Search results for: head trauma

Authors: Zohra Salim

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Objective: To access the relationship of primary tumor thickness with cervical lymphadenopathy in squamous cell carcinoma of buccal mucosa. Methodology: A cross-sectional observational study was carried out on 80 Patients with biopsy-proven oral squamous cell carcinoma of buccal mucosa at Dow University of Health Sciences. All the study participants were treated with wide local excision of the primary tumor with elective neck dissection. Patients with prior head and neck malignancy or those with prior radiotherapy or chemotherapy were excluded from the study. Data was entered and analyzed on SPSS 21. Chi-squared test with 95% C.I and 80% power of the test was used to evaluate the relationship of tumor depth with cervical lymph nodes. Results: 50 participants were male, and 30 patients were female. 30 patients were in the age range of 20-40 years, 36 patients in the range of 40-60 years, while 14 patients were beyond age 60 years. Tumor size ranged from 0.3cm to 5cm with a mean of 2.03cm. Tumor depth ranged from 0.2cm to 5cm. 20% of the participants reported with tumor depth greater than 2.5cm, while 80% of patients reported with tumor depth less than 2.5cm. Out of 80 patients, 27 reported with negative lymph nodes, while 53 patients reported with positive lymph nodes. Conclusion: Our study concludes that relationship exists between the depth of primary tumor and cervical lymphadenopathy in squamous cell carcinoma of buccal mucosa.

Keywords: squamous cell carcinoma, tumor depth, cervical lymphadenopathy, buccal mucosa

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Authors: Cao Yuping, Li Longfei, Zhao Xingfu, Zhang Yalin

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Purpose: This study examined the effects of exposure to domestic physical violence (DPV) on children’s behavior in a community sample. Method: Ninety-three 12-16 year-old adolescents exposed to DPV were matched with 54 adolescents with no exposure to DPV based on age, gender, family composition and parental age and education level. Participation included assessment with the Childhood Trauma Questionnaire (CTQ-SF) and Child Behavior Checklist (CBCL) by the adolescents and their parents respectively. Results: CBCL total score and anxiety/depression, social interaction problems, attention problems, delinquency, aggression and externalizing scores were significantly higher in adolescents exposed to DPV than those in controls (all ps<0.05).The CBCL total score and scores of anxiety/depression, social interaction problems, attention problems, delinquency, aggression and externalizing behaviors of boys were significantly higher in the research group than in the controls (all ps<0.05). Delinquency scores in abused adolescents were significantly higher than in DPV witnessed (p<0.05), but no other scores of CBCL were significant different. Different subtypes of behavioral problems were associated with different types of abuse. Conclusions: DPV exposure is associated with adverse behaviors in children, especially among boys. Children witness DPV alone have similar behavioral scores as the abused children. We recommend that both abused and DPV witness adolescents in Chinese communities need treatment to mitigate the effects on maladjusted behaviors.

Keywords: domestic violence, child, behavior, community, China

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Authors: Sonam Kelzang

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Background: Penetrating injuries as a result of traditional sports (Archery and Khuru) are commonly seen in Bhutan. To our knowledge, there is no study carried out looking into the data of penetrating injuries due to traditional sports. Aim: This is a retrospective analysis of cases of penetrating injuries as a result of traditional sports admitted to JDWNRH over the last 3 years to draw an inference on the pattern of injury and associated morbidity and mortality. Method: Data on penetrating injuries related to traditional sports (Archery and Khuru) were collected and reviewed over the period of 3 years. Assault cases were excluded. For each year we analysed age, sex, parts of the body affected, agent of injury and whether admission was required or not. Results: Out of the total 44 victims of penetrating injury by traditional sports (Archery and Khuru) between 2013 and 2015 (average of 15 cases of penetrating injuries per year). Eighty-five percent were male and 15% were female. Their age ranged from 4 yrs to 62 years. Sixty-one percent of the victims were in the working age group of 19-58 years; 30% of the victims were referred from various district hospitals; 38% of the victims needed admission; 42 % of the victims suffered injury to the head; and 54% of the injuries were caused by Khuru. Conclusion: Penetrating injuries due to traditional sports admitted to JDWNRH, Thimphu, remained same over the three years period despite safety regulations in place. Although there were no deaths during the last three years, morbidity still remains high.

Keywords: archery, Bhutan, Khuru, darts

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Authors: Lucia Mavudzi

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Socioeconomic and demographic factors influence male attendance of antenatal care (ANC) activities which are beneficial in improving maternal health and birth outcome. When a male, as the head of the family is expected to solely make decisions of how finances are managed, when and where health services are sought, it impacts on the woman’s health seeking behavior. Using the data from the Zimbabwe Demographic and Health Survey 2010-2011 this paper seeks to assess the prevalence of male ANC attendance in Zimbabwe and factors that influence male ANC attendance. We hypothesized that socioeconomic and demographic factors do not influence male ANC attendance. To achieve the objectives of this paper, descriptive analysis was used to describe the characteristics of men and the Binomial logistic modelling was used to assess the relationship between male ANC attendance and selected socioeconomic and demographic factors. Male ANC attendance was used as the dependent variable, and the independent variables are age, marital status, place of residence, wealth, education, religion and employment. A high percentage of males did not attend ANC with their pregnant partners. Religion, education, and place of residence were found to be significantly associated with male ANC attendance. There was no evidence to show that there was a difference in male ANC attendance by employment, marital status, and age. Findings from this paper are relevant to public health. They will be used to develop strategies and intervention programs to improve pregnant women’s attendance of ANC attendance by involving men in maternal health.

Keywords: antenatal care, male participation, maternal health, socio-economic and demographic factors

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Authors: Tirtha Raj Dhakal, Brian Davidson, Bob Farquharson

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Institutional design is an important aspect in efficient water resource management. In Nepal, the water supply in both farmers’- and agency-managed irrigation systems has become sub-standard because of the weak institutional framework. This study characterizes both forms of the schemes and links existing institution and governance of the schemes with its performance with reference to cost recovery, maintenance of the schemes and water distribution throughout the schemes. For this, two types of surveys were conducted. A management survey of ten farmers’-managed and five agency-managed schemes of Chitwan valley and its periphery was done. Also, a farm survey comprising 25 farmers from each of head, middle and tail regions of both schemes; Narayani Lift Irrigation Project (agency-managed) and Khageri Irrigation System (farmers’-managed) of Chitwan Valley as a case study was conducted. The results showed that cost recovery of agency-managed schemes in 2015 was less than two percent whereas service fee collection rate in farmers’-managed schemes was nearly 2/3rd that triggered poor maintenance of the schemes and unequal distribution of water throughout the schemes. Also, the institution on practice is unable to create any incentives for farmers for economical use of water as well as willingness to pay for its use. This, thus, compels the need of refined institutional framework which has been suggested in this paper aiming to improve the cost recovery and better water distribution throughout the irrigation schemes.

Keywords: cost recovery, governance, institution, schemes' performance

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Authors: Majid Khan

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Introduction: In this era of microsurgery, free flap holds a remarkable spot in reconstructive surgery. A free flap is well suited for composite defects as it provides sufficient and well-vascularized tissue for coverage. We report our experience with the use of the free flaps for the reconstruction of composite defects. Methods: This is a retrospective case series (chart review) of patients who underwent reconstruction of composite defects with a free flap at Aga Khan University Hospital, Karachi (Pakistan) from January 01, 2015, to December 31, 2019. Data were collected for patient demographics, size of the defect, size of flap, recipient vessels, postoperative complications, and outcome of the free flap. Results: Over this period, 532 free flaps are included in this study. The overall success rate is 95.5%. The mean age of the patient was 44.86 years. In 532 procedures, there were 448 defects from tumor ablation of head and neck cancer. The most frequent free flap was the anterolateral thigh flap in 232 procedures. In this study, the risk factor hypertension (p=0.004) was found significant for wound dehiscence, preop radiation/chemotherapy (p=0.003), and malnutrition (p=0.005) were found significant for fistula formation. Malnutrition (p=0.02) and use of vein grafts (p=0.025) were significant factors for flap failure. Conclusion: Free tissue transfer is a reliable option for the reconstruction of large and composite defects. Hypertension, malnutrition, and preoperative radiotherapy can cause significant morbidity.

Keywords: free flap, free flap failure, risk factors for flap failure, free flap outcome

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Authors: Erin Brands-Saliba

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In this evaluation study, we explore the efficacy and implementation of the five guiding principles of Bekaadendang “Being Peaceful,” a suite of services facilitated by our Anti-Human Trafficking Team, and a pivotal component of the Holistic Prevention Services department at NCFST. The guiding principles—trauma-informed care, cultural safety, 4-quadrant medicine wheel approach, harm reduction, and after-care peer support—are the foundation of Bekaadendang's mission to support at-risk individuals and survivors of human trafficking. This evaluation is of paramount importance given the profound impact of human trafficking on these communities and aims to ensure that Bekaadendang's principles are not only understood by staff but experienced by community members in a purposeful and meaningful manner. The issues at the heart of this evaluation are deeply entrenched in the historical and contemporary challenges faced by Indigenous communities, with a particular emphasis on Indigenous women and 2SLGBTQQIA+ individuals. Well-documented reports like the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) have cast a glaring light on the disproportionately high rates of violence, exploitation, and trafficking experienced by these communities. The MMIWG report underlines the pressing need for holistic, culturally informed interventions like Bekaadendang. Furthermore, the research efforts of scholars, both Indigenous and non-Indigenous, shed light on the persistent systemic issues that make Indigenous individuals more vulnerable to trafficking and exploitation. Recognizing this broader context is crucial to truly grasp the importance of evaluating the guiding principles that underpin Bekaadendang's service model.

Keywords: human trafficking, indigenous healing, MMIWG, program evaluation

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

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Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m²), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

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

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Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This research aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases. The contribution of this work to the field of forensic psychology will be significant, as it will analyze preexisting case studies and experimental data in an effort to improve the ways in which veteran cases are handled in the criminal justice system. Military personnel involved in the criminal justice system are a vulnerable population in need of healthcare and legislative attention, and this work will bring us one step closer to providing them with just that.

Keywords: forensic psychology, psychotraumatology, PTSD, veterans

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Authors: Thanura Randula Abeywardena

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This study recognized the effectiveness of cold-water immersion recovery post exhaustive short-term exercise. The purpose of this study was to understand if 16- 20°C of cold-water immersion would be beneficial in a tropical environment to achieve optimal recovery in sprint swim performance in comparison to 10-15°C of water immersion. Two 100m-sprint swim performance times were measured along with blood lactate (BLa), heart rate (HR) and rate of perceived exertion (RPE) in a 25m swimming pool with full body head out horizontal water immersions of 10-15°C, 16-20°C and 29-32°C (pool temperature) for 10 minutes followed by 5 minutes of seated passive rest outside; in between the two swim performances. Twelve well-trained adult swimmers (5 male and 5 female) within the top twenty in the Sri Lankan national swimming championships in 100m Butterfly and Freestyle in the years 2020 & 2021 volunteered for this study. One-way ANOVA analysis (p<0.05) suggested performance time, Bla and HR had no significant differences between the 3 conditions after the second sprint; however, RPE was significantly different with p=0.034 between 10-15°C and 16-20°C immersion conditions. The study suggested that the recovery post the two cold-water immersion conditions were similar in terms of performance and physiological factors; however, the 16-20°C temperature had a better “feel good” factor post sprint 2. Further study is recommended as there was participant bias with the swimmers not reaching optimal levels in sprint 1. Therefore, they might have possibly fully recovered before sprint 2, invalidating the physiological effect of recovery.

Keywords: hydrotherapy, blood lactate, fatigue, recovery, sprint-performance, sprint-swimming

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Authors: Robyn Therese Munnick

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This paper aims to report on a qualitative practice-based research study which explores the notion of nothingness and how it (nothingness) is the conceptual and theoretical foundation for artistic practice. Furthermore, this study explicates how the artist used their mother’s battle with cancer and the subsequent void it created as source material for the artistic expression of nothingness. The diagnosis which was followed by a physical and emotional absence of the matriarch of the artist family led to an emotional trauma that triggered a feeling of nothingness within the artist. The overarching problem in the study is thus: how this ‘nothingness’ could be expressed in visual art? Nothingness, as a product of expectation, is a notion which refers to where something used to be, should be or isn’t anymore, which attempts to grasp what is there by not being there. In attempting to express nothingness, the research aims to build on an exploration of various materials and modes utilized in order to underpin the research objectives. The primary mode of delivery for the art-making process is painting. However, through strengthening the messages and meaning of the hypothesis of nothingness within the art and research, the use of further modes and materials became pivotal. This involves the use of unconventional contrasting modes within a painting such as the cloth doily, thread, tubing, ceramics, food colour, spray paint, polyvinyl acetate paint, plaster, wooden boxes and fragments thereof. These materials and modes were vital in visualising and aestheticising the conceptual underpinnings of the research. As a result, this strengthened and emancipated the art from the traditional bounds of pure painting. Methods of data gathering took the form of artefacts, document analysis, and field notes in the form of photographic journaling. Ultimately the body of work and research validates that the idea of nothingness can be artistically explored.

Keywords: conceptual, nothingness, modes, unconventional

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Authors: Bakhtiar Azadbakht, Karim Adinehvand, Amin Sahebnasagh

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The purpose of this study was to evaluate dependence of PAGAT polymer gel dosimeter 1/T2 on different electron and photon energies as well as on different mean dose rates for a standard clinically used Co-60 therapy unit and an ELECTA linear accelerator. A multi echo sequence with 32 equidistant echoes was used for the evaluation of irradiated polymer gel dosimeters. The optimal post-manufacture irradiation and post imaging times were both determined to be one day. The sensitivity of PAGAT polymer gel dosimeter with irradiation of photon and electron beams was represented by the slope of calibration curve in the linear region measured for each modality. The response of PAGAT gel with photon and electron beams is very similar in the lower dose region. The R2-dose response was linear up to 30Gy. In electron beams the R2-dose response for doses less than 3Gy is not exact, but in photon beams the R2-dose response for doses less than 2Gy is not exact. Dosimeter energy dependence was studied for electron energies of 4, 12 and 18MeV and photon energies of 1.25, 4, 6 and 18MV. Dose rate dependence was studied in 6MeV electron beam and 6MV photon beam with the use of dose rates 80, 160, 240, 320, 400, and 480cGy/min. Evaluation of dosimeters were performed on Siemens Symphony, Germany 1.5T Scanner in the head coil. In this study no trend in polymer-gel dosimeter 1/T2 dependence was found on mean dose rate and energy for electron and photon beams.

Keywords: polymer gels, PAGAT gel, electron and photon beams, MRI

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Authors: Rika van Zyl

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South Africa’s racial discrimination past has led to the drafting of the Constitution with the Bill of Rights for the people of South Africa. The Bill of Rights prohibits the state from unfairly discriminating directly or indirectly on certain grounds, one of which is race and another is gender. This has forced changes to the law of succession. The customary law rule of male primogeniture was abolished to ensure that women were not excluded from the intestate succession of the male head of the family in 2005. It was said that this rule cannot be reconciled with the notions of equality and human dignity contained in the Bill of Rights. The freedom of testation has further come under fire in South Africa, where it was found to be unfair discrimination and against public policy to exclude a specific gender (women) from inheriting in a private will. Although no one has the right to inherit in South Africa, any person with an interest can approach the court alleging that a right in the Bill of Rights has been infringed. A will that is found inconsistent with the South African Bill of Rights then cannot be enforced. Recent case law found that to leave out a specific gender (women) from a will, based entirely on the fact that they are of said specific gender, is in contravention of the Constitution and should, therefore, be declared invalid. It was said that the courts should take a transformative constitutional approach when equality rights are affected. Otherwise, the historical and insidious unequal distribution of wealth in South Africa will continue along the fault lines such as gender. This decision has opened the debate on the extent to which the state can interfere with the private autonomy of an individual who is deceased. Some of these arguments will be discussed, including the ambit of public policy in this regard.

Keywords: equality, discrimination, succession, public policy

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Authors: Anupam Sibal

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Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Yilin Liao, Hewen Li, Paula McConvey

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Speed skaters often face a risk of concussion when they fall on the ice floor and impact crash mats during practices and competitive races. Several variables, including those related to the skater, the crash mat, and the impact position (body side/head/feet impact), are believed to influence the severity of the skater's concussion. While computer simulation modeling can be employed to analyze these accidents, the simulation process is time-consuming and does not provide rapid information for coaches and teams to assess the skater's injury risk in competitive events. This research paper promotes the exploration of the feasibility of using AI techniques for evaluating skater’s potential concussion severity, and to develop a fast concussion prediction tool using artificial neural networks to reduce the risk of treatment delays for injured skaters. The primary data is collected through virtual tests and physical experiments designed to simulate skater-mat impact. It is then analyzed to identify patterns and correlations; finally, it is used to train and fine-tune the artificial neural networks for accurate prediction. The development of the prediction tool by employing machine learning strategies contributes to the application of AI methods in sports science and has theoretical involvements for using AI techniques in predicting and preventing sports-related injuries.

Keywords: artificial neural networks, concussion, machine learning, impact, speed skater

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Authors: Suchismita Dattagupta

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Social rules and guidelines specify how a body should be clothed and how it should look. The social rules have made the body a space for expression, oppression and sexual 'commodification'. Being a malleable aspect of the human body, hair has always been worn in a number of ways and this characteristic of hair has made it an essential vehicle for conveying symbolic meaning. Hair, particularly women’s hair has always been considered to be associated with richness and beauty, apart from being associated with sexual power. Society has always had a preoccupation with hair bordering on obsession and has projected its moral and political supremacy by controlling and influencing how an individual wears their hair. Irrespective of the gender of the individual, society has tried to control an individual’s hair to express its control. However, with time, there has been a marked change in the way hair has been used by the individual. Hair has always been the focus of scholarly studies; not just aesthetically, but also in the cultural and social context. The fascination with hair rises from the fact that it is the only part of the human body that is always on display. Fetishization of hair is common in literature and goes ahead to reveal the character’s social and moral status. Modern authors for children and young adults have turned this concept on its head to point out how characters are breaking away from the mould and establishing their personal, moral and social boundaries. This paper will trace the change in hair symbolism in literature for children and young adults to understand how it has changed over the course of the time and what light it throws on the changing pattern of women’s position in society.

Keywords: gender, hair, social symbols, society, women's role

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Authors: Man Chung Chu

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In the dynamic family interaction, parental self-efficacy is connected with parent-child attachment. Parental self-efficacy and its corresponding behavior played an influential role in the lifespan development of the child. Recently, Mindful parenting is popularly addressed as it lightens parents’ awareness to their own thoughts feelings and behaviors by adapting a nonjudgmental attitude in the present moment being with the child. The effectiveness of mindful parent is considerably significant in enhancing parent-child relationship as well as family functioning. Parenting in early developmental stage is always challenging and essential for later growth, however, literature is rarely exploring the mediation of mindful parenting on the effect of parent self-efficacy on parent-child attachment in preschoolers’ families. The mediation effect of the research shed light on how mindful parenting should head, where parental self-efficacy training should be incorporated together with mindful family program in attempt to yield the best outcome in the family of young-aged children. Two hundred and eight (208) parents, of two to six years old children, were participated in the study and results supported the significance in the mediator effect of mindful parenting in both facets, i.e. Parent-focused - ‘Mindful Discipline’ and Child-focused – ‘Being in the moment with the child’ where parental self-efficacy is a significant predictor of mindful parenting. The implication of the result suggests that mindful parenting would be a therapeutic framework in promoting family functioning and child’s well-being, it would also be a ‘significant helping hand’ in maintaining continuous secure attachment relationship and growing their mindful children in a family.

Keywords: mediation effect, mindful parenting, parental self efficacy, parent-child attachment, preschoolers

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Africa Makasi

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The research explored factors influencing the adoption of disruptive technologies in the mobile telecommunications industry in Zimbabwe. Data was gathered from the second biggest competitor in the industry with over 3 million subscribers as the main case of study. The survey was conducted by purposively selecting 70 respondents from a population of 3,000,000 (three million) active subscribers from the company’s database. A skip interval of 42,857 was used to randomly select the sample. Customer representatives were selected from the company’s five regional offices using a two-stage cluster sampling technique. Employee participants were purposively selected from the company’s head office. Self-administered questionnaires were used in the research. A pilot test was conducted and the assessment of the reliability of the research instruments used in the research performed. Results of the pilot study were analyzed to test for reliability using SPSS. The results confirmed that the style of leadership and its thrust may help speed up or reduce the adoption of disruptive technologies. This was reflected by a p–value of 0.01 which is less than 0.05. The null hypothesis was thus rejected and the strong relationship between leadership and adoption of disruptive technology is confirmed. Similar results were also obtained with respect to staff competence, availability of funding and the type of infrastructure available Future research should look at organizational ambidexterity as well as exploitation and exploration paradigms in organizations in the telecommunications industry and their impact on the adoption of disruptive technologies.

Keywords: disruptive innovation, adoption, mobile telecommunication industry, exploration and exploitation

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Authors: Jasaswini Mishra, Ashim K. Dey

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This paper aims to investigate the group interaction effects of laterally loaded pile groups driven into a medium dense sand layer in submerged state. Static lateral load tests were carried out on pile groups consisting of varying number of piles and at different spacings. The test setup consists of a load cell (500 kg capacity) and an LVDT (50 mm) to measure the load and pile head deflection respectively. The piles were extensively instrumented with strain gauges so as to study the variation of soil resistance within the group. The bending moments at various depths were calculated from strain gauge data and these curves were fitted using a higher order polynomial in order to get 'p-y' curves. A comparative study between a single pile and a pile under a group has also been done for a better understanding of the group effect. It is observed that average load per pile is significantly reduced relative to single pile and it decreases with increase in the number of piles in a pile group. The loss of efficiency of the piles in the group, commonly referred to as "shadowing" effect, has been expressed by the use of a 'p-multiplier'. Leading rows carries greater amount of load when compared with the trailing rows. The variations of bending moment with depth for different rows of pile within a group and different spacing have been analyzed and compared with that of a single pile. p multipliers within different rows in a pile group were evaluated from the experimental study.

Keywords: group action, laterally loaded piles, p-multiplier, strain gauge

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Authors: A. Razavykia, A. Esmaeilzadeh, S. Iranmanesh

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Many orthopedic implants like proximal humerus cases require lower surface roughness and almost immediate/short lead time surgery. Thus, rapid response from the manufacturer is very crucial. Tool path strategy of milling process has a direct influence on the surface roughness and lead time of medical implant. High-speed milling as promised process would improve the machined surface quality, but conventional or super-abrasive grinding still required which imposes some drawbacks such as additional costs and time. Currently, many CAD/CAM software offers some different tool path strategies to milling free form surfaces. Nevertheless, the users must identify how to choose the strategies according to cutting tool geometry, geometry complexity, and their effects on the machined surface. This study investigates the effect of different tool path strategies for milling a proximal humerus head during finishing operation on stainless steel 316L. Experiments have been performed using MAHO MH700 S vertical milling machine and four machining strategies, namely, spiral outward, spiral inward, and radial as well as zig-zag. In all cases, the obtained surfaces were analyzed in terms of roughness and dimension accuracy compared with those obtained by simulation. The findings provide evidence that surface roughness, dimensional accuracy, and machining time have been affected by the considered tool path strategy.

Keywords: CAD/CAM software, milling, orthopedic implants, tool path strategy

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Authors: Mathieu Le Cam, Tejaswinee Darure, Mateusz Pawlucki

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Climate control of cabin aircraft is traditionally conditioned as a single unit by the environmental control system. Cabin temperature is controlled by the crew while passengers of the aircraft have control on the gaspers providing fresh air from the above head area. The small nozzles are difficult to reach and adjust to meet the passenger’s needs in terms of flow and direction. More dedicated control over the near environment of each passenger can be beneficial in many situations. The European project COCOON, funded under Clean Sky 2, aims at developing and demonstrating a microclimate conditioning module (MCM) integrated into a standard economy 3-seat row. The system developed will lead to improved passenger comfort with more control on their personal thermal area. This study focuses on the assessment of thermal comfort of passengers in the cabin aircraft through simulation on the TAITherm modelling platform. A first analysis investigates thermal comfort and sensation of passengers in varying cabin environmental conditions: from cold to very hot scenarios, with and without MCM installed in the seats. The modelling platform is also used to evaluate the impact of different physiologies of passengers on their thermal comfort as well as different seat locations. Under the current cabin conditions, a passenger of a 50th percentile body size is feeling uncomfortably cool due to the high velocity cabin air ventilation. The simulation shows that the in-seat MCM developed in COCOON project improves the thermal comfort of the passenger.

Keywords: cabin aircraft, in-seat HVAC, microclimate conditioning module, thermal comfort

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Authors: Sushish Baral, Pratibha Joshi, Yaman Maharjan

Abstract:

Glaucoma is a chronic eye condition that causes vision loss that is irreversible. Early detection and treatment are critical to prevent vision loss because it can be asymptomatic. For the identification of glaucoma, multiple deep learning algorithms are used. Transformer-based architectures, which use the self-attention mechanism to encode long-range dependencies and acquire extremely expressive representations, have recently become popular. Convolutional architectures, on the other hand, lack knowledge of long-range dependencies in the image due to their intrinsic inductive biases. The aforementioned statements inspire this thesis to look at transformer-based solutions and investigate the viability of adopting transformer-based network designs for glaucoma detection. Using retinal fundus images of the optic nerve head to develop a viable algorithm to assess the severity of glaucoma necessitates a large number of well-curated images. Initially, data is generated by augmenting ocular pictures. After that, the ocular images are pre-processed to make them ready for further processing. The system is trained using pre-processed images, and it classifies the input images as normal or glaucoma based on the features retrieved during training. The Vision Transformer (ViT) architecture is well suited to this situation, as it allows the self-attention mechanism to utilise structural modeling. Extensive experiments are run on the common dataset, and the results are thoroughly validated and visualized.

Keywords: glaucoma, vision transformer, convolutional architectures, retinal fundus images, self-attention, deep learning

Procedia PDF Downloads 186

Authors: Iveta Bryjova

Abstract:

Recording of viscoelastic strain-vs-time curves with the aid of the suction method and a follow-up analysis, resulting into evaluation of standard viscoelastic parameters, is a significant technique for non-invasive contact diagnostics of mechanical properties of skin and assessment of its conditions, particularly in acute burns, hypertrophic scarring (the most common complication of burn trauma) and reconstructive surgery. For elimination of the skin thickness contribution, usable viscoelastic parameters deduced from the strain-vs-time curves are restricted to the relative ones (i.e. those expressed as a ratio of two dimensional parameters), like grosselasticity, net-elasticity, biological elasticity or Qu’s area parameters, in literature and practice conventionally referred to as R2, R5, R6, R7, Q1, Q2, and Q3. With the exception of parameters R2 and Q1, the remaining ones substantially depend on the position of inflection point separating the elastic linear and viscoelastic segments of the strain-vs-time curve. The standard algorithm implemented in commercially available devices relies heavily on the experimental fact that the inflection time comes about 0.1 sec after the suction switch-on/off, which depreciates credibility of parameters thus obtained. Although the Qu’s US 7,556,605 patent suggests a method of improving the precision of the inflection determination, there is still room for nonnegligible improving. In this contribution, a novel method of inflection point determination utilizing the advantageous properties of the Savitzky–Golay filtering is presented. The method allows computation of derivatives of smoothed strain-vs-time curve, more exact location of inflection and consequently more reliable values of aforementioned viscoelastic parameters. An improved applicability of the five inflection-dependent relative viscoelastic parameters is demonstrated by recasting a former study under the new method, and by comparing its results with those provided by the methods that have been used so far.

Keywords: Savitzky–Golay filter, scarring, skin, viscoelasticity

Procedia PDF Downloads 299

Authors: Jeffrey Ho, Scott Joing, Paul Nystrom, William Heegaard, Danielle Hart, David Plummer, James Miner

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Body-Worn Cameras (BWCs) are used in public safety to record encounters. They are shown to enhance the accuracy of documentation in virtually every situation. They are not widely used in medical encounters in part because of concern for patient acceptance. The goal of this pilot study was to determine if BWC use is acceptable to the patient. This was a prospective, observational study of the AXON Flex BWC (TASER International, Scottsdale, AZ) conducted at an urban, Level 1 Trauma Center Emergency Department (ED). The BWC was worn by Emergency Physicians (EPs) on their shifts during a 30-day period. The BWC was worn at eye-level mounted on a pair of clear safety glasses. Patients seen by the EP were enrolled in the study by a trained research associate. Patients who were <18 years old, who were with other people in the exam room, did not speak English, were critically ill, had chief complaints involving genitalia or sexual assault, were considered to be vulnerable adults, or with an altered mental status were excluded. Consented patients were given a survey after the encounter to determine their perception of the BWC. The questions asked involved the patients’ perceptions of a BWC being present during their interaction with their EP. Data were analyzed with descriptive statistics. There were 417 patients enrolled in the study. 3/417 (0.7%) patients were intimidated by the BWC, 1/417 (0.2%) was nervous because of the BWC, 0/417 (0%) were inhibited from telling the EP certain things because of the BWC, 57/417 (13.7%) patients did not notice the device, and 305/417 (73.1%) patients were had a favorable perception about the BWC being used during their encounter. The use of BWCs appears feasible in the ED, with largely favorable perceptions and acceptance of the device by the patients. Further study is needed to determine the best use and practices of BWCs during ED patient encounters.

Keywords: body-worn camera, documentation, patient satisfaction, video

Procedia PDF Downloads 368

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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The neonatal mortality rates in dogs are considered high, varying between 5.7 and 21.2% around the world, and the causes of the deaths are often unknown. Data regarding canine neonatal mortality are scarce in Brazil. This study aims at describing the neonatal mortality rates in dogs, as well as the main causes of death. The study included 152 litters and 669 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil between January 2018 and September 2019. The overall mortality rate was 16.7% (112/669), with 40% (61/152) of the litters presenting at least one case of stillbirth or neonatal mortality. The rate of stillbirths was 7.7% (51/669), while the neonatal mortality rate was 9% (61/669). The early mortality rate (0 to 2 days) was 13.7% (92/669), accounting for 82.1% (92/112) of all deaths. The late mortality rate (3 to 30 days) was 2.7% (18/669), accounting for 16% (18/112) of all deaths. Infection was the causa mortis in 51.8% (58/112) of the newborns, of which 30.3% (34/112) were caused by bacterial sepsis, and 21.4% (24/112) were caused by other bacterial, viral or parasite infections. Other causes of death included congenital malformations (15.2%, 17/112), of which 5.3% (6/112) happened through euthanasia due to malformations incompatible with life; asphyxia/hypoxia by dystocia (9.8%, 11/112); wasting syndrome in debilitated newborns (6.2%, 7/112); aspiration pneumonia (3.6%, 4/112); agalactia (2.7%, 3/112); trauma (1.8%, 2/112); administration of contraceptives to the mother (1.8%, 2/112) and unknown causes (7.1%, 8/112). The neonatal mortality rate was considered high, but they may be even higher in locations without adequate care for the mothers and neonates. Therefore, prenatal examinations and early neonatal care are of utmost importance for the survival of these patients.

Keywords: neonate dogs, puppies, mortality rate, neonatal death

Procedia PDF Downloads 199

Authors: Nourah Alshalhoub

Abstract:

As Saudi Arabia is one of the countries moving toward more inclusive schools, there are few researchers who have examined the new model of inclusive practice; that is, a model introduced by the Tatweer project. Tatweer is an initiative supported by the Saudi government to develop education with a particular focus on inclusion. This on-going doctoral work aims to find out the nature of inclusive practice that Taweer introduced to create effective practice to include students with different abilities. While stakeholders are important elements to the implementation of inclusive education practice, the study’s goal is to find out and explore their understandings and perspectives. This study considers the perspectives of stakeholders, who are involved and influential on the implementation of the practice, from different dimensions. Tatweer project’s managers, head teachers, teachers and teaching assistants will be interviewed to find out how do they understand inclusive education concept and what perspective do they hold. Reliant on this material, this work seeks to inquire into what meaning inclusion and inclusive practice holds in Tatweer and to what extent this educational models let students with different abilities be more included. Four primary schools in Riyadh were purposively selected and data will be collected through semi-structured interviews. Semi-structured interview was selected as a study tool because it is a relevant and helpful method in understanding the thoughts, views, and beliefs of the stakeholders individually, and investigating issues more thoroughly in the context of Saudi Arabia.

Keywords: inclusive education, perspective, understanding, definition, inclusion

Procedia PDF Downloads 290

Authors: Jireh Reinor L. Vitto, Mylene S. Gumarao, Levy M. Fajanilan, Sheryll Ann M. Castillo, Leonardo B. Dorado, Miriam P. Narbarte

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Human trafficking may happen to anyone. The study aimed to explore the experiences of victim witnesses of human trafficking. It utilized a qualitative phenomenological study design. Eighteen women, 15 to 46 years old, had experienced human trafficking (sex or labor trafficking), and with a filed case or not. An in-depth semi-structured, open-ended interview was employed to gather information. Guardians were also interviewed for triangulation purposes. Findings showed that the participants experienced fatigue and abuse for their physical aspect and gained negative feelings such as burdened, sad, scared (fear), stress, anger, trauma, depress and suicidal thoughts for their psychological aspect. For the spiritual aspect, the participants concluded to have enhanced spiritual life where they knew about God, became closer to God, and learned how to pray. They also faced challenges such as dysfunctional family, delinquent friends, exploitation, problems kept from the family, and poverty, which resulted in their becoming victims of human trafficking. To cope with the situation, they utilized family support, prayers, guts or courage (lakas ng loob), negotiation with their employer, and support from kababayans. Their practices and mechanisms to recover were the Blas Ople Center, rescue/entrapment operation, shelter, and embassy. After the incident, the participants shared that they earned to have thoughts of having a good life without going abroad/makabayan, knowledge of overseas Filipino workers, wise choice of friends, contentment, and value for the family.

Keywords: victim-witnesses, human trafficking, lived experiences, challenges, coping strategies

Procedia PDF Downloads 124

Authors: L. Petrosyan

Abstract:

The problem of psychologist training remains a key priority in Armenia. During the Soviet period, the notion of a psychologist was obscure not only in Armenia but also in other Soviet republics. The breakup of the Soviet Union triggered a gradual change in this area activating the cooperation with specialists from other countries. The need for recovery from the psychological trauma caused by the 1988 earthquake pushed forward the development of practical psychology in Armenia. This phenomenon led to positive changes in perception of and interest to a psychologist profession.Armenian universities started designing special programs for psychologists’ preparation. Armenian psychologists combined their efforts in the field of training relevant specialists. During the recent years, the Bologna educational system was introduced in Armenia which led to implementation of education quality improvement programs. Nevertheless, even today the issue of psychologists’ training is not yet settled in Armenian universities. So far graduate psychologists haven’t got a clear idea of personal and professional qualities of a psychologist. Recently, as a result of educational reforms, the psychology curricula underwent changes, but so far they have not led to a desired outcome. Almost all curricula in certain specialties are aimed to form professional competencies and strengthen practical skills. A survey conducted in Armenia aimed to identify what are the ideas of young psychology specialists on the image of a psychologist. The survey respondents were 45 specialists holding bachelor’s degree as well as 30 master degree graduates, who have not been working yet. The research reveals that we need to change the approach of preparing psychology practitioners in the universities of Armenia. Such an approach to psychologist training will make it possible to train qualified specialists for enhancement of modern psychology theory and practice.

Keywords: practitioners, psychology degree, study, professional competencies

Procedia PDF Downloads 447