Search results for: health information exchange (hie)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19256

Search results for: health information exchange (hie)

10526 Sound Selection for Gesture Sonification and Manipulation of Virtual Objects

Authors: Benjamin Bressolette, S´ebastien Denjean, Vincent Roussarie, Mitsuko Aramaki, Sølvi Ystad, Richard Kronland-Martinet

Abstract:

New sensors and technologies – such as microphones, touchscreens or infrared sensors – are currently making their appearance in the automotive sector, introducing new kinds of Human-Machine Interfaces (HMIs). The interactions with such tools might be cognitively expensive, thus unsuitable for driving tasks. It could for instance be dangerous to use touchscreens with a visual feedback while driving, as it distracts the driver’s visual attention away from the road. Furthermore, new technologies in car cockpits modify the interactions of the users with the central system. In particular, touchscreens are preferred to arrays of buttons for space improvement and design purposes. However, the buttons’ tactile feedback is no more available to the driver, which makes such interfaces more difficult to manipulate while driving. Gestures combined with an auditory feedback might therefore constitute an interesting alternative to interact with the HMI. Indeed, gestures can be performed without vision, which means that the driver’s visual attention can be totally dedicated to the driving task. In fact, the auditory feedback can both inform the driver with respect to the task performed on the interface and on the performed gesture, which might constitute a possible solution to the lack of tactile information. As audition is a relatively unused sense in automotive contexts, gesture sonification can contribute to reducing the cognitive load thanks to the proposed multisensory exploitation. Our approach consists in using a virtual object (VO) to sonify the consequences of the gesture rather than the gesture itself. This approach is motivated by an ecological point of view: Gestures do not make sound, but their consequences do. In this experiment, the aim was to identify efficient sound strategies, to transmit dynamic information of VOs to users through sound. The swipe gesture was chosen for this purpose, as it is commonly used in current and new interfaces. We chose two VO parameters to sonify, the hand-VO distance and the VO velocity. Two kinds of sound parameters can be chosen to sonify the VO behavior: Spectral or temporal parameters. Pitch and brightness were tested as spectral parameters, and amplitude modulation as a temporal parameter. Performances showed a positive effect of sound compared to a no-sound situation, revealing the usefulness of sounds to accomplish the task.

Keywords: auditory feedback, gesture sonification, sound perception, virtual object

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10525 The Impact of Social Support on Anxiety and Depression under the Context of COVID-19 Pandemic: A Scoping Review and Meta-Analysis

Authors: Meng Wu, Atif Rahman, Eng Gee, Lim, Jeong Jin Yu, Rong Yan

Abstract:

Context: The COVID-19 pandemic has had a profound impact on mental health, with increased rates of anxiety and depression observed. Social support, a critical factor in mental well-being, has also undergone significant changes during the pandemic. This study aims to explore the relationship between social support, anxiety, and depression during COVID-19, taking into account various demographic and contextual factors. Research Aim: The main objective of this study is to conduct a comprehensive systematic review and meta-analysis to examine the impact of social support on anxiety and depression during the COVID-19 pandemic. The study aims to determine the consistency of these relationships across different age groups, occupations, regions, and research paradigms. Methodology: A scoping review and meta-analytic approach were employed in this study. A search was conducted across six databases from 2020 to 2022 to identify relevant studies. The selected studies were then subjected to random effects models, with pooled correlations (r and ρ) estimated. Homogeneity was assessed using Q and I² tests. Subgroup analyses were conducted to explore variations across different demographic and contextual factors. Findings: The meta-analysis of both cross-sectional and longitudinal studies revealed significant correlations between social support, anxiety, and depression during COVID-19. The pooled correlations (ρ) indicated a negative relationship between social support and anxiety (ρ = -0.30, 95% CI = [-0.333, -0.255]) as well as depression (ρ = -0.27, 95% CI = [-0.370, -0.281]). However, further investigation is required to validate these results across different age groups, occupations, and regions. Theoretical Importance: This study emphasizes the multifaceted role of social support in mental health during the COVID-19 pandemic. It highlights the need to reevaluate and expand our understanding of social support's impact on anxiety and depression. The findings contribute to the existing literature by shedding light on the associations and complexities involved in these relationships. Data Collection and Analysis Procedures: The data collection involved an extensive search across six databases to identify relevant studies. The selected studies were then subjected to rigorous analysis using random effects models and subgroup analyses. Pooled correlations were estimated, and homogeneity was assessed using Q and I² tests. Question Addressed: This study aimed to address the question of the impact of social support on anxiety and depression during the COVID-19 pandemic. It sought to determine the consistency of these relationships across different demographic and contextual factors. Conclusion: The findings of this study highlight the significant association between social support, anxiety, and depression during the COVID-19 pandemic. However, further research is needed to validate these findings across different age groups, occupations, and regions. The study emphasizes the need for a comprehensive understanding of social support's multifaceted role in mental health and the importance of considering various contextual and demographic factors in future investigations.

Keywords: social support, anxiety, depression, COVID-19, meta-analysis

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10524 Data Integration with Geographic Information System Tools for Rural Environmental Monitoring

Authors: Tamas Jancso, Andrea Podor, Eva Nagyne Hajnal, Peter Udvardy, Gabor Nagy, Attila Varga, Meng Qingyan

Abstract:

The paper deals with the conditions and circumstances of integration of remotely sensed data for rural environmental monitoring purposes. The main task is to make decisions during the integration process when we have data sources with different resolution, location, spectral channels, and dimension. In order to have exact knowledge about the integration and data fusion possibilities, it is necessary to know the properties (metadata) that characterize the data. The paper explains the joining of these data sources using their attribute data through a sample project. The resulted product will be used for rural environmental analysis.

Keywords: remote sensing, GIS, metadata, integration, environmental analysis

Procedia PDF Downloads 113
10523 Human Tracking across Heterogeneous Systems Based on Mobile Agent Technologies

Authors: Tappei Yotsumoto, Atsushi Nomura, Kozo Tanigawa, Kenichi Takahashi, Takao Kawamura, Kazunori Sugahara

Abstract:

In a human tracking system, expanding a monitoring range of one system is complicating the management of devices and increasing its cost. Therefore, we propose a method to realize a wide-range human tracking by connecting small systems. In this paper, we examined an agent deploy method and information contents across the heterogeneous human tracking systems. By implementing the proposed method, we can construct a human tracking system across heterogeneous systems, and the system can track a target continuously between systems.

Keywords: human tracking system, mobile agent, monitoring, heterogeneous systems

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10522 Evaluating the Characteristics of Paediatric Accidental Poisonings

Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

Abstract:

Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

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10521 About the Case Portfolio Management Algorithms and Their Applications

Authors: M. Chumburidze, N. Salia, T. Namchevadze

Abstract:

This work deal with case processing problems in business. The task of strategic credit requirements management of cases portfolio is discussed. The information model of credit requirements in a binary tree diagram is considered. The algorithms to solve issues of prioritizing clusters of cases in business have been investigated. An implementation of priority queues to support case management operations has been presented. The corresponding pseudo codes for the programming application have been constructed. The tools applied in this development are based on binary tree ordering algorithms, optimization theory, and business management methods.

Keywords: credit network, case portfolio, binary tree, priority queue, stack

Procedia PDF Downloads 140
10520 A Multinomial Logistic Regression Analysis of Factors Influencing Couples' Fertility Preferences in Kenya

Authors: Naomi W. Maina

Abstract:

Fertility preference is a subject of great significance in developing countries. Studies reveal that the preferences of fertility are actually significant in determining the society’s fertility levels because the fertility behavior of the future has a high likelihood of falling under the effect of currently observed fertility inclinations. The objective of this study was to establish the factors associated with fertility preference amongst couples in Kenya by fitting a multinomial logistic regression model against 5,265 couple data obtained from Kenya demographic health survey 2014. Results revealed that the type of place of residence, the region of residence, age and spousal age gap significantly influence desire for additional children among couples in Kenya. There was the notable high likelihood of couples living in rural settlements having similar fertility preference compared to those living in urban settlements. Moreover, geographical disparities such as in northern Kenya revealed significant differences in a couples desire to have additional children compared to Nairobi. The odds of a couple’s desire for additional children were further observed to vary dependent on either the wife or husbands age and to a large extent the spousal age gap. Evidenced from the study, was the fact that as spousal age gap increases, the desire for more children amongst couples decreases. Insights derived from this study would be attractive to demographers, health practitioners, policymakers, and non-governmental organizations implementing fertility related interventions in Kenya among other stakeholders. Moreover, with the adoption of devolution, there is a clear need for adoption of population policies that are County specific as opposed to a national population policy as is the current practice in Kenya. Additionally, researchers or students who have little understanding in the application of multinomial logistic regression, both theoretical understanding and practical analysis in SPSS as well as application on real datasets, will find this article useful.

Keywords: couples' desire, fertility, fertility preference, multinomial regression analysis

Procedia PDF Downloads 180
10519 Media Planning Decisions and Preferences through a Goal Programming Model: An Application to a Media Campaign for a Mature Product in Italy

Authors: Cinzia Colapinto, Davide La Torre

Abstract:

Goal Programming (GP) and its variants were applied to marketing and specific marketing issues, such as media scheduling problems in the last decades. The concept of satisfaction functions has been widely utilized in the GP model to explicitly integrate the Decision-Maker’s preferences. These preferences can be guided by the available information regarding the decision-making situation. A GP model with satisfaction functions for media planning decisions is proposed and then illustrated through a case study related to a marketing/media campaign in the Italian market.

Keywords: goal programming, satisfaction functions, media planning, tourism management

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10518 The Use of Flipped Classroom as a Teaching Method in a Professional Master's Program in Network, in Brazil

Authors: Carla Teixeira, Diana Azevedo, Jonatas Bessa, Maria Guilam

Abstract:

The flipped classroom is a blended learning modality that combines face-to-face and virtual activities of self-learning, mediated by digital information and communication technologies, which reverses traditional teaching approaches and presents, as a presupposition, the previous study of contents by students. In the following face-to-face activities, the contents are discussed, producing active learning. This work aims to describe the systematization process of the use of flipped classrooms as a method to develop complementary national activities in PROFSAÚDE, a professional master's program in the area of public health, offered as a distance learning course, in the network, in Brazil. The complementary national activities were organized with the objective of strengthening and qualifying students´ learning process. The network gathers twenty-two public institutions of higher education in the country. Its national coordination conducted a survey to detect complementary educational needs, supposed to improve the formative process and align important content sums for the program nationally. The activities were organized both asynchronously, making study materials available in Google classrooms, and synchronously in a tele presential way, organized on virtual platforms to reach the largest number of students in the country. The asynchronous activities allowed each student to study at their own pace and the synchronous activities were intended for deepening and reflecting on the themes. The national team identified some professors' areas of expertise, who were contacted for the production of audiovisual content such as video classes and podcasts, guidance for supporting bibliographic materials and also to conduct synchronous activities together with the technical team. The contents posted in the virtual classroom were organized by modules and made available before the synchronous meeting; these modules, in turn, contain “pills of experience” that correspond to reports of teachers' experiences in relation to the different themes. In addition, activity was proposed, with questions aimed to expose doubts about the contents and a learning challenge, as a practical exercise. Synchronous activities are built with different invited teachers, based on the participants 'discussions, and are the forum where teachers can answer students' questions, providing feedback on the learning process. At the end of each complementary activity, an evaluation questionnaire is available. The responses analyses show that this institutional network experience, as pedagogical innovation, provides important tools to support teaching and research due to its potential in the participatory construction of learning, optimization of resources, the democratization of knowledge and sharing and strengthening of practical experiences on the network. One of its relevant aspects was the thematic diversity addressed through this method.

Keywords: active learning, flipped classroom, network education experience, pedagogic innovation

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10517 Τhe Importance of Previous Examination Results, in Futural Differential Diagnostic Procedures and Especially in the Era of Covid-19

Authors: Angelis P. Barlampas

Abstract:

Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

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10516 Parental Awareness and Willingness to Vaccinate Adolescent Daughters against Human Papilloma Virus for Cervical Cancer Prevention in Eastern Region of Kenya: Towards Affirmative Action

Authors: Jacinta Musyoka, Wesley Too

Abstract:

Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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10515 Healthy Feeding and Drinking Troughs for Profitable Intensive Deep-Litter Poultry Farming

Authors: Godwin Ojochogu Adejo, Evelyn UnekwuOjo Adejo, Sunday UnenwOjo Adejo

Abstract:

The mainstream contemporary approach to controlling the impact of diseases among poultry birds rely largely on curative measures through the administration of drugs to infected birds. Most times as observed in the deep liter poultry farming system, entire flocks including uninfected birds receive the treatment they do not need. As such, unguarded use of chemical drugs and antibiotics has led to wastage and accumulation of chemical residues in poultry products with associated health hazards to humans. However, wanton and frequent drug usage in poultry is avoidable if feeding and drinking equipment are designed to curb infection transmission among birds. Using toxicological assays as guide and with efficiency and simplicity in view, two newly field-tested and recently patented equipments called 'healthy liquid drinking trough (HDT)' and 'healthy feeding trough (HFT)' that systematically eliminate contamination of the feeding and drinking channels, thereby, curbing wide-spread infection and transmission of diseases in the (intensive) deep litter poultry farming system were designed. Upon combined usage, they automatically and drastically reduced both the amount and frequency of antibiotics use in poultry by over > 50%. Additionally, they conferred optimization of feed and water utilization/elimination of wastage by > 80%, reduced labour by > 70%, reduced production cost by about 15%, and reduced chemical residues in poultry meat or eggs by > 85%. These new and cheap technologies which require no energy input are likely to elevate safety of poultry products for consumers' health, increase marketability locally and for export, and increase output and profit especially among poultry farmers and poor people who keep poultry or inevitably utilize poultry products in developing countries.

Keywords: healthy, trough, toxicological, assay-guided, poultry

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10514 Effect of Communication Pattern on Agricultural Employees' Job Performance

Authors: B. G. Abiona, E. O. Fakoya, S. O. Adeogun, J. O. Blessed

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This study assessed the influence of communication pattern on agricultural employees’ job performance. Data were collected from 61 randomly selected respondents using a structured questionnaire. Perceived communication pattern that influence job performance include: the attitude of the administrators (x̅ = 3.41, physical barriers to communication flow among employees (x̅ = 3.21). Major challenges to respondents’ job performance were different language among employees (x̅ = 3.12), employees perception on organizational issues (x̅ = 3.09), networking (x̅ = 2.88), and unclear definition of work (x̅ = 2.74). A significant relationship was found between employees’ perceived communication pattern (r = 0.423, p < 0.00) and job performance. Information must be well designed in such a way that would positively influence employees’ job performance as this is essential in any agricultural organizations.

Keywords: communication pattern, job performance, agricultural employees, constraint, administrators, attitude

Procedia PDF Downloads 350
10513 The Effect of Outliers on the Economic and Social Survey on Income and Living Conditions

Authors: Encarnación Álvarez, Rosa M. García-Fernández, Francisco J. Blanco-Encomienda, Juan F. Muñoz

Abstract:

The European Union Survey on Income and Living Conditions (EU-SILC) is a popular survey which provides information on income, poverty, social exclusion and living conditions of households and individuals in the European Union. The EUSILC contains variables which may contain outliers. The presence of outliers can have an impact on the measures and indicators used by the EU-SILC. In this paper, we used data sets from various countries to analyze the presence of outliers. In addition, we obtain some indicators after removing these outliers, and a comparison between both situations can be observed. Finally, some conclusions are obtained.

Keywords: poverty line, headcount index, risk of poverty, skewness coefficient

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10512 A Randomised Controlled Trial on the Nurse-Led Smartphone-Based Self-Management Programme for Type 2 Diabetes Patients with Poor Glycemic Control

Authors: Wenru Wang

Abstract:

Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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10511 Seroprevalence and Potential Risk Factors of Bovine Brucellosis under Diverse Production Systems in Central Punjab, Paksitan

Authors: A. Khan, I. Khan, M. Younus, S. E. Haque, U. Waheed, H. Neubauer, A. A. Anjum, S. A. Muhammad, A. Idrees T. Abbas, S. Raza, M. A. Ali, M. Farooq, M. Mahmood, A. Hussain, H. Danish, U. Tayyab, M. Zafar, M. Aslam.

Abstract:

Brucellosis is one of the major problems of milk producing animals in our country which deteriorate the health of livestock. It is a disease of zoonotic significance which is capable of producing disease in humans leading to infertility, orchitis, abortions, and synovitis. In this particular study, milk and serum samples of cattle and buffalo (n=402) were collected from different districts of Punjab including Narowal, Gujranwala and Gujrat. Milk samples were analyzed by Milk Ring Test (MRT), while serum samples were tested through Rose Bengal Plate agglutination Test (RBPT) and Indirect Enzyme Linked Immunosorbant Assay (i-ELISA). The sample tested with MRT were 9.5% positive, including cattle 9.6% and buffalo 9.3%. While using the RBPT test for the detection of serum samples and for screening purpose it was observed that 16.4% animals were seropositive, cattle were 18.8% and buffalo were 13.9% seropositive. The higher prevalence of brucellosis indicates the danger of the disease to human population. The serum samples positive by RBPT were further confirmed by the use of most specific and sensitive serological test known as i-ELISA. 11.4% animals were confirmed as seropositive by i-ELISA including cattle 13.5% seropositive and buffalo 9.3%. The results indicated high seroprevalence of brucellosis in cattle as compared to buffalos. Different risk factors were also studied to know the association between disease and their spread. Advanced age, larger herds, history of abortion and pregnancy of the animals is considered to be the important factors for the prevalence and spread of the hazardous zoonotic disease. It is a core issue of developing countries like Pakistan and has major public health impact.

Keywords: humans, bovines, infertility, orchitis, abortions, seroprevalence, brucellosis

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10510 A Study on the Prevalence and Microbiological Profile of Nosocomial Infections in the ICU of a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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10509 Communication Skills for Physicians: Adaptation to the Third Gender and Language Cross Cultural Influences

Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

Abstract:

We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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10508 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

Abstract:

Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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10507 Development of Gully Erosion Prediction Model in Sokoto State, Nigeria, using Remote Sensing and Geographical Information System Techniques

Authors: Nathaniel Bayode Eniolorunda, Murtala Abubakar Gada, Sheikh Danjuma Abubakar

Abstract:

The challenge of erosion in the study area is persistent, suggesting the need for a better understanding of the mechanisms that drive it. Thus, the study evolved a predictive erosion model (RUSLE_Sok), deploying Remote Sensing (RS) and Geographical Information System (GIS) tools. The nature and pattern of the factors of erosion were characterized, while soil losses were quantified. Factors’ impacts were also measured, and the morphometry of gullies was described. Data on the five factors of RUSLE and distances to settlements, rivers and roads (K, R, LS, P, C, DS DRd and DRv) were combined and processed following standard RS and GIS algorithms. Harmonized World Soil Data (HWSD), Shuttle Radar Topographical Mission (SRTM) image, Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS), Sentinel-2 image accessed and processed within the Google Earth Engine, road network and settlements were the data combined and calibrated into the factors for erosion modeling. A gully morphometric study was conducted at some purposively selected sites. Factors of soil erosion showed low, moderate, to high patterns. Soil losses ranged from 0 to 32.81 tons/ha/year, classified into low (97.6%), moderate (0.2%), severe (1.1%) and very severe (1.05%) forms. The multiple regression analysis shows that factors statistically significantly predicted soil loss, F (8, 153) = 55.663, p < .0005. Except for the C-Factor with a negative coefficient, all other factors were positive, with contributions in the order of LS>C>R>P>DRv>K>DS>DRd. Gullies are generally from less than 100m to about 3km in length. Average minimum and maximum depths at gully heads are 0.6 and 1.2m, while those at mid-stream are 1 and 1.9m, respectively. The minimum downstream depth is 1.3m, while that for the maximum is 4.7m. Deeper gullies exist in proximity to rivers. With minimum and maximum gully elevation values ranging between 229 and 338m and an average slope of about 3.2%, the study area is relatively flat. The study concluded that major erosion influencers in the study area are topography and vegetation cover and that the RUSLE_Sok well predicted soil loss more effectively than ordinary RUSLE. The adoption of conservation measures such as tree planting and contour ploughing on sloppy farmlands was recommended.

Keywords: RUSLE_Sok, Sokoto, google earth engine, sentinel-2, erosion

Procedia PDF Downloads 66
10506 Shape Management Method of Large Structure Based on Octree Space Partitioning

Authors: Gichun Cha, Changgil Lee, Seunghee Park

Abstract:

The objective of the study is to construct the shape management method contributing to the safety of the large structure. In Korea, the research of the shape management is lack because of the new attempted technology. Terrestrial Laser Scanning (TLS) is used for measurements of large structures. TLS provides an efficient way to actively acquire accurate the point clouds of object surfaces or environments. The point clouds provide a basis for rapid modeling in the industrial automation, architecture, construction or maintenance of the civil infrastructures. TLS produce a huge amount of point clouds. Registration, Extraction and Visualization of data require the processing of a massive amount of scan data. The octree can be applied to the shape management of the large structure because the scan data is reduced in the size but, the data attributes are maintained. The octree space partitioning generates the voxel of 3D space, and the voxel is recursively subdivided into eight sub-voxels. The point cloud of scan data was converted to voxel and sampled. The experimental site is located at Sungkyunkwan University. The scanned structure is the steel-frame bridge. The used TLS is Leica ScanStation C10/C5. The scan data was condensed 92%, and the octree model was constructed with 2 millimeter in resolution. This study presents octree space partitioning for handling the point clouds. The basis is created by shape management of the large structures such as double-deck tunnel, building and bridge. The research will be expected to improve the efficiency of structural health monitoring and maintenance. "This work is financially supported by 'U-City Master and Doctor Course Grant Program' and the National Research Foundation of Korea(NRF) grant funded by the Korea government (MSIP) (NRF- 2015R1D1A1A01059291)."

Keywords: 3D scan data, octree space partitioning, shape management, structural health monitoring, terrestrial laser scanning

Procedia PDF Downloads 295
10505 Local Energy and Flexibility Markets to Foster Demand Response Services within the Energy Community

Authors: Eduardo Rodrigues, Gisela Mendes, José M. Torres, José E. Sousa

Abstract:

In the sequence of the liberalisation of the electricity sector a progressive engagement of consumers has been considered and targeted by sector regulatory policies. With the objective of promoting market competition while protecting consumers interests, by transferring some of the upstream benefits to the end users while reaching a fair distribution of system costs, different market models to value consumers’ demand flexibility at the energy community level are envisioned. Local Energy and Flexibility Markets (LEFM) involve stakeholders interested in providing or procure local flexibility for community, services and markets’ value. Under the scope of DOMINOES, a European research project supported by Horizon 2020, the local market concept developed is expected to: • Enable consumers/prosumers empowerment, by allowing them to value their demand flexibility and Distributed Energy Resources (DER); • Value local liquid flexibility to support innovative distribution grid management, e.g., local balancing and congestion management, voltage control and grid restoration; • Ease the wholesale market uptake of DER, namely small-scale flexible loads aggregation as Virtual Power Plants (VPPs), facilitating Demand Response (DR) service provision; • Optimise the management and local sharing of Renewable Energy Sources (RES) in Medium Voltage (MV) and Low Voltage (LV) grids, trough energy transactions within an energy community; • Enhance the development of energy markets through innovative business models, compatible with ongoing policy developments, that promote the easy access of retailers and other service providers to the local markets, allowing them to take advantage of communities’ flexibility to optimise their portfolio and subsequently their participation in external markets. The general concept proposed foresees a flow of market actions, technical validations, subsequent deliveries of energy and/or flexibility and balance settlements. Since the market operation should be dynamic and capable of addressing different requests, either prioritising balancing and prosumer services or system’s operation, direct procurement of flexibility within the local market must also be considered. This paper aims to highlight the research on the definition of suitable DR models to be used by the Distribution System Operator (DSO), in case of technical needs, and by the retailer, mainly for portfolio optimisation and solve unbalances. The models to be proposed and implemented within relevant smart distribution grid and microgrid validation environments, are focused on day-ahead and intraday operation scenarios, for predictive management and near-real-time control respectively under the DSO’s perspective. At local level, the DSO will be able to procure flexibility in advance to tackle different grid constrains (e.g., demand peaks, forecasted voltage and current problems and maintenance works), or during the operating day-to-day, to answer unpredictable constraints (e.g., outages, frequency deviations and voltage problems). Due to the inherent risks of their active market participation retailers may resort to DR models to manage their portfolio, by optimising their market actions and solve unbalances. The interaction among the market actors involved in the DR activation and in flexibility exchange is explained by a set of sequence diagrams for the DR modes of use from the DSO and the energy provider perspectives. • DR for DSO’s predictive management – before the operating day; • DR for DSO’s real-time control – during the operating day; • DR for retailer’s day-ahead operation; • DR for retailer’s intraday operation.

Keywords: demand response, energy communities, flexible demand, local energy and flexibility markets

Procedia PDF Downloads 96
10504 Investigation of Enterotoxigenic Staphylococcus aureus in Kitchen of Catering

Authors: Çiğdem Sezer, Aksem Aksoy, Leyla Vatansever

Abstract:

This study has been done for the purpose of evaluation of public health and identifying of enterotoxigenic Staphyloccocus aureus in kitchen of catering. In the kitchen of catering, samples have been taken by swabs from surface of equipments which are in the salad section, meat section and bakery section. Samples have been investigated with classical cultural methods in terms of Staphyloccocus aureus. Therefore, as a 10x10 cm area was identified (salad, cutting and chopping surfaces, knives, meat grinder, meat chopping surface) samples have been taken with sterile swabs with helping FTS from this area. In total, 50 samples were obtained. In aseptic conditions, Baird-Parker agar (with egg yolk tellurite) surface was seeded with swabs. After 24-48 hours of incubation at 37°C, the black colonies with 1-1.5 mm diameter and which are surrounded by a zone indicating lecithinase activity were identified as S. aureus after applying Gram staining, catalase, coagulase, glucose and mannitol fermentation and termonuclease tests. Genotypic characterization (Staphylococcus genus and S.aureus species spesific) of isolates was performed by PCR. The ELISA test was applied to the isolates for the identification of staphylococcal enterotoxins (SET) A, B, C, D, E in bacterial cultures. Measurements were taken at 450 nm in an ELISA reader using an Ridascreen-Total set ELISA test kit (r-biopharm R4105-Enterotoxin A, B, C, D, E). The results were calculated according to the manufacturer’s instructions. A total of 50 samples of 97 S. aureus was isolated. This number has been identified as 60 with PCR analysis. According to ELISA test, only 1 of 60 isolates were found to be enterotoxigenic. Enterotoxigenic strains were identified from the surface of salad chopping and cutting. In the kitchen of catering, S. aureus identification indicates a significant source of contamination. Especially, in raw consumed salad preparation phase of contamination is very important. This food can be a potential source of food-borne poisoning their terms, and they pose a significant risk to consumers have been identified.

Keywords: Staphylococcus aureus, enterotoxin, catering, kitchen, health

Procedia PDF Downloads 396
10503 Application of Multivariate Statistics and Hydro-Chemical Approach for Groundwater Quality Assessment: A Study on Birbhum District, West Bengal, India

Authors: N. C. Ghosh, Niladri Das, Prolay Mondal, Ranajit Ghosh

Abstract:

Groundwater quality deterioration due to human activities has become a prime factor of modern life. The major concern of the study is to access spatial variation of groundwater quality and to identify the sources of groundwater chemicals and its impact on human health of the concerned area. Multivariate statistical techniques, cluster, principal component analysis, and hydrochemical fancies are been applied to measure groundwater quality data on 14 parameters from 107 sites distributed randomly throughout the Birbhum district. Five factors have been extracted using Varimax rotation with Kaiser Normalization. The first factor explains 27.61% of the total variance where high positive loading have been concentrated in TH, Ca, Mg, Cl and F (Fluoride). In the studied region, due to the presence of basaltic Rajmahal trap fluoride contamination is highly concentrated and that has an adverse impact on human health such as fluorosis. The second factor explains 24.41% of the total variance which includes Na, HCO₃, EC, and SO₄. The last factor or the fifth factor explains 8.85% of the total variance, and it includes pH which maintains the acidic and alkaline character of the groundwater. Hierarchical cluster analysis (HCA) grouped the 107 sampling station into two clusters. One cluster having high pollution and another cluster having less pollution. Moreover hydromorphological facies viz. Wilcox diagram, Doneen’s chart, and USSL diagram reveal the quality of the groundwater like the suitability of the groundwater for irrigation or water used for drinking purpose like permeability index of the groundwater, quality assessment of groundwater for irrigation. Gibb’s diagram depicts that the major portion of the groundwater of this region is rock dominated origin, as the western part of the region characterized by the Jharkhand plateau fringe comprises basalt, gneiss, granite rocks.

Keywords: correlation, factor analysis, hydrological facies, hydrochemistry

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10502 Application of Various Methods for Evaluation of Heavy Metal Pollution in Soils around Agarak Copper-Molybdenum Mine Complex, Armenia

Authors: K. A. Ghazaryan, H. S. Movsesyan, N. P. Ghazaryan

Abstract:

The present study was aimed in assessing the heavy metal pollution of the soils around Agarak copper-molybdenum mine complex and related environmental risks. This mine complex is located in the south-east part of Armenia, and the present study was conducted in 2013. The soils of the five riskiest sites of this region were studied: surroundings of the open mine, the sites adjacent to processing plant of Agarak copper-molybdenum mine complex, surroundings of Darazam active tailing dump, the recultivated tailing dump of “ravine - 2”, and the recultivated tailing dump of “ravine - 3”. The mountain cambisol was the main soil type in the study sites. The level of soil contamination by heavy metals was assessed by Contamination factors (Cf), Degree of contamination (Cd), Geoaccumulation index (I-geo) and Enrichment factor (EF). The distribution pattern of trace metals in the soil profile according to Cf, Cd, I-geo and EF values shows that the soil is much polluted. Almost in all studied sites, Cu, Mo, Pb, and Cd were the main polluting heavy metals, and this was conditioned by Agarak copper-molybdenum mine complex activity. It is necessary to state that the pollution problem becomes pressing as some parts of these highly polluted region are inhabited by population, and agriculture is highly developed there; therefore, heavy metals can be transferred into human bodies through food chains and have direct influence on public health. Since the induced pollution can pose serious threats to public health, further investigations on soil and vegetation pollution are recommended. Finally, Cf calculating based on distance from the pollution source and the wind direction can provide more reasonable results.

Keywords: Agarak copper-molybdenum mine complex, heavy metals, soil contamination, enrichment factor (EF), Armenia

Procedia PDF Downloads 229
10501 A Framework of Virtualized Software Controller for Smart Manufacturing

Authors: Pin Xiu Chen, Shang Liang Chen

Abstract:

A virtualized software controller is developed in this research to replace traditional hardware control units. This virtualized software controller transfers motion interpolation calculations from the motion control units of end devices to edge computing platforms, thereby reducing the end devices' computational load and hardware requirements and making maintenance and updates easier. The study also applies the concept of microservices, dividing the control system into several small functional modules and then deploy into a cloud data server. This reduces the interdependency among modules and enhances the overall system's flexibility and scalability. Finally, with containerization technology, the system can be deployed and started in a matter of seconds, which is more efficient than traditional virtual machine deployment methods. Furthermore, this virtualized software controller communicates with end control devices via wireless networks, making the placement of production equipment or the redesign of processes more flexible and no longer limited by physical wiring. To handle the large data flow and maintain low-latency transmission, this study integrates 5G technology, fully utilizing its high speed, wide bandwidth, and low latency features to achieve rapid and stable remote machine control. An experimental setup is designed to verify the feasibility and test the performance of this framework. This study designs a smart manufacturing site with a 5G communication architecture, serving as a field for experimental data collection and performance testing. The smart manufacturing site includes one robotic arm, three Computer Numerical Control machine tools, several Input/Output ports, and an edge computing architecture. All machinery information is uploaded to edge computing servers and cloud servers via 5G communication and the Internet of Things framework. After analysis and computation, this information is converted into motion control commands, which are transmitted back to the relevant machinery for motion control through 5G communication. The communication time intervals at each stage are calculated using the C++ chrono library to measure the time difference for each command transmission. The relevant test results will be organized and displayed in the full-text.

Keywords: 5G, MEC, microservices, virtualized software controller, smart manufacturing

Procedia PDF Downloads 76
10500 Autonomic Nervous System and CTRA Gene Expression among Healthy Young Adults in Japan

Authors: Yoshino Murakami, Takeshi Hashimoto, Steve Cole

Abstract:

The autonomic nervous system (ANS), particularly the sympathetic (SNS) and parasympathetic (PNS) branches, plays a vital role in modulating immune function and physiological homeostasis. In recent years, the Conserved Transcriptional Response to Adversity (CTRA) has emerged as a key marker of the body's response to chronic stress. This gene expression profile is characterized by SNS-mediated upregulation of pro-inflammatory genes (such as IL1B and TNF) and downregulation of antiviral response genes (e.g., IFI and MX families). CTRA has been observed in individuals exposed to prolonged stressors like loneliness, social isolation, and bereavement. Some research suggests that PNS activity, as indicated by heart rate variability (HRV), may help counteract the CTRA. However, previous PNS-CTRA studies have focused on Western populations, raising questions about the generalizability of these findings across different cultural and ethnic backgrounds. This study aimed to examine the relationship between HRV and CTRA gene expression in young, healthy adults in Japan. We hypothesized that HRV would be inversely related to CTRA gene expression, similar to patterns observed in previous Western studies. A total of 49 participants aged 20 to 39 were recruited, and after data exclusions, 26 participants' HRV and CTRA data were analyzed. HRV was measured using an electrocardiogram (ECG), and two time-domain indices were utilized: the root mean square of successive differences (RMSSD) and the standard deviation of NN intervals (SDNN). Blood samples were collected for gene expression analysis, focusing on a standard set of 47 CTRA indicator gene transcripts. it findings revealed a significant inverse relationship between HRV and CTRA gene expression, with higher HRV correlating with reduced pro-inflammatory gene activity and increased antiviral response. These results are consistent with findings from Western populations and demonstrate that the relationship between ANS function and immune response generalizes to an East Asian population. The study highlights the importance of HRV as a biomarker for psychophysiological health, reflecting the body's ability to buffer stress and maintain immune balance. These findings have implications for understanding how physiological systems interact across different cultures and ethnicities. Given the influence of chronic stress in promoting inflammation and disease risk, interventions aimed at improving HRV, such as mindfulness-based practices or physical exercise, could provide significant health benefits. Future research should focus on larger sample sizes and experimental interventions to better understand the causal pathways linking HRV to CTRA gene expression, and determine whether improving HRV may help mitigate the harmful effects of stress on health by reducing inflammation.

Keywords: autonomic nervous activity, neuroendocrine system, inflammation, Japan

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10499 Parameters Estimation of Power Function Distribution Based on Selective Order Statistics

Authors: Moh'd Alodat

Abstract:

In this paper, we discuss the power function distribution and derive the maximum likelihood estimator of its parameter as well as the reliability parameter. We derive the large sample properties of the estimators based on the selective order statistic scheme. We conduct simulation studies to investigate the significance of the selective order statistic scheme in our setup and to compare the efficiency of the new proposed estimators.

Keywords: fisher information, maximum likelihood estimator, power function distribution, ranked set sampling, selective order statistics sampling

Procedia PDF Downloads 458
10498 Case Report: A Case of Confusion with Review of Sedative-Hypnotic Alprazolam Use

Authors: Agnes Simone

Abstract:

A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

Procedia PDF Downloads 131
10497 A Quantitative Model for Replacement of Medical Equipment Based on Technical and Environmental Factors

Authors: Ghadeer Mohammad Said El-Sheikh, Samer Mohamad Shalhoob

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Medical equipment operation state is a valid reflection of health care organizations' performance, where such equipment highly contributes to the quality of healthcare services on several levels in which quality improvement has become an intrinsic part of the discourse and activities of health care services. In healthcare organizations, clinical and biomedical engineering departments play an essential role in maintaining the safety and efficiency of such equipment. One of the most challenging topics when it comes to such sophisticated equipment is the lifespan of medical equipment, where many factors will impact such characteristics of medical equipment through its life cycle. So far, many attempts have been made in order to address this issue where most of the approaches are kind of arbitrary approaches and one of the criticisms of existing approaches trying to estimate and understand the lifetime of a medical equipment lies under the inquiry of what are the environmental factors that can play into such a critical characteristic of a medical equipment. In an attempt to address this shortcoming, the purpose of our study rises where in addition to the standard technical factors taken into consideration through the decision-making process by a clinical engineer in case of medical equipment failure, the dimension of environmental factors shall be added. The investigations, researches and studies applied for the purpose of supporting the decision making process by a clinical engineers and assessing the lifespan of healthcare equipment’s in the Lebanese society was highly dependent on the identification of technical criteria’s that impacts the lifespan of a medical equipment where the affecting environmental factors didn’t receive the proper attention. The objective of our study is based on the need for introducing a new well-designed plan for evaluating medical equipment depending on two dimensions. According to this approach, the equipment that should be replaced or repaired will be classified based on a systematic method taking into account two essential criteria; the standard identified technical criteria and the added environmental criteria.

Keywords: technical, environmental, healthcare, characteristic of medical equipment

Procedia PDF Downloads 151