence of kidney disease/Kidney biopsy registry in Nepal, the exact etiology of different forms of glomerular disease is primarily unknown in our country. Method: We retrospectively analyzed 175 cases of renal biopsies performed from dated September 2014 to August 2016 at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Results: The commonest indication for renal biopsy was nephrotic syndrome (34.9%), followed by Systemic lupus erythematosus with suspected renal involvement (22.3%). Majority of patients were in the 30-60 year bracket (57.2%), with the mean age of the patients being 35.37 years. The average number of glomeruli per core was 13, with inadequate sampling in 5.1%. IgA nephropathy (17%) was found to be the most common primary glomerular disease, followed by membranous nephropathy (14.6%) and FSGS (14.6%). The commonest secondary glomerular disease was lupus nephritis. Complications associated with renal biopsy were pain at biopsy site in 18% of cases, hematuria in 6% and perinephric hematoma in 4% cases. Conclusion: The commonest primary and secondary glomerular disease was IgA nephropathy and lupus nephritis respectively. The high prevalence of Systemic lupus erythematosus with lupus nephritis among Nepalese in comparison with other developing countries warrants further evaluation. As an initial attempt towards documentation of glomerular diseases in the national context, this study should serve as a stepping stone towards the eventual establishment of a full-fledged national registry of glomerular diseases in Nepal.

Keywords: glomerular, Nepal, renal biopsy, systemic lupus erythematoses

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