Search results for: practices on pain management
12857 The Comparison of Forward Head Posture Measurements between Dominant and Non-Dominant Sides in Male Football Players and Non-Athletes
Authors: Mohamed Gomaa Mohamed
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Background and purpose: Ideal posture involves a minimal amount of stress or strain on various body segments which are aligned and worked in harmony to protect the body from injury or progressive deformity. One of most common faulty posture encountered in clinical setting is forward head posture (FHP) that was considered one of the main predictors for neck pain. Furthermore, FHP may predispose to thoracic outlet syndrome, temporomandibular joint dysfunction, shoulder pain and headache. The large financial burden related to neck disorders management raises the need to improve the quality of assessment and rehabilitation of FHP. So, the purpose of the study is to compare between measurements of FHP as indicated with craniovertebral (CVA) and gaze angles assessed from dominant and non-dominant sides in football players who extensively use their dominant side and non-athletic subjects. Participants: Twenty-four subjects were divided into 12 football players and 12 non-athletic subjects. Methods: CVA and gaze angles were assessed through photogrammetric method. Photos were taken from dominant and non-dominant sides of the subjects while assuming standing position. Paired t-test was used to assess angles differences between dominant and non-dominant sides of the subjects. Since there were no statistical differences between CVA and gaze angles measured from dominant and non-dominant sides in each group, we pooled data together to become 24 measurements for each group (12 from dominant and 12 from non-dominant). Independent t-test was used to assess angles differences between football players and non-athletic subjects. Results: No significant differences were found between CVA and gaze angles measured from dominant and non-dominant sides of both groups (P>0.05). Also, there were no significant differences between CVA and gaze angles measured from football players and non-athletic subjects (P>0.05). Conclusion: FHP can be assessed from dominant or non-dominant sides interchangeably either in football players or non-athletic subjects. Furthermore, playing football has no impact on measurements of FHP when compared to non-athletic subjects.Keywords: dominant side, forward head posture, football players, non-dominant side
Procedia PDF Downloads 25412856 Factors Contributing to Farmers’ Attitude Towards Climate Adaptation Farming Practices: A Farm Level Study in Bangladesh
Authors: Md Rezaul Karim, Farha Taznin
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The purpose of this study was to assess and describe the individual and household characteristics of farmers, to measure the attitude of farmers towards climate adaptation farming practices and to explore the individual and household factors contributing in predicting their attitude towards climate adaptation farming practices. Data were collected through personal interviews using a pre-tested interview schedule. The data collection was done at Biral Upazila under Dinajpur district in Bangladesh from 1st November to 15 December 2018. Besides descriptive statistical parameters, Pearson’s Product Moment Correlation Coefficient (r), multiple regression and step-wise multiple regression analysis were used for the statistical analysis. Findings indicated that the highest proportion (77.6 percent) of the farmers had moderately favorable attitudes, followed by only 11.2 percent with highly favorable attitudes and 11.2 percent with slightly favorable attitudes towards climate adaptation farming practices. According to the computed correlation coefficients (r), among the 10 selected factors, five of them, such as education of household head, farm size, annual household income, organizational participation, and information access by extension services, had a significant relationship with the attitude of farmers towards climate-smart practices. The step-wise multiple regression results showed that two characteristics as education of household head and information access by extension services, contributed 26.2% and 5.1%, respectively, in predicting farmers' attitudes towards climate adaptation farming practices. In addition, more than two-thirds of farmers cited their opinion to the problems in response to ‘price of vermi species is high and it is not easily available’ as 1st ranked problem, followed by ‘lack of information for innovative climate-smart technologies’. This study suggests that policy implications are necessary to promote extension education and information services and overcome the obstacles to climate adaptation farming practices. It further recommends that research study should be conducted in diverse contexts of nationally or globally.Keywords: factors, attitude, climate adaptation, farming practices, Bangladesh
Procedia PDF Downloads 9112855 A Novel Treatment of the Arthritic Hip: A Prospective, Cross-Sectional Study on Changes Following Bone Marrow Concentrate Injection and Arthroscopic Debridement
Authors: A. Drapeaux, S. Aviles, E. Garfoot
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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment
Procedia PDF Downloads 6912854 A Study on Conventional and Improved Tillage Practices for Sowing Paddy in Wheat Harvested Field
Authors: R. N. Pateriya, T. K. Bhattacharya
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In India, rice-wheat cropping system occupies the major area and contributes about 40% of the country’s total food grain production. It is necessary that production of rice and wheat must keep pace with growing population. However, various factors such as degradation in natural resources, shift in cropping pattern, energy constraints etc. are causing reduction in the productivity of these crops. Seedbed for rice after wheat is difficult to prepare due to presence of straw and stubbles, and require excessive tillage operations to bring optimum tilth. In addition, delayed sowing and transplanting of rice is mainly due to poor crop residue management, multiplicity of tillage operations and non-availability of the power source. With increasing concern for fuel conservation and energy management, farmers might wish to estimate the best cultivation system for more productivity. The widest spread method of tilling land is ploughing with mould board plough. However, with the mould board plough upper layer of soil is neither always loosened at the desired extent nor proper mixing of different layers are achieved. Therefore, additional operations carried out to improve tilth. The farmers are becoming increasingly aware of the need for minimum tillage by minimizing the use of machines. Soil management can be achieved by using the combined active-passive tillage machines. A study was therefore, undertaken in wheat-harvested field to study the impact of conventional and modified tillage practices on paddy crop cultivation. Tillage treatments with tractor as a power source were selected during the experiment. The selected level of tillage treatments of tractor machinery management were (T1:- Direct Sowing of Rice), (T2:- 2 to 3 harrowing and no Puddling with manual transplanting), (T3:- 2 to 3 harrowing and Puddling with paddy harrow with manual transplanting), (T4:- 2 to 3 harrowing and Puddling with Rotavator with manual transplanting). The maximum output was obtained with treatment T1 (7.85 t/ha)) followed by T4 (6.4 t/ha), T3 (6.25 t/ha) and T2 (6.0 t/ha)) respectively.Keywords: crop residues, cropping system, minimum tillage, yield
Procedia PDF Downloads 21312853 Learning the Most Common Causes of Major Industrial Accidents and Apply Best Practices to Prevent Such Accidents
Authors: Rajender Dahiya
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Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention
Procedia PDF Downloads 6212852 Innovate, Educate, and Transform, Tailoring Sustainable Waste Handling Solutions for Nepal’s Small Populated Municipalities: Insights From Chandragiri Municipality
Authors: Anil Kumar Baral
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The research introduces a ground-breaking approach to waste management, emphasizing innovation, education, and transformation. Using Chandragiri Municipality as a case study, the study advocates a shift from traditional to progressive waste management strategies, contributing an inventive waste framework, sustainability advocacy, and a transformative blueprint. The waste composition analysis highlights Chandragiri's representative profile, leading to a comprehensive plan addressing challenges and recommending a transition to a profitable waste treatment model, supported by relevant statistics. The data-driven approach incorporates the official data of waste Composition from Chandragiri Municipality as secondary data and incorporates the primary data from Chandragiri households, ensuring a nuanced perspective. Discussions on implementation, viability, and environmental preservation underscore the dual benefit of sustainability. The study includes a comparative analysis, monitoring, and evaluation framework, examining international relevance and collaboration, and conducting a social and environmental impact assessment. The results indicate the necessity for creative changes in Chandragiri's waste practices, recommending separate treatment centers in wards level rather than Municipal level, composting machines, and a centralized waste treatment plant. Educational reforms involve revising school curricula and awareness campaigns. The transformation's success hinges on reducing waste size, efficient treatment center operation, and ongoing public literacy. The conclusion summarizes key findings, envisioning a future with sustainable waste management practices deeply embedded in the community fabric.Keywords: innovate, educate, transform, municipality, method
Procedia PDF Downloads 4912851 Redefining Infrastructure as Code Orchestration Using AI
Authors: Georges Bou Ghantous
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This research delves into the transformative impact of Artificial Intelligence (AI) on Infrastructure as Code (IaaC) practices, specifically focusing on the redefinition of infrastructure orchestration. By harnessing AI technologies such as machine learning algorithms and predictive analytics, organizations can achieve unprecedented levels of efficiency and optimization in managing their infrastructure resources. AI-driven IaaC introduces proactive decision-making through predictive insights, enabling organizations to anticipate and address potential issues before they arise. Dynamic resource scaling, facilitated by AI, ensures that infrastructure resources can seamlessly adapt to fluctuating workloads and changing business requirements. Through case studies and best practices, this paper sheds light on the tangible benefits and challenges associated with AI-driven IaaC transformation, providing valuable insights for organizations navigating the evolving landscape of digital infrastructure management.Keywords: artificial intelligence, infrastructure as code, efficiency optimization, predictive insights, dynamic resource scaling, proactive decision-making
Procedia PDF Downloads 4112850 Developments in Corporate Governance: The Case of Vietnam
Authors: Lien T. H. Tran, David A. Holloway
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Corporate governance practices have changed significantly across the world in the past three decades. Spectacular corporate failures during this period have acted as a catalyst for the development of codes and guidelines that have resulted in the global acceptance of a ‘best practice’ model. This study assesses the relevance of such a ‘one size fits all model’ for the developing nation state of Vietnam. The findings of this analytical paper is that there are three key elements (government, international institutions and the nature of business) that are pertinent and central to corporate governance developments in the country. We also find that the quality of corporate governance in Vietnam is at a medium level when compared to international practices. Vietnam still has a long way to go to construct and embed effective corporate governance policies and practices and promote ethical business behaviours and sound decision making at board level.Keywords: corporate governance, government, international institutions, public companies, Vietnam
Procedia PDF Downloads 36612849 Sampling Error and Its Implication for Capture Fisheries Management in Ghana
Authors: Temiloluwa J. Akinyemi, Denis W. Aheto, Wisdom Akpalu
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Capture fisheries in developing countries provide significant animal protein and directly supports the livelihoods of several communities. However, the misperception of biophysical dynamics owing to a lack of adequate scientific data has contributed to the suboptimal management in marine capture fisheries. This is because yield and catch potentials are sensitive to the quality of catch and effort data. Yet, studies on fisheries data collection practices in developing countries are hard to find. This study investigates the data collection methods utilized by fisheries technical officers within the four fishing regions of Ghana. We found that the officers employed data collection and sampling procedures which were not consistent with the technical guidelines curated by FAO. For example, 50 instead of 166 landing sites were sampled, while 290 instead of 372 canoes were sampled. We argue that such sampling errors could result in the over-capitalization of capture fish stocks and significant losses in resource rents.Keywords: Fisheries data quality, fisheries management, Ghana, Sustainable Fisheries
Procedia PDF Downloads 9912848 Evidence-Based Practices in Education: A General Review of the Literature on Elementary Classroom Setting
Authors: Carolina S. Correia, Thalita V. Thomé, Andersen Boniolo, Dhayana I. Veiga
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Evidence-based practices (EBP) in education is a set of principles and practices used to raise educational policy, it involves the integration of professional expertise in education with the best empirical evidence in making decisions about how to deliver instruction. The purpose of this presentation is to describe and characterize studies about EBP in education in elementary classroom setting. Data here presented is part of an ongoing systematic review research. Articles were searched and selected from four academic databases: ProQuest, Scielo, Science Direct and Capes. The search terms were evidence-based practices or program effectiveness, and education or teaching or teaching practices or teaching methods. Articles were included according to the following criteria: The studies were explicitly described as evidence-based or discussed the most effective practices in education, they discussed teaching practices in classroom context in elementary school level. Document excerpts were extracted and recorded in Excel, organized by reference, descriptors, abstract, purpose, setting, participants, type of teaching practice, study design and main results. The total amount of articles selected were 1.185, 569 articles from Proquest Research Library; 216 from CAPES; 251 from ScienceDirect and 149 from Scielo Library. The potentially relevant references were 178, from which duplicates were removed. The final number of articles analyzed was 140. From 140 articles, are 47 theoretical studies and 93 empirical articles. The following research design methods were identified: longitudinal intervention study, cluster-randomized trial, meta-analysis and pretest-posttest studies. From 140 articles, 103 studies were about regular school teaching and 37 were on special education teaching practices. In several studies, used as teaching method: active learning, content acquisition podcast (CAP), precision teaching (PT), mediated reading practice, speech therapist programs and peer-assisted learning strategies (PALS). The countries of origin of the studies were United States of America, United Kingdom, Panama, Sweden, Scotland, South Korea, Argentina, Chile, New Zealand and Brunei. The present study in is an ongoing project, so some representative findings will be discussed, providing further acknowledgment on the best teaching practices in elementary classroom setting.Keywords: best practices, children, evidence-based education, elementary school, teaching methods
Procedia PDF Downloads 33512847 Anomalous Course of Left Ovarian Vein Associated with Pelvic Congestion Syndrome
Authors: Viyango Pandian, Kumaresh Athiyappan
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Pelvic congestion Syndrome (PCS) is usually seen in multiparous women who give history of chronic dull-aching pelvic pain. We report a case of a 17 year old unmarried female, who presented with acute onset of chronic dull-aching abdominal pain in the left iliac fossa, which particularly increased during menstruation and was finally diagnosed to be pelvic congestion syndrome. On ultrasonography, multiple tortuous and dilated veins were observed in the left adnexa. Both ovaries appeared normal in size, volume and echotexture. Computed tomography (CT) angiography was performed to precisely delineate the venous pathway and to assess any associated abnormality; which showed a dilated and tortuous left ovarian vein with an anomalous course around the left kidney and draining into the left renal vein. Clinical parameters and hormonal levels were within normal limits. This is a rare case of anomalous course of left ovarian vein associated with pelvic congestion syndrome.Keywords: anomalous course of ovarian vein, computed tomography, pelvic congestion syndrome, ultrasonography
Procedia PDF Downloads 42212846 An Index to Measure Transportation Sustainable Performance in Construction Projects
Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry
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The continuous increase in the world population, resource shortage and the warning of climate change cause various environmental and social issues to the world. Thus, sustainability concept is much needed nowadays. Organizations are progressively falling under strong worldwide pressure to integrate sustainability practices into their project decision-making development. Construction projects in the industry are amongst the most significant, since it is one of the biggest divisions and of main significance for the national economy and hence has a massive effect on the environment and society. So, it is important to discover approaches to incorporate sustainability into the management of those projects. This study presents a combined sustainability index of projects with sustainable transportation which has been formed as per a comprehensive literature review and survey study. Transportation systems enable the movement of goods and services worldwide, and it is leading to economic growth and creating jobs while creating negative impacts on the environment and society. This research is study to quantify the sustainability indicators, through 1) identifying the importance of sustainable transportation indicators that are based on the sustainable practices used for the construction projects and 2) measure the effectiveness of practices through these indicators on the three sustainable pillars. A total 26 sustainability indicators have been selected and grouped under each related sustainability pillars. A survey was used to collect the opinion about the sustainability indicators by a scoring system. A combined sustainability index considering three sustainable pillars can be helpful in evaluating the transportation sustainable practices of a project and making decisions regarding project selection. In addition to focus on the issue of financial resource allocation in a project selection, the decision-maker could take into account the sustainability as an important key in addition to the project’s return and risk. The purpose of this study is to measure the performance of transportation sustainability which allow companies to assess multiple projects selection. This is useful to decision makers to rank and focus more on future sustainable projects.Keywords: sustainable transportation, transportation performances, sustainable indicators, sustainable construction practice, sustainability
Procedia PDF Downloads 14612845 The Role of Accounting and Auditing in Anti-Corruption Strategies: The Case of ECOWAS
Authors: Edna Gnomblerou
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Given the current scale of corruption epidemic in West African economies, governments are seeking for immediate and effective measures to reduce the likelihood of the plague within the region. Generally, accountants and auditors are expected to help organizations in detecting illegal practices. However, their role in the fight against corruption is sometimes limited due to the collusive nature of corruption. The Denmark anti-corruption model shows that the implementation of additional controls over public accounts and independent efficient audits improve transparency and increase the probability of detection. This study is aimed at reviewing the existing anti-corruption policies of the Economic Commission of West African States (ECOWAS) as to observe the role attributed to accounting, auditing and other managerial practices in their anti-corruption drive. It further discusses the usefulness of accounting and auditing in helping anti-corruption commissions in controlling misconduct and increasing the perception to detect irregularities within public administration. The purpose of this initiative is to identify and assess the relevance of accounting and auditing in curbing corruption. To meet this purpose, the study was designed to answer the questions of whether accounting and auditing processes were included in the reviewed anti-corruption strategies, and if yes, whether they were effective in the detection process. A descriptive research method was adopted in examining the role of accounting and auditing in West African anti-corruption strategies. The analysis reveals that proper recognition of accounting standards and implementation of financial audits are viewed as strategic mechanisms in tackling corruption. Additionally, codes of conduct, whistle-blowing and information disclosure to the public are among the most common managerial practices used throughout anti-corruption policies to effectively and efficiently address the problem. These observations imply that sound anti-corruption strategies cannot ignore the values of including accounting and auditing processes. On one hand, this suggests that governments should employ all resources possible to improve accounting and auditing practices in the management of public sector organizations. On the other hand, governments must ensure that accounting and auditing practices are not limited to the private sector, but when properly implemented constitute crucial mechanisms to control and reduce corrupt incentives in public sector.Keywords: accounting, anti-corruption strategy, auditing, ECOWAS
Procedia PDF Downloads 26012844 Study on the Knowledge, Attitude and Practice (KAP) of Patients with Hypertension in Aseer Hospital, Asir Region, Saudi Arabia
Authors: Ayesha Siddiqua
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Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.Keywords: Attitude, hypertension, Knowledge, practices
Procedia PDF Downloads 35412843 Municipal Solid Waste Management in Ethiopia: Systematic Review of Physical and Chemical Compositions and Generation Rate
Authors: Tsegay Kahsay Gebrekidan, Gebremariam Gebrezgabher Gebremedhin, Abraha Kahsay Weldemariam, Meaza Kidane Teferi
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Municipal solid waste management (MSWM) in Ethiopia is a complex issue with institutional, social, political, environmental, and economic dimensions, impacting sustainable development. Effective MSWM planning necessitates understanding the generation rate and composition of waste. This systematic review synthesizes qualitative and quantitative data from various sources to aggregate current knowledge, identify gaps, and provide a comprehensive understanding of municipal solid waste management in Ethiopia. The findings reveal that the generation rate of municipal solid waste in Ethiopia is 0.38 kg/ca/day, with the waste composition being predominantly food waste, followed by ash, dust, and sand, and yard waste. Over 85% of this MSW is either reusable or recyclable, with a significant portion being organic matter (73.13% biodegradable) and 11.78% recyclable materials. Physicochemical analyses reveal that Ethiopian MSW is suitable for composting and biogas production, offering opportunities to reduce environmental pollution, and GHGs, support urban agriculture, and create job opportunities. However; challenges persist, including a lack of political will, weak municipal planning, limited community awareness, and inadequate waste management infrastructure, and only 31.8% of MSW is collected legally, leading to inefficient and harmful disposal practices. To improve MSWM, Ethiopia should focus on public awareness; increased funding, infrastructure investment, private sector partnerships, and implementing the 4 R principles (reduce, reuse, and recycle). An integrated approach involving government, industry, and civil society is essential. Further research on the physicochemical properties and strategic uses of MSW is needed to enhance management practices. Implications: The comprehensive study of municipal solid waste management (MSWM) in Ethiopia reveals the intricate interplay of institutional, social, political, environmental, and economic factors that influence the nation’s sustainable development. The findings underscore the urgent need for tailored, integrated waste management strategies that are informed by a thorough understanding of MSW generation rates, composition, and current management practices. Ethiopia’s lower per capita MSW generation compared to developed countries and the predominantly organic composition of its waste present significant opportunities for sustainable waste management practices such as composting and recycling. These practices can not only minimize the environmental impact but also support urban greening, agriculture, and renewable energy production. The high organic content, suitable physicochemical properties of MSW for composting, and potential for biogas and briquette production highlight pathways for creating employment, reducing waste, and enhancing soil fertility. Despite these opportunities, Ethiopia faces substantial challenges due to inadequate political will, weak municipal planning, limited community awareness, insufficient waste management infrastructure, and poor policy implementation. The high rate of illegal waste disposal further exacerbates environmental and health issues, emphasizing the need for a more effective and integrated MSWM approach. To address these challenges and harness the potential of MSW, Ethiopia must prioritize increasing public awareness; investing in infrastructure, fostering private sector partnerships, and implementing the principles of reduce, reuse, and recycle (3 R). Developing strategies that involve all stakeholders and turning waste into valuable resources is crucial. Government, industry, and civil society must collaborate to implement integrated MSWM systems that focus on waste reduction at the source, alternative material use, and advanced recycling technologies. Further research at both federal and regional levels is essential to optimize the physicochemical analysis and strategic use of MSW. Prompt action is required to transform waste management into a pillar of sustainable urban development, ultimately improving environmental quality and human health in Ethiopia.Keywords: biodegradable, healthy environment, integrated solid waste management, municipal
Procedia PDF Downloads 2612842 Effect of Preoperative Single Dose Dexamethasone and Lignocaine on Post-Operative Quality of Recovery and Pain Relief after Laparoscopic Cholecystectomy
Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan
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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery
Procedia PDF Downloads 12512841 Cultural Practices as a Coping Measure for Women who Terminated a Pregnancy in Adolescence: A Qualitative Study
Authors: Botshelo Rachel Sebola
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Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy, and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence participated in the study. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.Keywords: adolescence, culture, case study, pregnancy
Procedia PDF Downloads 8912840 A Mixed Method Approach Investigating EFL Teachers' Beliefs and Practices towards Classroom-Based Assessment in Saudi Higher Educational Institutions
Authors: Mashael AlSalem
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While research into language assessment has expanded in recent years, few if any studies to date have targeted the nature of thought processes used by teachers when constructing classroom-based assessment. This study reports on teachers’ conceptions of English grammar assessment and their classroom assessment practices in their Saudi higher educational facilities. A mixed-method approach using both qualitative and quantitative research instruments was employed to elicit teachers’ perceptions of English grammar assessment and their relationship to their current practices. Participants of the study included EFL teachers from 4 different educational facilities: King Saudi University, Princess Noura University, Imam Mouhamed Islamic University, and Institute of Public Administration. Data collection involved questionnaire (N=100), semi-structured interviews (N=30), retrospective thinking (N=20), and document analysis (N=20). Activity theory is used as an interpretive framework to explore and investigate the entire system of constructing classroom-based assessment. Preliminary findings reveal several similarities and differences between the participants’ stated beliefs and their current practices of assessing English grammar. Findings also showed that teacher participant’s beliefs about how English grammar should be assessed are influenced mostly by prior learning experience as well as their teaching instruction practices. Their practices, on the other hand, was more guided by educational policies and lack of teacher training in the field of assessment, among other factors. This research makes a significant contribution to knowledge in three different areas: it enriches the literature on language teacher cognition; it builds on the body of research on language classroom assessment, and it expands on the possibilities to use AC to investigate the relationship between teachers’ beliefs and practices.Keywords: activity theory, classroom-based assessment, language teacher cognition, mixed method approach
Procedia PDF Downloads 13612839 Insect Outbreaks, Harvesting and Wildfire in Forests: Mathematical Models for Coupling Disturbances
Authors: M. C. A. Leite, B. Chen-Charpentier, F. Agusto
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A long-term goal of sustainable forest management is a relatively stable source of wood and a stable forest age-class structure has become the goal of many forest management practices. In the absence of disturbances, this forest management goal could easily be achieved. However, in the face of recurring insect outbreaks and other disruptive processes forest planning becomes more difficult, requiring knowledge of the effects on the forest of a wide variety of environmental factors (e.g., habitat heterogeneity, fire size and frequency, harvesting, insect outbreaks, and age distributions). The association between distinct forest disturbances and the potential effect on forest dynamics is a complex matter, particularly when evaluated over time and at large scale, and is not well understood. However, gaining knowledge in this area is crucial for a sustainable forest management. Mathematical modeling is a tool that can be used to broader the understanding in this area. In this talk we will introduce mathematical models formulation incorporating the effect of insect outbreaks either as a single disturbance in the forest population dynamics or coupled with other disturbances: either wildfire or harvesting. The results and ecological insights will be discussed.Keywords: age-structured forest population, disturbances interaction, harvesting insects outbreak dynamics, mathematical modeling
Procedia PDF Downloads 52812838 Sleep Health Management in Residential Aged Care Facilities
Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini
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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.Keywords: registered nurses, residential aged care facilities, sedative use, sleep
Procedia PDF Downloads 10912837 Exploration of Barriers and Challenges to Innovation Process for SMEs: Possibilities to Promote Cooperation Between Scientific and Business Institutions to Address it
Authors: Indre Brazauskaite, Vilte Auruskeviciene
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Significance of the study is outlined through current strategic management challenges faced by SMEs. First, innovation is recognized as competitive advantage in the market, having ever changing market conditions. It is of constant interest from both practitioners and academics to capture and capitalize on business opportunities or mitigate the foreseen risks. Secondly, it is recognized that integrated system is needed for proper implementation of innovation process, especially during the period of business incubation, associated with relatively high risks of new product failure. Finally, ability to successful commercialize innovations leads to tangible business results that allow to grow organizations further. This is particularly relevant to SMEs due to limited structures, resources, or capabilities. Cooperation between scientific and business institutions could be a tool of mutual interest to observe, address, and further develop innovations during the incubation period, which is the most demanding and challenging during the innovation process. Material aims to address the following problematics: i) indicate the major barriers and challenges in innovation process that SMEs are facing, ii) outline the possibilities for these barriers and challenges to be addressed by cooperation between scientific and business institutions. Basis for this research is stage-by-stage integrated innovation management process which presents existing challenges and needed aid in operational decision making. The stage-by-stage innovation management process exploration highlights relevant research opportunities that have high practical relevance in the field. It is expected to reveal the possibility for business incubation programs that could combine interest from both – practices and academia. Methodology. Scientific meta-analysis of to-date scientific literature that explores innovation process. Research model is built on the combination of stage-gate model and lean six sigma approach. It outlines the following steps: i) pre-incubation (discovery and screening), ii) incubation (scoping, planning, development, and testing), and iii) post-incubation (launch and commercialization) periods. Empirical quantitative research is conducted to address barriers and challenges related to innovation process among SMEs that limits innovations from successful launch and commercialization and allows to identify potential areas for cooperation between scientific and business institutions. Research sample, high level decision makers representing trading SMEs, are approached with structured survey based on the research model to investigate the challenges associated with each of the innovation management step. Expected findings. First, the current business challenges in the innovation process are revealed. It will outline strengths and weaknesses of innovation management practices and systems across SMEs. Secondly, it will present material for relevant business case investigation for scholars to serve as future research directions. It will contribute to a better understanding of quality innovation management systems. Third, it will contribute to the understanding the need for business incubation systems for mutual contribution from practices and academia. It can increase relevance and adaptation of business research.Keywords: cooperation between scientific and business institutions, innovation barriers and challenges, innovation measure, innovation process, SMEs
Procedia PDF Downloads 15412836 Enterprise Risk Management, Human Capital and Organizational Performance: Insights from Public Listed Companies
Authors: Omar Moafaq Saleh Aljanabi, Noradiva Hamzah, Ruhanita Maelah
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In today’s challenging global economy, which is driven by information and knowledge, risk management is undergoing a great change, as organizations shift from traditional and compartmental risk management to an enterprise-wide approach. Enterprise risk management (ERM), which aims at increasing the sustainability of an organization and achieving competitive advantage, is gaining global attention and fast becoming an essential concern in all industries. Furthermore, in order to be effective, ERM should be managed by managers with high-level skills and knowledge. Despite the importance of the knowledge embedded in, there remains a paucity of evidence concerning how human capital could influence the organization’s ERM. Responses from 116 public listed companies (PLCs) on the main market of Bursa Malaysia were analyzed using Structural Equation Modelling (SEM). This study found that there is a significant association between ERM and organizational performance. The results also indicate that human capital has a positive moderating effect on the relationship between ERM and performance. The study contributes to the ERM literature by providing empirical evidence on the relationship between ERM, human capital, and organizational performance. Findings from this study also provide guidelines for managers, policy makers, and the regulatory bodies, to evaluate the ERM practices in PLCs.Keywords: enterprise risk management, human capital, organizational performance, Malaysian public listed companies
Procedia PDF Downloads 20212835 Drug Abuse among Immigrant Youth in Canada
Authors: Qin Wei
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There has been an increased number of immigrants arriving in Canada and a concurrent rise in the number of immigrant youth suffering from drug abuse. Immigrant youths’ drug abuse has become a significant social and public health concern for researchers. This literature review explores the nature of immigrant youths’ drug abuse by examining the factors influencing the onset of substance misuse, the barriers that discourage youth to seek out treatment, and how to resolve addictions amidst immigrant youth. Findings from the literature demonstrate that diminished parental supervision, acculturation challenges, peer conformity, discrimination, and ethnic marginalization are all significant factors influencing youth to use drugs as an outlet for their pain, while culturally competent care and fear of family and culture-based addiction stigma act as barriers discouraging youth from seeking out addiction support. To resolve addiction challenges amidst immigrant youth, future research should focus on promoting and implementing culturally sensitive practices and psychoeducational initiatives into immigrant communities and within public health policies.Keywords: approaches, barriers, drug abuse, Canada, immigrant youth, reasons
Procedia PDF Downloads 23912834 Disability and the Role of Culture, Religion and Medicine in Nigeria
Authors: Alapa Peters Odugbo
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The remarkable but fascinatingly intricate book 'The Lives of Jessie Sampter', by Sarah Imhoff, which describes Jessie Sampter's three different lives as a queer, a disabled person, and a Zionist, served as the main inspiration for this work. Her second chapter of Imhoff, which covers disability in-depth, inspired the focus of my study. This paper critically explores how culture, religion, and medicine contribute to and sustain discriminatory practices against people with disabilities in Nigeria. These practices include continued and often unchallenged stigmatization, unequal treatment, and denial of basic social services, employment prospects, and fundamental human rights. The paper makes crucial recommendations to help combat and eliminate these practices and negative perceptions toward people with disabilities in Nigeria, as well as to safeguard and promote their interests and rights.Keywords: disability, culture, religion, medicine
Procedia PDF Downloads 13712833 Assessing the Impact of Adopting Climate Smart Agriculture on Food Security and Multidimensional Poverty: Case of Rural Farm Households in the Central Rift Valley of Ethiopia
Authors: Hussien Ali, Mesfin Menza, Fitsum Hagos, Amare Haileslassie
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Climate change has perverse effects on agricultural productivity and natural resource base, negatively affecting the well-being of the households and communities. The government and NGOs promote climate smart agricultural (CSA) practices to help farmers adapt to and mitigate the negative effects of climate change. This study aims to identify widely available CSA practices and examine their impacts on food security and multi-dimensional poverty of rural farm households in the Central Rift Valley, Ethiopia. Using three-stage proportional to size sampling procedure, the study randomly selected 278 households from two kebeles from four districts each. A cross-sectional data of 2020/21 cropping season was collected using structured and pretested survey questionnaire. Food consumption score, dietary diversity score, food insecurity experience scale, and multidimensional poverty index were calculated to measure households’ welfare indicators. Multinomial endogenous switching regression model was used to assess average treatment effects of CSA on these outcome indicators on adopter and non-adopter households. The results indicate that the widely adopted CSA practices in the area are conservation agriculture, soil fertility management, crop diversification, and small-scale irrigation. Adopter households have, on average, statistically higher food consumption score, dietary diversity score and lower food insecurity access scale than non-adopters. Moreover, adopter households, on average, have lower deprivation score in multidimensional poverty compared to non-adopter households. Up scaling the adoption of CSA practices through the improvement of households’ implementation capacity and better information, technical advice, and innovative financing mechanisms is advised. Up scaling CSA practices can further promote achieving global goals such as SDG 1, SDG 2, and SDG 13 targets, aimed to end poverty and hunger and mitigate the adverse impacts of climate change, respectively.Keywords: climate-smart agriculture, food security, multidimensional poverty, upscaling CSA, Ethiopia
Procedia PDF Downloads 9812832 Analyzing Software Testing Phase in Agile Project Management: The Case of Jordan
Authors: Ghaleb Y. Abbasi, Satanay Alhiary
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This paper focused on software testing phase of activities, types, techniques, teams and methods under agile project management (APM) in the Jordanian software industry. The effect of using agile principles and practices on testing process in software development life cycle (SDLC) was analyzed in order to create full view of the agile testing aspects such as phases, levels, types, methods, team and customers. Qualitative and quantitative research methods were utilized to cover earlier literature and collect data via web survey and short interviews in Jordanian software companies. Results indicated that agile testing had positive influence on quality of product, team performance, and customer satisfaction with a rate above 80%. APM is a powerful practice of moving software project forward in current markets with a rate above 51% by early involvement of testing activities in development.Keywords: agile project management, software development life cycle, agile methods, agile testing, software testing
Procedia PDF Downloads 45912831 The School Based Support Program: An Evaluation of a Comprehensive School Reform Initiative in the State of Qatar
Authors: Abdullah Abu-Tineh, Youmen Chaaban
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This study examines the development of a professional development (PD) model for teacher growth and learning that is embedded into the school context. The School based Support Program (SBSP), designed for the Qatari context, targets the practices, knowledge and skills of both school leadership and teachers in an attempt to improve student learning outcomes. Key aspects of the model include the development of learning communities among teachers, strong leadership that supports school improvement activities, and the use of research-based PD to improve teacher practices and student achievement. This paper further presents findings from an evaluation of this PD program. Based on an adaptation of Guskey’s evaluation of PD models, 100 teachers at the participating schools were selected for classroom observations and 40 took part in in-depth interviews to examine changed classroom practices. The impact of the PD program on student learning was also examined. Teachers’ practices and their students’ achievement in English, Arabic, mathematics and science were measured at the beginning and at the end of the intervention.Keywords: initiative, professional development, school based support Program (SBSP), school reform
Procedia PDF Downloads 50012830 Examining the Influence of Firm Internal Level Factors on Performance Variations among Micro and Small Enterprises: Evidence from Tanzanian Agri-Food Processing Firms
Authors: Pulkeria Pascoe, Hawa P. Tundui, Marcia Dutra de Barcellos, Hans de Steur, Xavier Gellynck
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A majority of Micro and Small Enterprises (MSEs) experience low or no growth. Understanding their performance remains unfinished and disjointed as there is no consensus on the factors influencing it, especially in developing countries. Using a Resource-Based View (RBV) as the theoretical background, this cross-sectional study employed four regression models to examine the influence of firm-level factors (firm-specific characteristics, firm resources, manager socio-demographic characteristics, and selected management practices) on the overall performance variations among 442 Tanzanian micro and small agri-food processing firms. Study results confirmed the RBV argument that intangible resources make a larger contribution to overall performance variations among firms than that tangible resources. Firms' tangible and intangible resources explained 34.5% of overall performance variations (intangible resources explained the overall performance variability by 19.4% compared to tangible resources, which accounted for 15.1%), ranking first in explaining the overall performance variance. Firm-specific characteristics ranked second by influencing variations in overall performance by 29.0%. Selected management practices ranked third (6.3%), while the manager's socio-demographic factors were last on the list, as they influenced the overall performance variability among firms by only 5.1%. The study also found that firms that focus on proper utilization of tangible resources (financial and physical), set targets, and undertake better working capital management practices performed higher than their counterparts (low and average performers). Furthermore, accumulation and proper utilization of intangible resources (relational, organizational, and reputational), undertaking performance monitoring practices, age of the manager, and the choice of the firm location and activity were the dominant significant factors influencing the variations among average and high performers, relative to low performers. The entrepreneurial background was a significant factor influencing variations in average and low-performing firms, indicating that entrepreneurial skills are crucial to achieving average levels of performance. Firm age, size, legal status, source of start-up capital, gender, education level, and total business experience of the manager were not statistically significant variables influencing the overall performance variations among the agri-food processors under the study. The study has identified both significant and non-significant factors influencing performance variations among low, average, and high-performing micro and small agri-food processing firms in Tanzania. Therefore, results from this study will help managers, policymakers and researchers to identify areas where more attention should be placed in order to improve overall performance of MSEs in agri-food industry.Keywords: firm-level factors, micro and small enterprises, performance, regression analysis, resource-based-view
Procedia PDF Downloads 9112829 Anti-Inflammatory and Analgesic Effects of Methanol Extract of Rhizophora racemosa Leaf in Albino Rats
Authors: Angalabiri-Owei E. Bekekeme, Brambaifa Nelson
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In view of the peculiar environment of the Niger Delta, access to modern health care is limited, hence the inhabitants especially those in the swampy areas resorts to sourcing for alternatives cure for their ailments using plants commonly found in this area without scientific evaluation. Rhizophora racemosa, G. F. Meyer (Rhizophoraceae) is the most abundant mangrove plant in the Niger Delta Area of Nigeria. The plant has been observed to be used for relief of a toothache and dysmenorrhoea among some Ijaw communities in the region. This work has revealed the likely potential of the plant in drug discovery and development. The crude methanol extract at doses of 300 mg/kg and 600 mg/kg (intraperitoneal) were tested for analgesic effect using fresh egg albumin induced inflammatory pain and Randall–Sellito method to assess the pain threshold. The anti-inflammatory effect was also evaluated with the extract at doses of 300 mg/kg and 600 mg/kg (intraperitoneal) using acute inflammatory model; fresh egg albumin induced paw oedema and assessed using Plethysmometer in rats. The methanol extracts 300 mg/kg and 600 mg/kg exhibited a significant (P < 0.001) and dose-dependent analgesic activity compared with the negative control and a standard drug diclofenac using ANOVA with Least Significant Difference post hoc test as evidenced by increased pain threshold. Also, the extract significantly (P < 0.001) reduced the rat paw oedema induced by the sub plantar injection of fresh egg albumin when compared with the negative control and a standard diclofenac using above statistical methods. This study revealed that the plant possesses analgesic and anti-inflammatory activities hence provide scientific bases for use as medicine.Keywords: analgesic, anti-inflammatory, plethysmometer, Rhizophora racemosa
Procedia PDF Downloads 36312828 Higher-Level Return to Female Karate Competition Following Multiple Patella Dislocations
Authors: A. Maso, C. Bellissimo, G. Facchinetti, N. Milani, D. Panzin, D. Pogliana, L. Garlaschelli, L. Rivaroli, S. Rivaroli, M. Zurek, J. Konin
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15 year-old female karate athlete experienced two unilateral patella dislocations: one contact and one non-contact. This challenged her from competing as planned at the regional and national competitions as a result of her inability to perform at a high level. Despite these injuries and other complicated factors, she was able to modify her training timeline and successfully perform, winning third at the National Cup. Initial pain numeric rating scale 8/10 during karate training isometric figures, taking the stairs, long walking, a positive rasp test, palpation pain on the lateral patella joint 9/10, pain performing open kinetic chain 0°-45° and close kinetic chain 30°-90°, tensor fascia lata, vastus lateralis, psoas muscles retraction/stiffness. Foot hyper pronation, internally rotated femur, and knee flexion 15° were the postural findings. Exercise prescription for three days/week for three weeks to include exercise-based rehabilitation and soft tissue mobilization with massage and foam rolling. After three weeks, the pain was improved during activity daily living 5/10, and soft tissue stiffness decreased. An additional four weeks of exercise-based rehabilitation was continued. At this time, axial x-rays and TA-GT TAC were taken, and an orthopaedic medical check was recommended to continue conservative treatment. At week seven, she performed 2/4 karate position technique without pain and 2/4 with pain. An isokinetic test was performed at week 12, demonstrating a 10% strength deficit and 6% resistance deficit both to the left hamstrings. Moreover, an 8% strength and resistance surplus to the left quadriceps was found. No pain was present during activity, daily living and sports activity, allowing a return to play training to begin. A plan for the return to play framework collaborated with her trainer, her father, a physiotherapist, a sports scientist, an osteopath, and a nutritionist. Within 4 and 5 months, both non-athlete and athlete movement quality analysis tests were performed. The plan agreed to establish a return to play goal of 7 months and the highest level return to competition goal of 9 months from the start of rehabilitation. This included three days/week of training and repeated testing of movement quality before return to competition with detectable improvements from 77% to 93%. Beginning goals of the rehabilitation plan included the importance of a team approach. The patient’s father and trainer were important to collaborate with to assure a safe and timely return to competition. The possibility of achieving the goals was strongly related to orthopaedic decision-making and progress during the first weeks of rehabilitation. Without complications or setbacks, the patient can successfully return to her highest level of competition. The patient returned to participation after five months of rehabilitation and training, and then she returned to competition at the national level in nine months. The successful return was the result of a team approach and a compliant patient with clear goals.Keywords: karate, knee, performance, rehabilitation
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