Search results for: clinical signs

Authors: Caio E. G. Reis, Sara Wassell, Adriana L. Porto, Angélica A. Amato, Leslie J. C. Bluck, Teresa H. M. da Costa

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Background: Multiple epidemiologic studies have consistently reported association between increased coffee consumption and a lowered risk of Type 2 Diabetes Mellitus. However, the mechanisms behind this finding have not been fully elucidated. Objective: We investigate the effect of coffee (caffeinated and decaffeinated) on glucose effectiveness and insulin sensitivity using the stable isotope minimal model protocol with oral glucose administration in healthy men. Design: Fifteen healthy men underwent 5 arms randomized crossover single-blinding (researchers) clinical trial. They consumed decaffeinated coffee, caffeinated coffee (with and without sugar), and controls – water (with and without sugar) followed 1 hour by an oral glucose tolerance test (75 g of available carbohydrate) with intravenous labeled dosing interpreted by the two compartment minimal model (225 minutes). One-way ANOVA with Bonferroni adjustment were used to compare the effects of the tested beverages on glucose metabolism parameters. Results: Decaffeinated coffee resulted in 29% and 85% higher insulin sensitivity compared with caffeinated coffee and water, respectively, and the caffeinated coffee showed 15% and 60% higher glucose effectiveness compared with decaffeinated coffee and water, respectively. However, these differences were not significant (p > 0.10). In overall analyze (0 – 225 min) there were no significant differences on glucose effectiveness, insulin sensitivity, and glucose and insulin area under the curve between the groups. The beneficial effects of coffee did not seem to act in the short-term (hours) on glucose metabolism parameters mainly on insulin sensitivity indices. The benefits of coffee consumption occur in the long-term (years) as has been shown in the reduction of Type 2 Diabetes Mellitus risk in epidemiological studies. The clinical relevance of the present findings is that there is no need to avoid coffee as the drink choice for healthy people. Conclusions: The findings of this study demonstrate that the consumption of caffeinated and decaffeinated coffee with or without sugar has no acute effects on glucose metabolism in healthy men. Further researches, including long-term interventional studies, are needed to fully elucidate the mechanisms behind the coffee effects on reduced risk for Type 2 Diabetes Mellitus.

Keywords: coffee, diabetes mellitus type 2, glucose, insulin

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Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

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Authors: Pedro Llanos, Diego García

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This paper is addressed to expanding our understanding of the effects of hypoxia training on our bodies to better model its dynamics and leverage some of its implications and effects on human health. Hypoxia training is a recommended practice for military and civilian pilots that allow them to recognize their early hypoxia signs and symptoms, and Scientist Astronaut Candidates (SACs) who underwent hypobaric hypoxia (HH) exposure as part of a training activity for prospective suborbital flight applications. This observational-analytical study describes physiologic responses and symptoms experienced by a SAC group before, during and after HH exposure and proposes a model for assessing predicted versus observed physiological responses. A group of individuals with diverse Science Technology Engineering Mathematics (STEM) backgrounds conducted a hypobaric training session to an altitude up to 22,000 ft (FL220) or 6,705 meters, where heart rate (HR), breathing rate (BR) and core temperature (Tc) were monitored with the use of a chest strap sensor pre and post HH exposure. A pulse oximeter registered levels of saturation of oxygen (SpO₂), number and duration of desaturations during the HH chamber flight. Hypoxia symptoms as described by the SACs during the HH training session were also registered. This data allowed to generate a preliminary predictive model of the oxygen desaturation and O₂ pressure curve for each subject, which consists of a sixth-order polynomial fit during exposure, and a fifth or fourth-order polynomial fit during recovery. Data analysis showed that HR and BR showed no significant differences between pre and post HH exposure in most of the SACs, while Tc measures showed slight but consistent decrement changes. All subjects registered SpO₂ greater than 94% for the majority of their individual HH exposures, but all of them presented at least one clinically significant desaturation (SpO₂ < 85% for more than 5 seconds) and half of the individuals showed SpO₂ below 87% for at least 30% of their HH exposure time. Finally, real time collection of HH symptoms presented temperature somatosensory perceptions (SP) for 65% of individuals, and task-focus issues for 52.5% of individuals as the most common HH indications. 95% of the subjects experienced HH onset symptoms below FL180; all participants achieved full recovery of HH symptoms within 1 minute of donning their O₂ mask. The current HH study performed on this group of individuals suggests a rapid and fully reversible physiologic response after HH exposure as expected and obtained in previous studies. Our data showed consistent results between predicted versus observed SpO₂ curves during HH suggesting a mathematical function that may be used to model HH performance deficiencies. During the HH study, real-time HH symptoms were registered providing evidenced SP and task focusing as the earliest and most common indicators. Finally, an assessment of HH signs of symptoms in a group of heterogeneous, non-pilot individuals showed similar results to previous studies in homogeneous populations of pilots.

Keywords: slow onset hypoxia, hypobaric chamber training, altitude sickness, symptoms and altitude, pressure cabin

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Authors: Horesh Reinman Netta

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Objectives: To examine the relationship between stressful life events and recurrent major depressive disorders Methods: Three groups of 50 subjects were assessed. One group had a recurrent major depressive disorder with melancholic features; the second group met the criteria for borderline personality disorder, and the third consisted of healthy controls. The Structured Clinical Interview for AXIS I DSM-IV Disorders sand the Structured Clinical Interview for AXIS II DSM-IV Disorders were used for diagnosis. The Israel Psychiatric Epidemiology Research Interview (IPERI) Life Event Scale and the Coddington Life Events Schedule (CLES) were used to measure life events which were confirmed with a confirmatory semi-structured interview. The Beck Depression Inventory and the Satisfaction from Life scales were also administered. Results : The total number of loss-related events in childhood and in the year preceding the first episode was significantly higher in the affective disorder group than in the two control groups. Total number of LE, uncontrolled and independent events were also more common in the depressed patients in the year preceding the first episode. No category of SLE was differentiated among any of the three groups during any period of time following the first depressive episode. Conclusions: SLE play an important role in the onset of affective disorders. There appear to be specific kinds of SLE occurring in childhood and in the year preceding a first episode that have particular significance. SLE may have a lesser role in the maintenance of this illness.

Keywords: modd dosorders, recurrent depression, stress, life events

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Authors: Amna B. Medani, M. A. Elbadwi Samia, Hassan A. Khalid

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In our study, nine Nubian goat kids were obtained, allotted into three groups, and healthily adapted in pens within the premises of the Veterinary Teaching Hospital, University of Khartoum to be given the oral doses of the dried herb shoots at daily doses of 1 and 5 gm/kg/day with drinking water, while the kids of the control group were left undosed. All goats were slaughtered,if not died, after 35 days. S. argel at the given doses caused signs of arched posture, ruffled hair, shivering and paralysis of limbs. On post mortem, lesions were seen to be hepatic fatty changes, renal necrosis, congested lungs and inflamed intestines. Serum chemistry investigations revealed significant increase (P< 0.05-0.01) in the activities of ALP(alkaline phosphates) and AST( aspartate-aminotransferase) in goats dosed with 5 gm /kg/ day. Also observed were significant increases in inorganic phosphorus and urea concentrations (P < 0.05-0.01) in both dosed goat groups. .Other investigations including the activity of GGT( gamma glutamyltransferase), creatinine, calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. On haematological evaluation , the goat kids dosed with 5 gm/kg/dayshowed a decrease in haemoglobin concentration and red blood cells count of (P < 0.05-0.01).Both groups of dosed goats showed a higher packed cell volume values of (P < 0.05) when compared to the control goats .Mean corpuscular haemoglobin values were not different from those of the control kids. S. argel at the given doses caused signs of arched posture, ruffled hair, shivering and paralysis of limbs. On post mortem, lesions were seen to be hepatic fatty changes, renal necrosis, congested lungs and inflamed intestines. Serum chemistry investigations revealed significant increase (P < 0.05-0.01) in the activities of ALP(alkaline phosphates) and AST( aspartate-aminotransferase) in goats dosed with 5 gm /kg/ day. Also observed were significant increases in inorganic phosphorus and urea concentrations (P < 0.05-0.01) in both dosed goat groups. .Other investigations including the activity of GGT( gamma-glutamyltransferase), creatinine, calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. On haematological evaluation , the goat kids dosed with 5 gm/kg/dayshowed a decrease in haemoglobin concentration and red blood cells count of (P < 0.05-0.01).Both groups of dosed goats showed a higher packed cell volume values of (P < 0.05) when compared to the control goats .Mean corpuscular haemoglobin values were not different from those of the control kids. Data obtained were then discussed to find S. argel irritable to intestines , toxic to the kidney and liver and a haematological mild toxin.Suggestions for future were forwarded.

Keywords: hargal, nubian goats, solenstemma argel, toxicity

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Authors: Nana Benma Osei

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Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

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Authors: Jihene Bettaieb, Ghassen kharroubi, Rym mallekh, Ines Cherif, Taoufik Atawa, Kaouther Harrabech

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Brucellosis is a major worldwide zoonosis. It is a reportable condition in Tunisia where the disease remains endemic, especially in rural areas. The aim of this study was to describe the epidemiological, clinical, and bacteriological profile of human brucellosis cases notified in the district of Tunis. It was a retrospective descriptive study of cases reported in the district of Tunis through the national surveillance system between the 1st January and 31th December 2017. During the study period, 133 brucellosis confirmed cases were notified. The mean age was 37.5 ± 18.0 years, and 54.9% of cases were males. More than four-fifths (82.7%) of cases were reported in spring and summer with a peak in the month of May (36 cases). Fever and sweats were the most common symptoms; they occurred in 95% and 72% of cases, respectively. Osteoarticular complications occurred in 10 cases, meningitis in one case and endocarditis in one other case. Wright agglutination test and Rose Bengale test were positive in 100% and 91% of cases, respectively. While blood culture was positive in 9 cases and PCR in 2 cases. Brucella melitensis was the only identified specie (9 cases). Almost all cases (99.2%) reported the habit of consuming raw dairy products. Only 5 cases had a suspect contact with animals; among them, 3 persons were livestock breeders. The transmission was essentially due to raw dairy product consumption. It is important to enhance preventive measures to control animal Brucellosis and to educate the population regarding the risk factors of the disease.

Keywords: brucellosis, risk factors, surveillance system, Tunisia

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Authors: Yuri Melis, Mattia Resteghini, Emanuela Apicella, Eugenia Dozio, Leonardo Mendolicchio

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Aim: This retrospective study was created to analyze the psychometric, anthropometric and body composition values in patients at the beginning and the discharge of their of hospitalization in the residential care clinic for eating and feeding disorders (EFD’s). Method: The sample was composed by (N=59) patients with mean age N= 33,50, divided in subgroups: Anorexia Nervosa (AN) (N=28), Bulimia Nervosa (BN) (N=13) and Binge Eating Disorders (BED) (N=14) recruited from a residential care clinic for eating and feeding disorders. The psychometrics level was measured with self-report questionnaires: Eating Disorders Inventory-3 (EDI-3) The Body Uneasiness Test (BUT), Minnesota Multiphasic Personality Inventory (MMPI – 2). The anthropometric and nutritional values was collected by Body Impedance Assessment (B.I.A), Body mass index (B.M.I.). Measurements were made at the beginning and at the end of hospitalization, with an average time of recovery of about 8,6 months. Results: The all data analysis showed a statistical significance (p-value >0,05 | power size N=0,950) in variation from T0 (start of recovery) to T1 (end of recovery) in the clinical scales of MMPI-2, AN group (Hypocondria T0 64,14 – T1 56,39) (Depression T0 72,93 – T1 59,50) (Hysteria T0 61,29 – T1 56,17) (Psychopathic deviation T0 64,00 – T1 60,82) (Paranoia T0 63,82 – T1 56,14) (Psychasthenia T0 63,82 – T1 57,86) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 60,36 – T1 55,68); BN group (Hypocondria T0 64,08 – T1 47,54) (Depression T0 67,46 – T1 52,46) (Hysteria T0 60,62 – T1 47,84) (Psychopathic deviation T0 65,69 – T1 58,92) (Paranoia T0 67,46 – T1 55,23) (Psychasthenia T0 60,77 – T1 53,77) (Schizophrenia T0 64,68 – T1 60,43) (Obsessive T0 62,92 – T1 54,08); B.E.D groups (Hypocondria T0 59,43 – T1 53,14) (Depression T0 66,71 – T1 54,57) (Hysteria T0 59,86 – T1 53,82) (Psychopathic deviation T0 67,39 – T1 59,03) (Paranoia T0 58,57 – T1 53,21) (Psychasthenia T0 61,43 – T1 53,00) (Schizophrenia T0 62,29 – T1 56,36) (Obsessive T0 58,57 – T1 48,64). EDI-3 report mean value is higher than clinical cut-off at T0, in T1, there is a significant reduction of the general mean of value. The same result is present in the B.U.T. test in the difference between T0 to T1. B.M.I mean value in AN group is (T0 14,83 – T1 18,41) BN group (T0 20 – T1 21,33) BED group (T0 42,32 – T1 34,97) Phase Angle results: AN group (T0 4,78 – T1 5,64) BN (T0 6 – T1 6,53) BED group (T0 6 – T1 6,72). Discussion and conclusion: The evident presence that on the whole sample, we have an altered serious psychiatric and clinic conditions at the beginning of recovery. The interesting conclusions that we can draw from this analysis are that a multidisciplinary approach that includes the entire care of the subject: from the pharmacological treatment, analytical psychotherapy, Psychomotricity, nutritional rehabilitation, and rehabilitative, educational activities. Thus, this Multidisciplinary treatment allows subjects in our sample to be able to restore psychopathological and metabolic values to below the clinical cut-off.

Keywords: feeding and eating disorders, anorexia nervosa, care clinic treatment, multidisciplinary treatment

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Authors: Zahra Shokrolahi, Mohammad Reza Atashzar

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The goals of treating patients with breast cancer are to cure the disease, prolong survival, and improve quality of life. Immune cells in the tumor microenvironment have an important role in regulating tumor progression. The term of cellular immunotherapy refers to the administration of living cells to a patient; this type of immunotherapy can be active, such as a dendritic cell (DC) vaccine, in that the cells can stimulate an anti-tumour response in the patient, or the therapy can be passive, whereby the cells have intrinsic anti-tumour activity; this is known as adoptive cell transfer (ACT) and includes the use of autologous or allogeneic lymphocytes that may, or may not, be modified. The most important breast cancer cellular immunotherapies involving the use of T cells and natural killer (NK) cells in adoptive cell transfer, as well as dendritic cells vaccines. T cell-based therapies including tumour-infiltrating lymphocytes (TILs), engineered TCR-T cells, chimeric antigen receptor (CAR T cell), Gamma-delta (γδ) T cells, natural killer T (NKT) cells. NK cell-based therapies including lymphokine-activated killers (LAK), cytokine-induced killer (CIK) cells, CAR-NK cells. Adoptive cell therapy has some advantages and disadvantages some. TILs cell strictly directed against tumor-specific antigens but are inactive against tumor changes due to immunoediting. CIK cell have MHC-independent cytotoxic effect and also need concurrent high dose IL-2 administration. CAR T cell are MHC-independent; overcome tumor MHC molecule downregulation; potent in recognizing any cell surface antigen (protein, carbohydrate or glycolipid); applicable to a broad range of patients and T cell populations; production of large numbers of tumor-specific cells in a moderately short period of time. Meanwhile CAR T cells capable of targeting only cell surface antigens; lethal toxicity due to cytokine storm reported. Here we present the most popular cancer cellular immunotherapy approaches and discuss their clinical relevance referring to data acquired from clinical trials .To date, clinical experience and efficacy suggest that combining more than one immunotherapy interventions, in conjunction with other treatment options like chemotherapy, radiotherapy and targeted or epigenetic therapy, should guide the way to cancer cure.

Keywords: breast cancer , cell therapy , CAR T cell , CIK cells

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Authors: A. Bruce Janati, Muhammad Umair Khan, Naif Alghassab, Ibrahim Alzeir, Assem Mahmoud, M. Sammour

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Rationale: Lennox-Gastaut syndrome(LGS) is an electro-clinical syndrome composed of the triad of mental retardation, multiple seizure types, and the characteristic generalized slow spike-wave complexes in the EEG. In this article, we report on two patients with LGS whose brain MRI showed dysgenesis of corpus callosum(CC). We review the literature and stress the role of CC in the genesis of secondary bilateral synchrony(SBS). Method: This was a clinical study conducted at King Khalid Hospital. Results: The EEG was consistent with LGS in patient 1 and unilateral slow spike-wave complexes in patient 2. The MRI showed hypoplasia of the splenium of CC in patient 1, and global hypoplasia of CC combined with Joubert syndrome in patient 2. Conclusion: Based on the data, we proffer the following hypotheses: 1-Hypoplasia of CC interferes with functional integrity of this structure. 2-The genu of CC plays a pivotal role in the genesis of secondary bilateral synchrony. 3-Electrodecremental seizures in LGS emanate from pacemakers generated in the brain stem, in particular the mesencephalon projecting abnormal signals to the cortex via thalamic nuclei. 4-Unilateral slow spike-wave complexes in the context of mental retardation and multiple seizure types may represent a variant of LGS, justifying neuroimaging studies.

Keywords: EEG, Lennox-Gastaut syndrome, corpus callosum , MRI

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Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay

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Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.

Keywords: trauma, coagulopathy, prediction, model

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Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

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Authors: O. I. Papagianni, P. Potsaki, K. Almpounioti, D. Chatzicharalampous, A. Voutsa, O. Katira, A. Michalaki, H. C. Karantonis, A. E. Koutelidakis

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High intakes of carbohydrates and fats have been associated with an increased risk of chronic diseases due to the role of postprandial oxidative stress. This pilot nutritional intervention aimed to examine the acute effect of consuming two different types of breadsticks prepared from durum wheat flour mixtures differing in total phenolic content on postprandial inflammatory and oxidant responses in healthy volunteers. A cross-over, controlled, and single-blind clinical trial was designed, and two isocaloric high-fat and high-carbohydrate meals were tested. Serum total, HDL- and LDL-cholesterol, triglycerides, glucose, CRP, uric acid, plasma total antioxidant capacity, and antiplatelet activity were determined in fasting and 30, 60, and 120 min after consumption. The results showed a better postprandial HDL-cholesterol and total antioxidant activity response in the intervention group. The choice of durum wheat flours with higher phenolic content and antioxidant activity is presented as promising for human health, and clinical studies will expand to draw safer conclusions.

Keywords: breadsticks, durum wheat flours, postprandial inflammation, postprandial oxidative stress, ex vivo antiplatelet activity

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Authors: Farideh Aramideh

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The aim of this essay is to study the light in Zoroastrianism, and Masnavi by Rumi. The use of light goes back to thousand years B.C. the light in the legacy of ancient Iranian wisdom has been used in Mithraism, Zurvanism, Zoroastrianism and Manichaean religion and spirituality has been emanated in the world through the light. Ontology and angelology and the sacredness of fire in Zoroastrianism have been interpreted according to the concept of light. The ruling atmosphere on mazdaism world is the world which is full of light and angels, and light is one of the basis of worldview in ancient Iranian mysticism, especially Zoroastrianism and Manichaean, continued widely in Islamic mysticism, and also it always provokes discussions among scholars and mystics especially Iranian mystics. Light and fire are used as the signs and symbols of God's existence, The Shining lights emanated from the sacred essence of God, knowledge, and mysticism, love, discovering the wisdom and a way to God. Rumi speaks eloquently about light in Masnavi, and by using the light; he could render his readers the fundamental mystic subjects such as the true existence of God, the verity of prophets and saints, intuition of God, spiritual states of union with God and abiding in God, which are the most complicated mystic terms.

Keywords: zoroastrianism, myticims, Masnavi, light

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Authors: Anmol Patel

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Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.

Keywords: DNACPR, resuscitation, DNAR, patient communication

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Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu

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The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.

Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity

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Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

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Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

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Authors: Noora Al Muftah, Reda Rawi, Richard Thompson, Halima Bensmail

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Clinical responses to anticancer therapies are often restricted to a subset of patients. In some cases, mutated cancer genes are potent biomarkers of response to targeted agents. There is an urgent need to identify biomarkers that predict which patients with are most likely to respond to treatment. Systematic efforts to correlate tumor mutational data with biologic dependencies may facilitate the translation of somatic mutation catalogs into meaningful biomarkers for patient stratification. To identify genomic features associated with drug sensitivity and uncover new biomarkers of sensitivity and resistance to cancer therapeutics, we have screened and integrated a panel of several hundred cancer cell lines from different databases, mutation, DNA copy number, and gene expression data for hundreds of cell lines with their responses to targeted and cytotoxic therapies with drugs under clinical and preclinical investigation. We found mutated cancer genes were associated with cellular response to most currently available Glioma cancer drugs and some frequently mutated genes were associated with sensitivity to a broad range of therapeutic agents. By linking drug activity to the functional complexity of cancer genomes, systematic pharmacogenomic profiling in cancer cell lines provides a powerful biomarker discovery platform to guide rational cancer therapeutic strategies.

Keywords: cancer, gene network, Lasso, penalized regression, P-values, unbiased estimator

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Authors: Ryan Dale B. Elnar

Abstract:

This study developed a multidimensional need assessment scale for college students called The University of Mindanao Needs Assessment Scale (UMNAS). Although there are context-specific instruments measuring the needs of clinical and non-clinical samples, literature reveals no standardized scales to measure the needs of the college students thus a four-phase item development process was initiated to support its content validity. Comprising seven broad facets namely spiritual-moral, intrapersonal, socio-personal, psycho-emotional, cognitive, physical and sexual, a pyramid model of college needs was deconstructed through FGD sample to support the literature review. Using various construct validity procedures, the model was further tested using a total of 881 Filipino college samples. The result of the study revealed evidences of the reliability and validity of the UMNAS. The reliability indices range from .929-.933. Exploratory and confirmatory factor analyses revealed a one-factor-six-dimensional instrument to measure the needs of the college students. Using multivariate regression analysis, year level and course are found predictors of students’ needs. Content analysis attested the usefulness of the instrument to diagnose students’ personal and academic issues and concerns in conjunction with other measures. The norming process includes 1728 students from the different colleges of the University of Mindanao. Further validation is recommended to establish a national norm for the instrument.

Keywords: needs assessment scale, validity, factor analysis, college students

Procedia PDF Downloads 431

Authors: A. Biran, P. Sobhe Bidari, K. Raahemifar

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Diabetic Retinopathy (DR) is an eye disease that leads to blindness. The earliest signs of DR are the appearance of red and yellow lesions on the retina called hemorrhages and exudates. Early diagnosis of DR prevents from blindness; hence, many automated algorithms have been proposed to extract hemorrhages and exudates. In this paper, an automated algorithm is presented to extract hemorrhages and exudates separately from retinal fundus images using different image processing techniques including Circular Hough Transform (CHT), Contrast Limited Adaptive Histogram Equalization (CLAHE), Gabor filter and thresholding. Since Optic Disc is the same color as the exudates, it is first localized and detected. The presented method has been tested on fundus images from Structured Analysis of the Retina (STARE) and Digital Retinal Images for Vessel Extraction (DRIVE) databases by using MATLAB codes. The results show that this method is perfectly capable of detecting hard exudates and the highly probable soft exudates. It is also capable of detecting the hemorrhages and distinguishing them from blood vessels.

Keywords: diabetic retinopathy, fundus, CHT, exudates, hemorrhages

Procedia PDF Downloads 255

Authors: Masome Moeni, Roya Abedizadeh, Elham Aram, Hamid Sadeghi-Abandansari, Davood Sabour, Robert Menzel, Ali Hassanpour

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Significant number of studies and preclinical research in formulation of cancer nano-pharmaceutics have led to an improvement in cancer care. Nonetheless, the antineoplastic agents have ‘failed to live up to its promise’ since their clinical performance is moderately low. For almost ninety years, iron oxide nanoparticles (IONPS) have managed to keep its reputation in clinical application due to their low toxicity, versatility and multi-modal capabilities. Drug Administration approved utilization of IONPs for diagnosis of cancer as contrast media in magnetic resonance imaging, as heat mediator in magnetic hyperthermia and for the treatment of iron deficiency. Furthermore, IONPs have high drug-loading capacity, which makes them good candidates as therapeutic agent transporters. There are yet challenges to overcome for successful clinical application of IONPs, including stability of drug and poor delivery, which might lead to (i) drug resistance, (ii) shorter blood circulation time, and (iii) rapid elimination and adverse side effects from the system. In this study, highly stable and super paramagnetic IONPs were prepared for efficient and targeted drug delivery in cancer treatment. The synthesis procedure was briefly involved the production of IONPs via co-precipitation followed by coating with tetraethyl orthosilicate and 3-aminopropylethoxysilane and grafting with folic acid for stability targeted purposes and controlled drug release. Physiochemical and morphological properties of modified IONPs were characterised using different analytical techniques. The resultant IONPs exhibited clusters of 10 nm spherical shape crystals with less than 100 nm size suitable for drug delivery. The functionalized IONP showed mesoporous features, high stability, dispersibility and crystallinity. Subsequently, the functionalized IONPs were successfully loaded with oxaliplatin, a chemotherapeutic agent, for a controlled drug release in an actively targeting cancer cells. FT-IR observations confirmed presence of oxaliplatin functional groups, while ICP-MS results verified the drug loading was ~ 1.3%.

Keywords: cancer treatment, chemotherapeutic agent, drug delivery, iron oxide, multi-functional nanoparticle

Procedia PDF Downloads 66

Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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Authors: B. Lee, B. H. Choi

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The loss of safety for reservoirs brought about by climate change and facility aging leads to reservoir failures, which results in the loss of lives and property damage in downstream areas. Therefore, it is necessary to provide a reservoir failure alert system for downstream residents to detect the early signs of failure (with sensors) in real-time and perform safety management to prevent and minimize possible damage. 10 case studies were carried out to verify the water level management criteria of four levels (attention, caution, alert, serious). Peak changes in water level data were analysed. The results showed that ‘Caution’ and ‘Alert’ were closed to 33% and 66% of difference in level between flood water level and full water level. Therefore, it is adequate to use initial water level management criteria of reservoir failure alert system for the first year. Acknowledgment: This research was supported by a grant (2017-MPSS31-002) from 'Supporting Technology Development Program for Disaster Management' funded by the Ministry of the Interior and Safety(MOIS)

Keywords: alert system, management criteria, reservoir failure, sensor

Procedia PDF Downloads 186

Authors: Amin Davoudi

Abstract:

Aim: New approaches have been introduced to improve soft tissue indices of the dental implants. This systematic review aimed to investigate the effect of computer-aided design and computer-assisted manufacture (CAD/CAM) zirconia (Zr) implant abutments on periodontal aspects. Materials and Methods: Five electronic databases were searched thoroughly based on prior defined MeSH and non-MeSH keywords. Clinical studies were collected via hand searches in English language journals up to September 2020. Interproximal papilla stability, papilla recession, pink and white esthetic score (PES, WES), bone and gingival margin levels, color, and contour of soft tissue were reviewed. Results: The initial literature search yielded 412 articles. After the evaluation of abstracts and full texts, six studies were eligible to be screened. The study design of the included studies was a prospective cohort (n=3) and randomized clinical trial (n=3). The outcome was found to be significantly better for Zr than titanium abutments, however, the studies did not show significant differences between stock and CAD/CAM abutments. Conclusion: Papilla fill, WES, PES, and the distance from the contact point to dental crest bone of adjacent tooth and inter-tooth–implant distance were not significantly different between Zr CAD/CAM and Zr stock abutments. However, soft tissue stability and recession index were better in Zr CAD/CAM abutments.

Keywords: zirconia, CADCAM, periodental, implant

Procedia PDF Downloads 85

Authors: John Gaber, Youssef Ahmed, Hossam A.Gabbar, Jing Ren

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Nuclear Power Plant (NPP) operators have a large responsibility on their shoulders. They must allow the plant to generate a high amount of energy while inspecting and maintaining the safety of the plant. This type of occupation comes with high amounts of mental fatigue, and a small mistake can have grave consequences. Electroencephalography (EEG) is a method of gathering the electromagnetic waves emitted by a human brain. We propose a safety system by monitoring brainwaves for signs of mental fatigue. This requires an analysis of the tasks and mental models of the NPP operator, as well as risk factors on mental fatigue and attention that NPP operators face when performing their tasks. The brain waves generated from experiencing mental fatigue can then be monitored for. These factors are analyzed, developing an EEG-based monitoring system, which aims to alert NPP operators when levels of mental fatigue and attention start affecting their performance in task completion.

Keywords: EEG, power plant operator, psychology, task analysis

Procedia PDF Downloads 79

Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

Procedia PDF Downloads 267

Authors: Aya Al Masri, Kamel Guerchouche, Youssef Laynaoui, Safoin Aktaou, Malorie Martin, Fouad Maaloul

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Introduction: Mobile C-arms move throughout operating rooms of the operating theater. Being designed to move between rooms, they are not equipped with relays to retrieve the exposition information and export it outside the room. Therefore, no light signaling is available outside the room to warn the X-ray emission for staff. Inadvertent exposition of staff outside the operating theater is a real problem for radiation protection. The French standard NFC 15-160 require that: (1) access to any room containing an X-ray emitting device must be controlled by a light signage so that it cannot be inadvertently crossed, and (2) setting up an emergency button to stop the X-ray emission. This study presents a system that we developed to meet these requirements and the results of its clinical test. Materials and methods: The system is composed of two communicating boxes: o The "DetectBox" is to be installed inside the operating theater. It identifies the various operation states of the C-arm by analyzing its power supply signal. The DetectBox communicates (in wireless mode) with the second box (AlertBox). o The "AlertBox" can operate in socket or battery mode and is to be installed outside the operating theater. It detects and reports the state of the C-arm by emitting a real time light signal. This latter can have three different colors: red when the C-arm is emitting X-rays, orange when it is powered on but does not emit X-rays, and green when it is powered off. The two boxes communicate on a radiofrequency link exclusively carried out in the ‘Industrial, Scientific and Medical (ISM)’ frequency bands and allows the coexistence of several on-site warning systems without communication conflicts (interference). Taking into account the complexity of performing electrical works in the operating theater (for reasons of hygiene and continuity of medical care), this system (having a size <10 cm²) works in complete safety without any intrusion in the mobile C-arm and does not require specific electrical installation work. The system is equipped with emergency button that stops X-ray emission. The system has been clinically tested. Results: The clinical test of the system shows that: it detects X-rays having both high and low energy (50 – 150 kVp), high and low photon flow (0.5 – 200 mA: even when emitted for a very short time (<1 ms)), Probability of false detection < 10-5, it operates under all acquisition modes (continuous, pulsed, fluoroscopy mode, image mode, subtraction and movie mode), it is compatible with all C-arm models and brands. We have also tested the communication between the two boxes (DetectBox and AlertBox) in several conditions: (1) Unleaded room, (2) leaded room, and (3) rooms with particular configuration (sas, great distances, concrete walls, 3 mm of lead). The result of these last tests was positive. Conclusion: This system is a reliable tool to alert the staff present outside the operating room for X-ray emission and insure their radiation protection.

Keywords: Clinical test, Inadvertent staff exposition, Light signage, Operating theater

Procedia PDF Downloads 113

Authors: Hacer Erdöl, Merve Aydın, Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık

Abstract:

Like all occupations, nursing is significantly influenced by the society which it serves and it also affects it. Social structure affects attitudes of nurses, nursing practice, society's attitudes towards nursing and those who have chosen nursing as a profession. People who choose nursing schools take the views of the society’s they live in on nursing to nursing school. Until the 1960s, many nursing schools had not accepted men as students and women had received nursing education and profession had been carried out by women. In our country, in 2007 an amendment to article eight of Nursing Law was passed and with these changes men also began to be able to choose the nursing as a profession. In Turkish, nurse means 'sister'. Hence, in this study to determine the problems that male nursing students likely encounter at the clinic, non-clinical environment and in their private life regarding the title of nurse, among qualitative research methods phenomenological research design was used. Using purpose sampling method, a total of 18 voluntary male students-13 in third grade and 5 in fourth grade at nursing school- were taken to the study. Data were collected through interviews and by the ethical principles much attention was paid to ensure the confidentiality and to protect participants’ identity. During the interviews lasting 30-40 minutes on average, nine pre-configured standard questions were asked and when necessary free questions were also used in order to ensure the clarity of the responses. With pre- configured standard questions, the reasons why students chose the profession, the problems they had in clinical and non-clinical environment and the potential problems they might encounter in their private lives regarding the title of nurse were questioned. Content analysis was performed on data collected and three main themes were obtained. According to the findings of the evaluation of data, it was found that almost all the students preferred the profession due to possible work opportunities, there were students who did not bother nurse title as well as the ones who did bother and as the most important problem they might encounter in their private lives was to feel worried if their kids had to answer "What does your father" question as "my dad is a nurse" and being ridiculed afterwards. The results of this study show that studies should be done to change the social judgment stemmed from the recognition of nursing as a female profession and take advantage of media through creating public spotlight to accomplish this.

Keywords: choice of profession, the title of the profession, title problems, nursing

Procedia PDF Downloads 182

Authors: Lu Yang, Meiyang Song, Xiang Yu, Wenhao Zhou, Chuntao Feng

Abstract:

To address the problem that the FM continuous-wave radar (FMCW) extracts human vital sign signals which are susceptible to noise interference and low reconstruction accuracy, a new detection scheme for the sign signals is proposed. Firstly, an improved complete ensemble empirical modal decomposition with adaptive noise (ICEEMDAN) algorithm is applied to decompose the radar-extracted thoracic signals to obtain several intrinsic modal functions (IMF) with different spatial scales, and then the IMF components are optimized by a BP neural network improved by immune genetic algorithm (IGA). The simulation results show that this scheme can effectively separate the noise and accurately extract the respiratory and heartbeat signals and improve the reconstruction accuracy and signal-to-noise ratio of the sign signals.

Keywords: frequency modulated continuous wave radar, ICEEMDAN, BP neural network, vital signs signal

Procedia PDF Downloads 141

Authors: Jaime R. Silva, Gabriel E. Reyes, Marianne Krause

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Background: The two-polarity model of the depressive personality argues that experience is organized around two axes: interpersonal relatedness and self-definition. Differential emphasis on one of these poles defines three types of depressive experience: Anaclitic, Introjective or Mixed pattern. On the one hand, Anaclitic pattern has been conceptually related with exaggerated biological stress sensitivity. On the other hand, the Introjective pattern was linked with anhedonic symptomatology. The general aim of the study was to find empirical support for this relationship. Methods: 101 non-clinical individuals participated in two experimental sessions. During the first session, the biological stress reactivity (cortisol concentration in saliva) and the subjective stress perceived (self-reported) during the Trier Social Stress Test (TSST), were investigated. In the second session, a visual discrimination task with a specific reward system, to study the reinforcement sensitivity (anhedonia), was performed. Results: Results evidenced that participants with Introjective depressive symptoms showed a higher interpersonal sensitivity and a diminished sensitivity to reinforcement. In addition, results also indicated that such a group has a poor psychological detection of its exacerbated reactivity to stress, which is the opposite pattern evidenced amongst the Anaclitic group. Conclusions: In perspective, these results empirically support the two-polarity of the depressive personality model. Clinical implications are discussed.

Keywords: depression, interpersonal stress, personality, trier social stress test

Procedia PDF Downloads 236