Search results for: regular medication

Authors: F. DelGaudio, H. Gill

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Resuscitation during cardiopulmonary (CPA) arrest is dynamic, high stress, high acuity situation, which can easily lead to communication breakdown, and errors. The care of these high acuity patients has also been shown to increase physiologic stress and task saturation of providers, which can negatively impact the care being provided. These difficulties are further complicated during a global pandemic and pose a significant safety risk to bedside providers. Nurse-led codes are a relatively new concept that may be a potential solution for alleviating some of these difficulties. An experienced nurse who has completed advanced cardiac life support (ACLS), and additional training, assumed the responsibility of directing the mechanics of the appropriate ACLS algorithm. This was done in conjunction with a physician who also acted as a physician leader. The additional nurse-led code training included a multi-disciplinary in situ simulation of a CPA on a suspected COVID-19 patient. During the CPA, the nurse leader’s responsibilities include: ensuring adequate compression depth and rate, minimizing interruptions in chest compressions, the timing of rhythm/pulse checks, and appropriate medication administration. In addition, the nurse leader also functions as a last line safety check for appropriate personal protective equipment and limiting exposure of staff. The use of nurse-led codes for CPA has shown to decrease the cognitive overload and task saturation for the physician, as well as limiting the number of staff being exposed to a potentially infectious patient. The real-world application has allowed physicians to perform and oversee high-risk procedures such as intubation, line placement, and point of care ultrasound, without sacrificing the integrity of the resuscitation. Nurse-led codes have also given the physician the bandwidth to review pertinent medical history, advanced directives, determine reversible causes, and have the end of life conversations with family. While there is a paucity of research on the effectiveness of nurse-led codes, there are many potentially significant benefits. In addition to its value during a pandemic, it may also be beneficial during complex circumstances such as extracorporeal cardiopulmonary resuscitation.

Keywords: cardiopulmonary arrest, COVID-19, nurse-led code, task saturation

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Authors: Sarayu Vanga, Jorge Galeano-Cabral, Kaya Wei

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Cerebral hypoxia refers to a condition in which there is a decrease in oxygen supply to the brain. Patients suffering from this condition experience a decrease in their body temperature. While there isn't any cure to treat cerebral hypoxia as of date, certain procedures are utilized to help aid in the treatment of the condition. Regulating the body temperature is an example of one of those procedures. Hypoxia is well known to reduce the body temperature of mammals, although the neural origins of this response remain uncertain. In order to speed recovery from this condition, it is necessary to maintain a stable body temperature. In this study, we present an approach to regulating body temperature for patients who suffer from cerebral hypoxia or other similar conditions. After a thorough literature study, we propose the use of thermoelectric blankets, which are temperature-controlled thermal blankets based on thermoelectric devices. These blankets are capable of heating up and cooling down the patient to stabilize body temperature. This feature is possible through the reversible effect that thermoelectric devices offer while behaving as a thermal sensor, and it is an effective way to stabilize temperature. Thermoelectricity is the direct conversion of thermal to electrical energy and vice versa. This effect is now known as the Seebeck effect, and it is characterized by the Seebeck coefficient. In such a configuration, the device has cooling and heating sides with temperatures that can be interchanged by simply switching the direction of the current input in the system. This design integrates various aspects, including a humidifier, ventilation machine, IV-administered medication, air conditioning, circulation device, and a body temperature regulation system. The proposed design includes thermocouples that will trigger the blanket to increase or decrease a set temperature through a medical temperature sensor. Additionally, the proposed design allows an efficient way to control fluctuations in body temperature while being cost-friendly, with an expected cost of 150 dollars. We are currently working on developing a prototype of the design to collect thermal and electrical data under different conditions and also intend to perform an optimization analysis to improve the design even further. While this proposal was developed for treating cerebral hypoxia, it can also aid in the treatment of other related conditions, as fluctuations in body temperature appear to be a common symptom that patients have for many illnesses.

Keywords: body temperature regulation, cerebral hypoxia, thermoelectric, blanket design

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Authors: Rajan Jakhu, Rohit Mehra

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Radon (²²²Rn) and its decay products are the major sources of natural radiation exposure to general population. The activity concentrations of radon, thoron gasses, and their unattached and attached short-lived progeny in indoor environment of the Jaipur and Ajmer districts of Rajasthan had been calculated via passive measurements using the Pinhole cup dosimeter, deposition based progeny sensors (DRPS/DTPS) and wire mesh capped (DRPS/DTPS) progeny sensors. The results of this study revealed that radon and thoron concentrations (CRn, CTn) are highest in the winter season. The variation of the radon and its decay products are observed to vary seasonally, but these environmental parameters seem not to be affecting the thoron and its decay product concentrations in a regular manner. The average values of the radon and its decay products are maximum in winter and minimum in summer. The equilibrium factor for radon is observed to be 0.50, 0.47 and 0.49 in winter, rainy and summer seasons. The annual average value of the unattached fraction of the radon progeny comes out to be 0.34. On the other hand, the average value of thoron (²²⁰Rn) concentration and its equilibrium factor in the studied area comes to be 74, 39, 45 Bq m⁻³ and 0.07, 0.11, 0.07 respectively for the winter, rainy and summer seasons with the annual average value of the unattached fraction of about 0.18. The annual average radiological dose from exposure to indoor radon and thoron progeny comes out to be 0.88 and 0.78 mSv.

Keywords: equilibrium factor, radon, seasonal variation, thoron, unattached fraction

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Authors: Bindu Kumari, Bindu Kumari Singh

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Endosulfan is known to be one of the highly toxic agricultural pesticides commonly used in our societies. With the widespread use of Endosulfan in agriculture, human beings are most likely to be exposed to it, either orally by eating Endosulfan-contaminated foods or by nose and whole body inhalation in the farms during its application. The present study was conducted to observe the changes in the serum uric acid level of the Swiss albino rats due to the administration of Endosulfan. 3.0 mg Endosulfan/kg body weight was daily administered orally to albino rats for 28 days period. Alterations in their K.F.T. parameters were recorded at a regular interval of 7 days within this 28 days period and were compared with those of control rats. All rats were monitored for any observable toxic symptoms throughout the experimental period and they also were weighted weekly to monitor body weight gain. Alteration recorded in K.F.T. parameters within the groups were due to Endosulfan exposure and serum uric acid level was significantly elevated in the 3mg/kg dose group. Pathological changes of rats treated with Endosulfan were observed with typical signs of toxicity. Uric acid is a heterocyclic compound formed as an end product of metabolism of purine nucleotides. It forms ions and salts known as urate and acid urate which are harmful to our health. Uric acid clearance is one of the numerous important functions of the kidney. Defects in this process resulted in Gout, kidney stone or Kidney failure.

Keywords: KFT parameters, blood uric acid level, endosulfan, eat

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Authors: Elisa Monteiro, Kiiko Ikegami

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The inclusion of children with diverse learning needs and/or disabilities in regular classrooms has been identified as crucial to the provision of educational equity and quality for all students. In this, teachers play an essential role, as they have a strong impact on student attainment. Whilst the adoption of inclusive practice is increasing, with potential benefits for the teaching profession, there is also a rise in the level of its challenges in Macao as many more students with learning disabilities are now being included in general education classes. Consequently, there has been a significant focus on teacher professional development to ensure that teachers are adequately prepared to teach in inclusive classrooms that give access to diverse students. Major changes in teacher education will need to take place to include more inclusive education content and to equip teachers with the necessary skills in the area of inclusive practice. This paper draws on data from in-depth interviews with 20 teachers to examine teachers’ views of support, challenges, and barriers to inclusive practices at the school and classroom levels. Thematic analysis was utilised to determine major themes within the data. Several themes emerged and serve to illustrate the identified barriers and the potential value of effective teacher education. Suggestions for increased professional development opportunities for inclusive education specific to higher education institutions are presented and the implications for practice and teacher education are discussed.

Keywords: inclusion, inclusive practice, teacher education, higher education

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Authors: Silvia Maria Moya

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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: Vivien Chee Pei Wei

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Today we live in a scenario in which letters share space with images on screens that vary in size, shape, and style. The popularization of television, then the computer and now the e-readers, tablets, and smartphones made the electronic assume the role that previously was restricted to printed materials. Since the extensive use of new technologies to produce, disseminate, collect and access electronic publications began, the changes to reading has been intensified. To be able to read online, it involves more than just utilizing specific skills, strategies, and practices, but also in negotiating multiple information sources. In this study, different perspectives of digital reading are being explored in order to define the key aspects of the term. The focus is to explore how new technologies affect how undergraduates’ reading behavior, which in turn, gives readers different reading levels and engagement with the text and other support materials in the same media. There is also the importance of the relationship between reading platforms, reading levels and formats of electronic publications. The study looks at the online reading practices of about 100 undergraduates from a local university. The data collected using the survey and interviews with the respondents are analyzed thematically. Findings from this study found that both digital and traditional reading are interrelated, and should not be viewed as separate, but complementary to each other. However, reading online complicates some of the skills required by traditional reading. Consequently, in order to successfully read and comprehend multiple sources of information online, undergraduates need regular opportunities to practice and develop their skills as part of their natural reading practices.

Keywords: concepts, digital reading, literacy, traditional reading

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Authors: Swarnali Chakma, Akihiko Hokugo

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Research on three case studies reviewed here explains many aspects and complications of evacuation behavior during an emergency period. The scenario and phenomenon of the disaster were different, but the similarities are that after receiving the warning peoples does not take it seriously. Many individuals evacuated after taking some kind of action, for example; return to home, searching for family members, prepared valuable things etc. Based on a review of the literature, the data identified a number of factors that help explain evacuation behavior during the disaster. In the case of Japan, cultural inhibitors impact people’s behavior; for example, following the traffic rules, some people lost their time to skip because of the slow-moving car makes overcrowded traffic and some of them were washed away by the tsunami. In terms of Bangladeshi culture, women did not want to evacuate without men because staying men and women who do not know each other under the same roof together is not regular practice or comfortable. From these three case studies, it is observed that early warning plays an important role in cyclones, typhoons and earthquakes. A high level of trust from residents in the warning system is important to real evacuation. It is necessary to raise awareness of disaster and provide information on the vulnerability to cyclones, typhoons and earthquakes hazards at community levels. The local level may help decision makers and other stakeholders to make a better decision regarding an effective disaster management.

Keywords: disaster management, emergency period, evacuation, shelter, typhoon

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Authors: Jyoti Singh, Swati Dubey, Mukta Singh, R. P. Singh

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The freshwater microalgae Chlorella sp. is alluring considerable interest as a source for biofuel production due to its fast growth rate and high lipid content. Under nitrogen limited conditions, they can accumulate significant amounts of lipids. Thus, it is important to gain insight into the molecular mechanism of their lipid metabolism. In this study under nitrogen limited conditions, regular pattern of growth characteristics lipid accumulation and gene expression analysis of key regulatory genes of lipid biosynthetic pathway were carried out in microalgae Chlorella sp 3. Our results indicated that under nitrogen limited conditions there is a significant increase in the lipid content and lipid productivity, achieving 44.21±2.64 % and 39.34±0.66 mg/l/d at the end of the cultivation, respectively. Time-course transcript patterns of lipid biosynthesis genes i.e. acetyl coA carboxylase (accD) and diacylglycerol acyltransferase (dgat) showed that during late log phase of microalgae Chlorella sp.3 both the genes were significantly up regulated as compared to early log phase. Moreover, the transcript level of the dgat gene is two-fold higher than the accD gene. The results suggested that both the genes responded sensitively to the nitrogen limited conditions during the late log stage, which proposed their close relevance to lipid biosynthesis. Further, this transcriptome data will be useful for engineering microalgae species by targeting these genes for genetic modification to improve microalgal biofuel quality and production.

Keywords: biofuel, gene, lipid, microalgae

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Authors: Saraswati Verma, Ankit Batra

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In the modern day, structures are designed with a lot of complexities due to economical, aesthetical, and functional needs causing various levels of irregularities to be induced. In the past, several studies have repeatedly shown that irregular structures suffer more damage than regular structures during earthquakes. The present study makes an effort to study the contribution of the orientation of columns in the seismic behaviour of buildings with vertical irregularities namely, soft storey irregularity, mass irregularity and geometric irregularity. The response of the various models is analysed using sap2000 version 14. The parameters through which a comparative response is investigated are displacement, variation in the stiffness contribution, and inter-storey drift. Models with different configurations of column orientations were studied for each vertical irregularity and it was observed that column orientation contributed significantly in affecting a better seismic response. Square columns of the same cross-sectional area showed a good response as compared to that of rectangular columns. The study concludes that as displacement values for buildings with a soft storey and mass irregularity are very high, square columns could be used to minimise the effect of displacement in x and y-axis. In buildings with geometric irregularity, exterior column orientations can be played with to enhance the stiffness in the shorter direction to control the displacement and drift values in both x and y directions.

Keywords: soft storey, mass irregularity, geometric irregularity, column orientation, square column

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Authors: Maryam Mousavi Nik, Sara Pasandian

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The aim of the current research was to determine the effectiveness of Cognitive-Behavioral Group Therapy (G-CBT) on stress, illness anxiety and obsessions-compulsion caused by the coronavirus crisis in adolescents (14-18-Year-olds) in Tehran, Iran. This research was carried out in the form of a semi-experimental study with a control group and in the framework of a pre-test and post-test design for both experimental and control groups. The statistical population of this research consisted of all high schools in Tehran in 2022. The sample size includes 32 Adolescents (14-18-Year-olds) who were selected using a cluster sampling method, and then they were randomly replaced in two experimental (n=16) and control (n=16) groups. In this research, an adolescent stress questionnaire (ASQ-N) with an emphasis on the impact of Coronavirus, Coronavirus disease anxiety (CDAS) and The Children's Yale-Brown Obsessive Compulsive Symptom Scale (CY-BOCS) emphasis on the Coronavirus were used, and group therapy intervention with The cognitive-behavioral approach was conducted for 8 sessions of 90 minutes in the experimental group. The research data were analyzed by Multivariate analysis of covariance (MANCOVA) and covariance (ANCVA) tests. The results of multivariate covariance analysis showed that group therapy intervention with a cognitive-behavioral approach had a significant effect on at least one of the variables of stress, illness anxiety and obsession-compulsion at the level (P<0.01, F=94.772) in the post-test stage. Also, the results of covariance analysis of one variable showed that group therapy intervention with a cognitive-behavioral approach in the level of (P<0.01, F=106.377) stress, in the level of (P<0.01, F=48.147) disease anxiety and in the level (P>0.01, F=17.033) of obsession-compulsion had a significant effect in the post-test stage. The results showed that The treatment with GCBT can be effective in decreasing stress, illness anxiety and obsessions and compulsion caused by the coronavirus crisis in Adolescents (15-20-Year-olds) and may be considered as an alternative to either individual cognitive-behavioral therapy or medication.

Keywords: stress, disease anxiety, obsession-compulsion, coronavirus (Covid-19) crisis, and cognitive-behavioral therapy

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Authors: Kamran Siddique, Hiroyuki Asada, Yoshifumi Ogami

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Micro gas turbine (MGT) nowadays has a wide variety of applications from drones to hybrid electric vehicles. As microfabrication technology getting better, the size of MGT is getting smaller. Overall performance of MGT is dependent on the individual components. Each component’s performance is dependent and interrelated with another component. Therefore, careful consideration needs to be given to each and every individual component of MGT. In this study, the focus is on improving the performance of the compressor in order to improve the overall performance of MGT. Computational Fluid Dynamics (CFD) is being performed using the software FLUENT to analyze the design of a micro compressor. Operating parameters like mass flow rate and RPM, and design parameters like inner blade angle (IBA), outer blade angle (OBA), blade thickness and number of blades are varied to study its effect on the performance of the compressor. Pressure ratio is used as a tool to measure the performance of the compressor. Higher the pressure ratio, better the design is. In the study, target mass flow rate is 0.2 g/s and RPM to be less than or equal to 900,000. So far, a pressure ratio of above 3 has been achieved at 0.2 g/s mass flow rate with 5 rotor blades, 0.36 mm blade thickness, 94.25 degrees OBA and 10.46 degrees IBA. The design in this study differs from a regular centrifugal compressor used in conventional gas turbines such that compressor is designed keeping in mind ease of manufacturability. So, this study proposes a compressor design which has a good pressure ratio, and at the same time, it is easy to manufacture using current microfabrication technologies.

Keywords: computational fluid dynamics, FLUENT microfabrication, RPM

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Authors: Aadil Khan, Yasser Chomayil, P. P. Venugopalan

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Background: Budd-Chiari syndrome is caused by thrombosis of the hepatic veins and/or the thrombosis of the intrahepatic or suprahepatic IVC. The etiology remains idiopathic in 16% -35% of cases. Malignancy, rheumatological disorder, myeloproliferative disease, inheritable coagulopathy, infection or hyperestrogen state can be identified in many cases. Methodology: Review of case records of the patient presented to Aster Medcity, Emergency Department, Cochin. Introduction:17 years old female was presented to ED with fever, jaundice and abdominal distention since 1 week. O/E: Pallor+, icterus+. Abdomen- gross distension+, shifting dullness+, generalized anasarca+. USG abdomen showed hepatomegaly with mild coarse echotexture and moderate to gross ascites. CT abdomen and chest showed hepatomegaly with thrombosis of all three hepatic vein and moderate ascites suggestive of Budd-Chiari syndrome. Patient was taken for catheter vein thrombolysis. Venogram done the next day revealed almost > 50% opening of the right hepatic vein. Concurrent doppler showed colour and doppler signals in middle hepatic veins. She gradually improved and was discharged home on anticoagulant and adviced regular follow up. Conclusion: Being a rare disease in this young population, high suspicion is required when evaluating young patients with abdominal pain and jaundice.

Keywords: Budd-Chiari syndrome, rare disease, abdominal pain, India

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Authors: Frederick Monyepao

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Crack cocaine first appeared on the scene in the form of cocaine freebasing in the late 1970s. Stockbrokers, investment bankers, rock stars, Hollywood elites, and a few pro athletes were regular users of the substance. As criminogenic factors associated with substance abuse began to surface, congress passed new legislation. The laws led to the increase of health coverage insurances and the expansion of hospitals. By the mid-1980s, crack use spread into America's inner cities among impoverished African Americans and Latinos. While substance abuse increased among minority communities, legislation pertaining to substance abuse evolved. The prison industry also expanded the number of cells available. A qualitative approach was taken, drawing from a range secondary sources for contextual analysis. This paper traces out the continued marginalisation and racist undertones towards minorities as perpetuated by certain drug policies. It was discovered that the new legislation on crack was instrumental in the largest incarcerations the United States ever faced. Drug offenders increased in prisons eightfold from 1986 to 2000. The paper concludes that American drug control policies are consistently irrational and ineffective when measured by levels of substance use and abuse. On the contrary, these policies have been successful as agents of social control in maintaining the stratification patterns of racial/ethnic minorities and women. To move beyond prohibition, radical law and policy reform may require a change in narratives on substance use.

Keywords: crack, drug policy, minorities, racism, substance abuse

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Authors: D. Maryama AG. Daud, Zuliana Bacho, Stephanie Chok, DG. Mashitah PG. Baharuddin, Mohd Hatta Tarmizi, Nathira Abdul Majeed, Helen Lasimbang

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Lifestyle, physical activity, food intake, genetics and medication are contributing factors for people getting obese. Which in some of the obese people were a low or non-responder to exercise. And obesity is very common clinical feature in women affected by Polycystic Ovarian Syndrome (PCOS). Labisia pumila var. alata (LP) is a local herb which had been widely used by Malay women in treating menstrual irregularities, painful menstruation and postpartum well-being. Therefore, this study was carried out to investigate the effect of LP with a structured exercise program on anthropometric, body composition and physical fitness performance of PCOS patients. By using a single blind and parallel study design, where by subjects were assigned into a 16-wk structured exercise program (3 times a week) interventions; (LP and exercise; LPE, and exercise only; E). All subjects in the LPE group were prescribed 200mg LP; once a day, for 16 weeks. The training heart rate (HR) was monitored based on a percentage of the maximum HR (HRmax) achieved during submaximal exercise test that was conducted at wk-0 and wk-8. The progression of aerobic exercise intensity from 25–30 min at 60 – 65% HRmax during the first week to 45 min at 75–80% HRmax by the end of this study. Anthropometric (body weight, Wt; waist circumference, WC; and hip circumference, HC), body composition (fat mass, FM; percentage body fat, %BF; Fat Free Mass, FFM) and physical fitness performance (push up to failure, PU; 1-minute Sit Up, SU; and aerobic step test, PVO2max) were measured at wk-0, wk-4, wk-8, wk-12, and wk-16. This study found that LP does not have a significant effect on body composition, anthropometric and physical fitness performance of PCOS patients underwent a structured exercise program. It means LP does not improve exercise responses of PCOS patients towards anthropometric, body composition and physical fitness performance. The overall data shows exercise responses of PCOS patients is by increasing their aerobic endurance and muscle endurance performances, there is a significant reduction in FM, PBF, HC, and Wt significantly. Therefore, exercise program for PCOS patients have to focus on aerobic fitness, and muscle endurance.

Keywords: polycystic ovarian syndrome, Labisia pumila var. alata, body composition, aerobic endurance, muscle endurance, anthropometric

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Authors: Cansu Arslan Turan, Tuba Cimilli Ozturk, Ebru Unal Akoglu, Kemal Aygun, Ecem Deniz Kırkpantur, Ozge Ecmel Onur

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Although the mechanism of action is not well known, Intravenous Lipid Emulsion (ILE) has been shown to be effective in the treatment of lipophilic drug intoxications. It is thought that ILE probably separate the lipophilic drugs from target tissue by creating a lipid-rich compartment in the plasma. The second theory is that ILE provides energy to myocardium with high dose free fatty acids activating the voltage gated calcium channels in the myocytes. In this study, the effects of ILE treatment on digoxin overdose which are frequently observed in emergency departments was searched in an animal model in terms of cardiac side effects and survival. The study was carried out at Yeditepe University, Faculty of Medicine-Experimental Animals Research Center Labs in December 2015. 40 Sprague-Dawley rats weighing 300-400 g were divided into 5 groups randomly. As the pre-treatment, the first group received saline, the second group received lipid, the third group received DigiFab, and the fourth group received DigiFab and lipid. Following that, digoxin was infused to all groups until death except the control group. First arrhythmia and cardiac arrest occurrence times were recorded. As no medication causing arrhythmia was infused, Group 5 was excluded from the statistical analysis performed for the comparisons of first arrhythmia and death time. According to the results although there was no significant difference in the statistical analysis comparing the four groups, as the rats, only exposed to digoxin intoxication were compared with the rats pre-treated with ILE in terms of first arrhythmia time and cardiac arrest occurrence times, significant difference was observed between the groups. According to our results, using DigiFab treatment, intralipid treatment, intralipid and DigiFab treatment for the rats exposed to digoxin intoxication makes no significant difference in terms of the first arrhythmia and death occurrence time. However, it is not possible to say that at the doses we use in the study, ILE treatment might be successful at least as a known antidote. The fact that the statistical significance between the two groups is not observed in the inter-comparisons of all the groups, the study should be repeated in the larger groups.

Keywords: arrhytmia, cardiac arrest, DigiFab, digoxin intoxication

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Authors: Mohammad Mehdizadeh, Sara Miri

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Due to the recent events surrounding the global health crisis and the spread of the coronavirus (COVID-19), the activities of many businesses and start-up companies have been disrupted. It solves many economic problems and can reduce unemployment in countries because governments can take advantage of their potential without direct investment. However, with the help of their innovative ideas and new technologies, these companies can develop and grow the economy. But it is essential to consider that there will be no guarantee of their success in the event of unforeseen events, as the coronavirus outbreak in the last two years has seriously damaged these companies and, like other businesses, challenges and stagnation have started. The startup companies' challenge in the face of coronavirus begins with its impact on customers. Changing customer behavior can affect their products and distribution channels. On the other hand, to prevent countless losses in this crisis, startup companies require creative solutions to address challenges in various areas of human capital, supply chain management, sales and marketing, and so on. Therefore, all business leaders must consider and plan for the current crisis and the future; after overcoming these conditions and returning to regular business routines, it will no longer be an option, and new situations will prevail in a competitive environment. The essential strategies for developing and growing startups during the Coronavirus outbreak can be connecting with the global startup ecosystem, hosting webinars, providing podcasts and free question and answer sessions, mentoring services to growing teams, and consulting pointed out this to firms for digitalization.

Keywords: business, COVID-19, digitalization, startups

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Authors: Justyna Skrzyńska, Zdzisław Kobos, Zbigniew Wochyński

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The assessment of characterologic type is an essential element which decides about the proper task performance in the Air Forces. The aim of the research was to specify the percentage distribution of characterologic features by cadets studying particular courses in Polish Air Force Academy with the use of questionnaire. 34 first-year cadets chosen by lot and disunited into aircrafts pilots (N-10), helicopter pilots (N-13) and navigators(N-11) participated in the research. All of the questioned have had their psychomotor education examined in Military Aviation Medicine Institute in Warsaw, Poland. Moreover all of them are characterised by very good fitness. In the research, an anonymous poll(based on Myers-Briggs Type Indicator) appraising cadets’ characterologic type has been used. Cadets were provided with the same accommodation and nutrition. The findings have shown that percentage distribution was diversified, however it could be distinctly observed that most of future helicopter pilots (69%) are introverts whereas the majority of aircrafts pilots (70%) and navigators (100%) are extraverts. Moreover, it was also observed that 70% of cadets studying aircrafts pilotage run regular lifestyle and have judging skill according to Myers-Briggs Type Indicator. In future navigators group, 73% of students do not have this characteristic. The research has shown that cadets studying pilotage are more likely to demonstrate the characteristics which are essential for a performance of the important tasks in pilots environment than the cadets studying navigation.

Keywords: pilot, Myers-Briggs Type indicator, questionnaire research, cadets, psychomotor education

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Authors: Lopita Pal, Suresh V. Madha

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Wetlands are areas of marsh, fen, peat land or water, whether natural or artificial, permanent or temporary, with water that is static or flowing, fresh, brackish or salt, including areas of marine water the depth of which at low tide does not exceed six metres. The rapidly expanding human population, large scale changes in land use/land cover, burgeoning development projects and improper use of watersheds all has caused a substantial decline of wetland resources in the world. Major degradations have been impacted from agricultural, industrial and urban developments leading to various types of pollutions and hydrological perturbations. Regular fishing activities and unsustainable grazing of animals are degrading the wetlands in a slow pace. The paper focuses on the spatio-temporal change detection of the area of the water body and the main cause of this depletion. The total area under study (22°19’87’’ N, 88°20’23’’ E) is a wetland region in West Bengal of 213 sq.km. The procedure used is the Normalized Difference Water Index (NDWI) from multi-spectral imagery and Landsat to detect the presence of surface water, and the datasets have been compared of the years 2016, 2006 and 1996. The result shows a sharp decline in the area of water body due to a rapid increase in the agricultural practices and the growing urbanization.

Keywords: spatio-temporal change, NDWI, urbanization, wetland

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Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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Authors: Angelis P. Barlampas

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PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

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Authors: Asha Manoharan, Sooraj A. O, Anju K. G

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Enlarged vestibular aqueduct (EVA) refers to the presence of congenital sensorineural hearing loss with an enlarged vestibular aqueduct. The Audiological symptoms of EVA are fluctuating and progressive in nature and the diagnosis of EVAS can be confirmed only with radiological evaluation. Hence it is difficult to differentiate EVA from conditions like Meniere’s disease, semi-circular dehiscence, etc based on audiological findings alone. EVA in adults is easy to identify due to distinct vestibular symptoms. In children, EVA can remain either unidentified or misdiagnosed until the vestibular symptoms are evident. Motor developmental delay, especially the ones involving a change of body alignment, has been reported in the pediatric population with EVA. So, it should be made mandatory to recommend radiological evaluation in young children with fluctuating hearing loss reporting with motor developmental delay. This single case study of a baby with Enlarged Vestibular Aqueduct (EVA) primarily aimed to address the following: a) Challenges while diagnosing young patients with EVA and fluctuating hearing loss, b) Importance of radiological evaluation in audiological diagnosis in the pediatric population, c) Need for regular monitoring of hearing, hearing aid performance, and cochlear implant mapping closely for potential fluctuations in such populations, d) Importance of reviewing developmental, language milestones in very young children with fluctuating hearing loss.

Keywords: enlarged vestibular aqueduct (EVA), motor delay, radiological evaluation, fluctuating hearing loss, cochlear implant

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Authors: Opeyemi Atiba-Oyewo, Maurice S. Onyango, Christian Wolkersdorfer

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Characterization and nanostructure formation of banana peels as sorbent material are described in this paper. The transformation of this agricultural waste via mechanical milling to enhance its properties such as changed in microstructure and surface area for water pollution control and other applications were studied. Mechanical milling was employed using planetary continuous milling machine with ethanol as a milling solvent and the samples were taken at time intervals between 10 h to 30 h to examine the structural changes. The samples were characterised by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infra-red (FTIR), Transmission electron microscopy (TEM) and Brunauer Emmett and teller (BET). Results revealed three typical structures with different deformation mechanisms and the grain-sizes within the range of (71-12 nm), nanostructure of the particles and fibres. The particle size decreased from 65µm to 15 nm as the milling progressed for a period of 30 h. The morphological properties of the materials indicated that the particle shapes becomes regular and uniform as the milling progresses. Furthermore, particles fracturing resulted in surface area increment from 1.0694-4.5547 m2/g. The functional groups responsible for the banana peels capacity to coordinate and remove metal ions, such as the carboxylic and amine groups were identified at absorption bands of 1730 and 889 cm-1, respectively. However, the choice of this sorbent material for the sorption or any application will depend on the composition of the pollutant to be eradicated.

Keywords: characterization, nanostructure, nanosorbent, eco-friendly, banana peels, mechanical milling, water quality

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Authors: Aljabryn Dalal Hamad

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The present explanatory study concerns with the relation between Diabetes Mellitus and Food Balance in the Kingdom of Saudi Arabia during 2005-2010, using published data. Results illustrated that Saudi citizen daily protein consumption (DPC) during 2005-2007 (g/capita/day) is higher than the average global consumption level of protein with 15.27%, daily fat consumption (DFC) with 24.56% and daily energy consumption (DEC) with 16.93% and increases than recommended level by International Nutrition Organizations (INO) with 56% for protein, 60.49% for fat and 27.37% for energy. On the other hand, DPC per capita in Saudi Arabia decreased during the period 2008-2010 from 88.3 to 82.36 gram/ day. Moreover, DFC per capita in Saudi Arabia decreased during the period 2008-2010 from 3247.90 to 3176.43 Cal/capita/ day, and daily energy consumption (DEC) of Saudi citizen increases than world consumption with 16.93%, while increases with 27.37% than INO. Despite this, DPC, DFC and DEC per capita in Saudi Arabia still higher than world mean. On the other side, results illustrated that the number of diabetic patients in Saudi Arabia during the same period (2005-2010). The curve of diabetic patient’s number in Saudi Arabia during 2005-2010 is regular ascending with increasing level ranged between 7.10% in 2005 and 12.44% in 2010. It is essential to devise Saudi National programs to educate the public about the relation of food balances and diabetes so it could be avoided, and provide citizens with healthy dietary balances tables.

Keywords: Diabetes mellitus, food balance, energy, fat, protein, Saudi Arabia

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Authors: Yakubu Nkom Bityong, A. I. Kabido, K. Venkateswarlu

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The influence of branding and consultancy services on sports development and marketing mix has been a matter of interest among coaches athletes and sports managers in Nigeria. Marketers use sports as a promotional vehicle towards attracting customers to their products and services. The use of images, names, and photographs of sports personalities to advertise beverages, cars, and a whole range of other products and services as it is clearly noticed all over the television, radio and print media has generated a lot of argument among consumers who have vested interest and are more drawn to their favorite teams and sports personalities than they are to many company products This paper examines the influence of branding and consultancy services on sports Performance of coaches, athletes and sports managers in Nigeria. From a population of 7,441 made up of coaches, athletes and sports managers, 372 respondents were sampled for the study. A self developed and standardized questionnaire was the instrument used for data collection. One-tailed t-test was used to test the hypothesis. Results revealed that branding and consultancy services influence the performances of coaches, athletes and sports managers in Nigeria. It was concluded that the establishment of the National Institute of Sports (NIS) in Lagos with affiliated sports training programmes in Nigerian Universities is responsible for boosting the performance of sports personalities in Nigeria. It was recommended that National Policy on Sports should be reviewed in order to inculcate new methods and strategies towards enhancing sports development initiatives in the country while stakeholders should intensify regular training and retraining programmes for coaches, athletes and sports managers to update their knowledge and skills.

Keywords: branding, consultancy, sports performance, sports development

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Authors: Mohammad Shahjahan, Md. Monoarul Haque

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In the research work information and data were collected from both types of sources, direct and indirect. Numerological, qualitative and participatory analysis methods have been followed. There were two principal sources of collecting information and data. Firstly, the data provided by the service recipients (300 nos. of women and children victims) in the Victim Support Centre and service providing policemen, executives and staffs (60 nos.). Secondly, data collected from Specialists, Criminologists and Sociologists involved in victim support services through Consultative Interview, KII, Case Study and FGD etc. The initial data collection has been completed with the help of questionnaires as per strategic variations and with the help of guidelines. It is to be noted that the main objective of this research was to determine whether services provided to the victims for their facilities, treatment/medication and rehabilitation by different government/non-government organizations was veritable at all. At the same time socio-economic background and demographic characteristics of the victims have also been revealed through this research. The results of the study show that although the number of victims has increased gradually due to socio-economic, political and cultural realities in Bangladesh, the number of victim support centers has not increased as expected. Awareness among the victims about the effectiveness of the 8 centers working in this regard is also not up to the mark. Two thirds of the victims coming to get service were not cognizant regarding the victim support services at all before getting the service. Most of those who have finally been able to come under the services of the Victim Support Center through various means, have received sheltering (15.5%), medical services (13.32%), counseling services (13.10%) and legal aid (12.66%). The opportunity to stay in security custody and psycho-physical services were also notable. Usually, women and children from relatively poor and marginalized families of the society come to victim support center for getting services. Among the women, young unmarried women are the biggest victims of crime. Again, women and children employed as domestic workers are more affected. A number of serious negative impacts fall on the lives of the victims. Being deprived of employment opportunities (26.62%), suffering from psycho-somatic disorder (20.27%), carrying sexually transmitted diseases (13.92%) are among them. It seems apparent to urgently enact distinct legislation, increase the number of Victim Support Centers, expand the area and purview of services and take initiative to increase public awareness and to create mass movement.

Keywords: crime, victim, support, Bangladesh

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Authors: Georgitta Joseph Valiyamattam

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Autism spectrum disorders (ASD) are a growing phenomenon in India with over 10 million cases being recorded. Children with various levels and forms of ASD can be a major challenge both within the context of regular or special schooling. According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD) against a ratio of one in 110 few years back. The growing number of children with autism spectrum disorders places greater demands on health services and necessitates the roping in of non-traditional modes of treatment to complement or even substitute traditional health care methods when possible. Research evidence, particularly from Western countries, as also some parts of Asia, suggests that animal-assisted therapy, or zootherapy, may be used as an effective individual or complementary therapeutic tool for increasing overall wellbeing and quality of life among children with Autism spectrum disorders. The paper through a case-study format seeks to evaluate the efficacy (initial stage) of animal assisted therapy (canine-therapy with visiting dog: breed-Golden retriever), as a non-conventional treatment modality for improving cognitive functioning and managing the behavioral and psychological symptoms of Autism Spectrum Disorders. As a pilot study forming the basis for subsequent larger application of AAT, it analyses areas of efficacy as also the challenges faced, both with regard to the mode of therapy, as also particular to the Indian setting.

Keywords: animal assisted therapy, autism, canine therapy, analyzing initial efficacy

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Authors: Gabriela Kloudova, Miloslav Stehlik, Peter Sos

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The quality of sleep can affect combat performance where the vigilance, accuracy and reaction time are a decisive factor. In the present study, airborne and special units are measured on duty using actigraphy fingerprint scoring algorithm and QEEG (quantitative EEG). Actigraphic variables of interest will be: mean nightly sleep duration, mean napping duration, mean 24-h sleep duration, mean sleep latency, mean sleep maintenance efficiency, mean sleep fragmentation index, mean sleep onset time, mean sleep offset time and mean midpoint time. In an attempt to determine the individual somnotype of each subject, the data like sleep pattern, chronotype (morning and evening lateness), biological need for sleep (daytime and anytime sleepability) and trototype (daytime and anytime wakeability) will be extracted. Subsequently, a series of recommendations will be included in the training plan based on daily routine, timing of the day and night activities, duration of sleep and the number of sleeping blocks in a defined time. The aim of these modifications in the training plan is to reduce day-time sleepiness, improve vigilance, attention, accuracy, speed of the conducted tasks and to optimize energy supplies. Regular improvement of the training supposed to have long-term neurobiological consequences including neuronal activity changes measured by QEEG. Subsequently, that should enhance cognitive functioning in subjects assessed by the digital cognitive test batteries and improve their overall performance.

Keywords: sleep quality, combat performance, actigraph, somnotype

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Yu-Ting Su, Joffrey Hsu, Hui-Zhu Chen

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Acute intestinal obstruction is one of the differentials of acute abdomen and requires timely alleviation of intestinal distention and abdominal pain to avoid perforation, intra-abdominal infection, and peritonitis. Investigation to identify the cause of obstruction will direct treatment planning and allow for more effective management. In this study, we present a 71-year-old female presenting with symptoms of acute intestinal obstruction for five days. After extensive history taking, physical exam, medical imaging, and pathology, the patient was diagnosed with colon cancer with lung metastasis and acute intestinal obstruction. The patient was placed on nil per os status with intravenous fluid support, intravenous antibiotics, and a decompression nasogastric tube was placed. The patient received decompression with colostomy creation surgery. After assessing the patient’s clinical condition and tumor staging, a multidisciplinary healthcare team created an individualized treatment plan, which included plans to prepare the patient for home self-care and maintain good mental health with regular monitoring in the clinic setting. This case demonstrates the importance of early diagnosis, effective treatment, and a multidisciplinary approach to the management of acute intestinal obstruction secondary to colon cancer.

Keywords: acute intestinal obstruction, colostomy surgery, metastatic colon cancer, multidisciplinary healthcare team

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Authors: Frank Fan

Abstract:

PharmD (Doctor of Pharmacy) education has confronted an increasing challenge — curricular overload, a phenomenon resulting from the expansion of curricular requirements, as PharmD education strives to produce graduates who are practice-ready. The aftermath of the global pandemic has amplified the need for healthcare professionals, leading to a growing trend of assigning more responsibilities to them to address the global healthcare shortage. For instance, the pharmacist’s role has expanded to include not only compounding and distributing medication but also providing clinical services, including minor ailments management, patient counselling and vaccination. Consequently, PharmD programs have responded by continually expanding their curricula adding more requirements. While these changes aim to enhance the education and training of future professionals, they have also led to unintended consequences, including curricular overload, student burnout, and a potential decrease in program quality. To address the issue and ensure program quality, there is a growing need for evidence-based curriculum reforms. My research seeks to integrate Cognitive Load Theory, emerging machine learning algorithms within artificial intelligence (AI), and statistical approaches to develop a quantitative framework for optimizing curriculum design within the PharmD program at the University of Toronto, the largest PharmD program within Canada, to provide quantification and measurement of issues that currently are only discussed in terms of anecdote rather than data. This research will serve as a guide for curriculum planners, administrators, and educators, aiding in the comprehension of how the pharmacy degree program compares to others within and beyond the field of pharmacy. It will also shed light on opportunities to reduce the curricular load while maintaining its quality and rigor. Given that pharmacists constitute the third-largest healthcare workforce, their education shares similarities and challenges with other health education programs. Therefore, my evidence-based, data-driven curriculum analysis framework holds significant potential for training programs in other healthcare professions, including medicine, nursing, and physiotherapy.

Keywords: curriculum, curriculum analysis, health professions education, reflective writing, machine learning

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