Search results for: hip fracture rehabilitation

Authors: Noopur Anand, Amit Gupta

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Sewage divers are the workers involved in cleaning and maintaining of the sewerage lines by entering through manholes. The working conditions of sewage divers in India are more challenging than in other countries. Though India has legal acts framed to ensure protection of the divers called 'The Prohibition of Employment of Manual Scavengers and their Rehabilitation Act, 2013' by Ministry of Law and Justice but these are usually not implemented. Further, the divers are not even provided with safety gear like mask, eyewear, helmet, safety suit, safety belt, gloves, and shoes because of lack of initiative among the agencies/individuals employing them and low awareness of importance of the protective gear amongst workers themselves. Several reports and studies show that because of the non-availability of safety gear, many sewage workers get infected and many of them retire even before attaining superannuation and about 70% of the manual scavengers die while on job. Though there are neoprene safety suits, costing only a few thousand, available in the market which can suffice but is beyond the buying capacity of the sewage diver and agencies/individuals employing them are reluctant to procure it as they find it expensive. In absence of safety suits, the divers get exposed to the parasites, viruses, and disease-causing germs present in the sewage. The research was undertaken with the objective of developing an affordable safety-suit which would save diver from coming into direct contact with the sewage thus preventing infections and diseases. The low cost of the suit may also motivate their employers to procure them for sewage divers.

Keywords: manhole cleaner, manual scavenger, prototype, low-cost safety-suit

Procedia PDF Downloads 164

Authors: Carmen Viñas Arrebola, Antonio Rodriguez Sanchez, Sheila Varela Lujan, Mariano Gonzalez Cortina, Cesar Porras Amores

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The research group TEMA from the School of Building (UPM) is working in the line of energy efficiency and comfort in building. The need to reduce energy consumption in the building construction implies designing new constructive systems. These systems help to reduce both consumption and energy losses in order to achieve adequate thermal comfort for people in any type of building. In existing buildings the best option is the rehabilitation focused on thermal insulation. The aim of this paper is to design, monitor and analyze the first results of thermal behavior of the ETICS system in façades. This retrofitting solution consists of adding thermal insulation on the outside of the building, helping to create a continuous envelope on the façades. The analysis is done by comparing a rehabilitated part of the building with ETICS system and another part which has not been rehabilitated, and it is taken as reference. Both of them have the same characteristics. Temperature measurements were taken with type K thermocouples according to the previous design of the monitoring and in the same period of time. The pilot building of the study is situated in Benimamet Street, in San Cristobal de Los Ángeles, in the south of Madrid. It was built in the late 50s. The 51st entrance hall, which is restored, and the 47th entrance hall, in original conditions, have been studied.

Keywords: comfort in building, energy efficiency in building, ETICS, thermal properties

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Authors: Kamrun N. Keya, Nasrin A. Kona, Ruhul A. Khan

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Pineapple leaf fiber (PALF) reinforced polypropylene (PP) based composites were fabricated by a conventional compression molding technique. In this investigation, PALF composites were manufactured using different percentages of fiber, which were varying from 25-50% on the total weight of the composites. To fabricate the PALF/PP composites, untreated and treated fibers were selected. A systematic study was done to observe the physical, mechanical and interfacial behavior of the composites. In this study, mechanical properties of the composites such as tensile, impact and bending properties were observed precisely. It was found that 45wt% of fiber composites showed better mechanical properties than others. Maximum tensile strength (TS) and bending strength (BS) was observed, 65 MPa and 50 MPa respectively, whereas the highest tensile modulus (TM) and bending modulus (BM) was examined, 1.7 GPa and 0.85 GPa respectively. The PALF/PP based composites were treated with irradiated under gamma radiation (the source strength 50 kCi Cobalt-60) of various doses (2.5 kGy to 10 kGy). The effect of gamma radiation on the composites was also investigated, and it found that the effect of 5.0 kGy (i.e. units for radiation measurement is 'gray', kGy=kilogray ) gamma dose showed better mechanical properties than other doses. The values of TS, BS, TM, and BM of the irradiated (5.0 kGy) composites were found to improve by 19%, 23%, 17% and 25 % over non-irradiated composites. After flexural testing, fracture sides of the untreated and treated both composites were studied by scanning electron microscope (SEM). SEM results of the treated PALF/PP based composites showed better fiber-matrix adhesion and interfacial bonding than untreated PALF/PP based composites. Water uptake and soil degradation tests of untreated and treated composites were also investigated.

Keywords: PALF, polypropylene, compression molding technique, gamma radiation, mechanical properties, scanning electron microscope

Procedia PDF Downloads 148

Authors: Mihail Nagea, Olivera Lupescu, Nicolae Ciurea, Alexandru Dimitriu, Alina Grosu

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Introduction: As severe open injuries are more and more frequent in modern traumatology, threatening not only the integrity of the affected limb but even the life of the patients, new methods desired to cope with the consequences of these traumas were described. Vacuum therapy is one such method which has been described as enhancing healing in trauma with extensive soft-tissue injuries, included those with septic complications. Material and methods: Authors prospectively analyze 15 patients with severe lower limb trauma with MESS less than 6, with considerable soft tissue loss following initial debridement and fracture fixation. The patients needed serial debridements and vacuum therapy was applied after delayed healing due to initial severity of the trauma, for an average period of 12 days (7 - 23 days).In 7 cases vacuum therapy was applied for septic complications. Results: Within the study group, there were no local complications; secondary debridements were performed for all the patients and vacuum system was re-installed after these debridements. No amputations were needed. Medical records were reviewed in order to compare the outcome of the patients: the hospital stay, anti-microbial therapy, time to healing of the bone and soft tissues (there is no standard group to be compared with) and the result showed considerable improvements in the outcome of the patients. Conclusion: Vacuum therapy improves healing of the soft tissues, including those infected; hospital stay and the number of secondary necessary procedures are reduced. Therefore it is considered a valuable support in treating trauma of the limbs with severe soft tissue injuries.

Keywords: complex injuries, negative pressure, open fractures, wound therapy

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Authors: Yahya Asanoglu, Celaletdin Ergun

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Ceramic-matrix composites (CMC) have significant prominence in various engineering applications because of their heat resistance associated with an ability to withstand the brittle type of catastrophic failure. In this study, specific raw materials have been chosen for the purpose of having suitable CMC material for high-temperature dielectric applications. CMC material will be manufactured through the polymer infiltration and pyrolysis (PIP) method. During the manufacturing process, vacuum infiltration and autoclave will be applied so as to decrease porosity and obtain higher mechanical properties, although this advantage leads to a decrease in the electrical performance of the material. Time and temperature adjustment in pyrolysis parameters provide a significant difference in the properties of the resulting material. The mechanical and thermal properties will be investigated in addition to the measurement of dielectric constant and tangent loss values within the spectrum of Ku-band (12 to 18 GHz). Also, XRD, TGA/PTA analyses will be employed to prove the transition of precursor to ceramic phases and to detect critical transition temperatures. Additionally, SEM analysis on the fracture surfaces will be performed to see failure mechanism whether there is fiber pull-out, crack deflection and others which lead to ductility and toughness in the material. In this research, the cost-effectiveness and applicability of the PIP method will be proven in the manufacture of CMC materials while optimization of pyrolysis time, temperature and cycle for specific materials is detected by experiment. Also, several resins will be shown to be a potential raw material for CMC radome and antenna applications. This research will be distinguished from previous related papers due to the fact that in this research, the combination of different precursors and fabrics will be experimented with to specify the unique cons and pros of each combination. In this way, this is an experimental sum of previous works with unique PIP parameters and a guide to the manufacture of CMC radome and antenna.

Keywords: CMC, PIP, precursor, quartz

Procedia PDF Downloads 157

Authors: Selman Cagman

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A detailed analysis is made within an organized industrial zone (OIZ) that has 1165 production facilities such as manufacturing of furniture, fabricated metal products (machinery and equipment), food products, plastic and rubber products, machinery and equipment, non-metallic mineral products, electrical equipment, textile products, and manufacture of wood and cork products. In this OIZ, a field study is done by choosing some facilities that can represent the whole OIZ sectoral distribution. In this manner, there are 207 facilities included to the site visit, and there is a 17 questioned survey carried out with each of them to assess their inputs, outputs, and waste amounts during manufacturing processes. The survey result identify that MDF/Particleboard and chipboard particles, textile, food, foam rubber, sludge (treatment sludge, phosphate-paint sludge, etc.), plastic, paper and packaging, scrap metal (aluminum shavings, steel shavings, iron scrap, profile scrap, etc.), slag (coal slag), ceramic fracture, ash from the fluidized bed are the wastes come from these facilities. As a result, there are 5 industrial symbiosis projects established with this study. One of the projects is a 2.840 kW capacity Integrated Biomass Based Waste Incineration-Energy Production Facility running on 35.000 tons/year of MDF particles and chipboard waste. Another project is a biogas plant with 225 tons/year whey, 100 tons/year of sesame husk, 40 tons/year of burnt wafer dough, and 2.000 tons/year biscuit waste. These two plants investment costs and operational costs are given in detail. The payback time of the 2.840 kW plant is almost 4 years and the biogas plant is around 6 years.

Keywords: industrial symbiosis, energy, biogas, waste to incineration

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Authors: Sang Koo Jeon, Seung Hoon Nahm, Oh Heon Kwon

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The unit cell of solid oxide fuel cell (SOFC) must be stacked as several layers type to obtain the high power. The most of researcher have concerned about the performance of stacked SOFC rather than the structural stability of stacked SOFC and especially interested how to design for reducing the electrical loss and improving the high efficiency. Consequently, the stacked SOFC able to produce the electrical high power and related parts like as manifold, gas seal, bipolar plate were developed to optimize the stack design. However, the unit cell of SOFC was just layered on the interconnector without the adhesion and the hydrogen and oxygen were injected to the interfacial layer in the high temperature. On the operating condition, the interfacial layer can be the one of the weak point in the stacked SOFC. Therefore the evaluation of the structural safety for the failure is essentially needed. In this study, interfacial adhesion between SOFC and metal adhesive was estimated in the high temperature environment. The metal adhesive was used to strongly connect the unit cell of SOFC with interconnector and provide the electrical conductivity between them. The four point bending test was performed to measure the interfacial adhesion. The unit cell of SOFC and SiO2 wafer were diced and then attached by metal adhesive. The SiO2 wafer had the center notch to initiate a crack from the tip of the notch. The modified stereomicroscope combined with the CCD camera and system for measuring the length was used to observe the fracture behavior. Additionally, the interfacial adhesion was evaluated in the high temperature condition because the metal adhesive was affected by high temperature. Also the specimen was exposed in the furnace during several hours and then the interfacial adhesion was evaluated. Finally, the interfacial adhesion energy was quantitatively determined and compared in the each condition.

Keywords: solid oxide fuel cell (SOFC), metal adhesive, adhesion, high temperature

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Authors: Ida D. Souza, Lena Ashok

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Every child has a fundamental right to be protected and it is only a safe, supported child who can effectively cope with difficult circumstances and lead a happy childhood. The vulnerability of children has increased due to emerging lifestyles, raising cost of living, higher expectations from adults, parental and care-giver stress /burn-out and a general raise in demand for services for children. A major area of concern is the rise of juvenile crimes in the overall crimes committed in the country. The UNCRC 1989 and JJ Act 2000 enables the structures to handle the juvenile children in care and concern in its real terms. One of the mechanisms to protect the children is the JJB a justice system. The aim is to hold a child culpable (guilty) for offence they committed, not through punishment, but counseling the child to understand their actions and persuade them away from such deviated activities in the future. The JJB consists of two social workers and a judicial magistrate and one of whom should be a woman. This study aims at understanding the role of social workers in best practices in deciding the best course of action for the rehabilitation of the child. Two case studies were carried out through in-depth interviews with the social worker member of the JJB of two Udupi and Mangalore districts. The best practices reported in which children are being allowed to express themselves in a child friendly environment and in the best interest of the child. The study highlighted team work to be very effective in understanding the child in their reformation.

Keywords: child protection, best practices, juvenile justice, reformation teamwork

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Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem

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Postmenopausal osteoporosis is characterized by low bone density which leads to increased bone fragility and greater susceptibility to fracture. Current treatments for osteoporosis are dominated by drugs that inhibit bone resorption although they also suppress bone formation that may contribute to pathogenesis of osteonecrosis. To restore the extensive bone loss, there is a great need for anabolic treatments that induce osteoblasts to build new bone. Pre-osteoblastic cells produce proteins of the extra-cellular matrix, including type I collagen at first, and then to successively produce alkaline phosphatase (ALP) and osteocalcin during differentiation to osteoblasts. Finally, osteoblasts deposit calcium. Present study investigated the effects of egg yolk peptide (EYP) on osteogenic activities and bone matrix gene expressions in human osteoblastic MG-63 cells. The effects of EYP on cell proliferation, alkaline phosphatase (ALP) activity, collagen synthesis, and mineralization were measured. The expression of osteogenic genes including COL1A1 (collagen, type I, alpha 1), ALP, BGLAP (osteocalcin), and SPP1 (secreted phosphoprotein 1, osteopontin) were measured by quantitative realtime PCR. EYP dose-dependently increased MG-63 cell proliferation, ALP activity, collagen synthesis, and calcium deposition. Furthermore, COL1A1, ALP, and SPP1 gene expressions were increased by EYP treatment. Present study suggested that EYP treatment enhanced osteogenic activities and increased bone matrix osteogenicgenes. These results could provide a mechanistic explanation for the bone-strengthening effects of EYP.

Keywords: egg yolk peptide, osteoblastic MG-63 cells, alkaline phosphatase, collagen synthesis, osteogenic genes, COL1A1, osteocalcin, osteopontin

Procedia PDF Downloads 383

Authors: Amine Rezzoug, Selsabil Rokia Laraba, Mourad Ancer, Said Abdi

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Composite materials are taking center stage in different fields thanks to their mechanical characteristics and their ease of preparation. Environmental constraints have led to the development of composite with natural reinforcements. The sandwich structure has the advantage to have good flexural proprieties for low density, which is why it was chosen in this work. The development of these materials is related to an energy saving strategy and environmental protection. The present work refers to the study of the development and characterization of sandwiches composites based on hybrids laminates with natural reinforcements (Alfa and Jute), a metal fabric was introduced into composite in order to have a compromise between weight and properties. We use different configurations of reinforcements (jute, metallic fabric) to develop laminates in order to use them as thin facings for sandwiches materials. While the core was an epoxy matrix reinforced with Alfa short fibers, a chemical treatment sodium hydroxide was cared to improve the adhesion of the Alfa fibers. The mechanical characterization of our materials was made by the tensile and bending test, to highlight the influence of jute and Alfa. After testing, the fracture surfaces are observed by scanning electron microscopy (SEM). Optical microscopy allowed us to calculate the degree of porosity and to observe the morphology of the individual layers. Laminates based on jute fabric have shown better results in tensile test as well as to bending, compared to those of the metallic fabric (100%, 65%). Sandwich Panels were also characterized in terms of bending test. Results we had provide, shows that this composite has sufficient properties for possible replacing conventional composite materials by considering the environmental factors.

Keywords: bending test, bio-composites, sandwiches, tensile test

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Authors: Jiun-De Lin

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The main purpose of this study was to investigate the empowerment effect of the older people through a structured reminiscence play therapeutic group program in Changhua county of Taiwan. This program was used Taiwanese traditional culture as the main concept based on the topic of reminiscence. In order to assimilate into the process for older people, thematic group activities were easy to operate. During the reminiscence play activities, they would improve their personal control and competence, the same as empowerment. A counselor who acted as a group leader led 10 elderly people participated in this reminiscence group play therapy. The participants of the study were 10 older people consisting of 7 males and 3 females who lived in a rehabilitation center in Changhua county of Taiwan. The participants’ average age was 72.5 years old. The study adopted the methods of survey research and the instruments in this study included subjects’ demographic information and the empowerment inventory for adults. A one-group pretest-posttest design was adopted by researchers to test the study hypothesis. The collected data were analyzed by descriptive statistics, and Wilcoxon matched paired signed-ranks test. The main finding of this study was that the reminiscence group play therapy had a significant effect (Z= 2.382, p < .05) to promote the state of empowerment of older people participated in this group play therapy. Based on the conclusion of this study, the suggestions and implications were proposed for the practices and future research.

Keywords: empowerment, group play therapy, older people, reminiscence

Procedia PDF Downloads 145

Authors: Amany Mohamed, Alaa Balbaa, Magdoline Mishel

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Background: Pain in the neck or scapular region is one of the most frequent symptoms in cervical radiculopathy, which is commonly caused by degenerative process in the spine. Purpose: To determine the effect of scapular stabilization exercises in the treatment of chronic neck pain regarding pain and disability and limitation in the range of motion. Patients and Methods: Thirty male and female patients with chronic neck pain were involved. Aged between 30-50 years old. They were randomly assigned into two groups. In group (A), patients received physical therapy program in the form of infrared, transcutaneous electrical nerve stimulation (TENS), Stretching and cervical stabilization exercises. In group (B), patients received scapular stabilization exercises in addition to the same physical therapy program. Treatment was given 3 times a week for 4 weeks. Range of motion of the cervical spine, range of motion of the scapula, neck pain and disability were assessed before and after treatment. Results: There was significant improvement in both groups (A and B) in cervical range of motion, pain and disability. Group (B) showed more significant improvement than group (A) in cervical range of motion and pain and disability. There was no significant improvement in both groups in scapular range of motion. Conclusion: Scapular stabilization exercises should be used as an integral part in the rehabilitation program

Keywords: Neck pain, neck stabilization exercise, scapular stabilization exercise, chronic neck pain

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Authors: Anat Yaron Antar, Tomer Einat

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This study explores the effects of the imprisonment of women together with females with mental disorders on the well-being of the former both during imprisonment and after their release from prison. Based on in-depth interviews with 22 women ex-prisoners who had been imprisoned for a period of at least two years in the single Israeli female correctional facility, Neve Tirza Prison, and released one to three months before the initiation of the study to a community-based agency managed by the Israeli Prisoner Rehabilitation Authority, and based on a qualitative, constructive strategy. We found that: (i) mentally ill prisoners’ conduct creates severe feelings of stress and discomfort among many of the prisoners without a mental disorder prisoners; (ii) The intimate and often long-term encounters with prisoners with a mental illness lead to increased feelings of distress, helplessness, fear, and frustration among many of the women prisoners; (iii) the damaging encounters between women prisoners and mentally-ill prisoners harmed the reintegration of the formers into society after release, and (iv) The women ex-prisoners lacked the basic mental, cognitive, and social tools necessary for dealing with female inmates with a mental illness and had received no psychological or emotional support from the prison personnel. Consequently, they suffered – and still suffer – from traumatic and upsetting memories Our findings led us to conclude that women prisoners should be imprisoned separately from female prisoners with mental disorders or be offered a wide range of psychological and emotional coping tools as well as various rehabilitative treatment programs.

Keywords: women, prisoners, mentally ill, health

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Authors: S. Asad Ali Gillani, Ahmed Toumi, Anaclet Turatsinze

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After a certain period of time, the degradation of concrete structures is unavoidable. For large concrete areas, thin bonded cement-based overlay is a suitable rehabilitation technique. Previous research demonstrated that durability of bonded cement-based repairs is always a problem and one of its main reasons is deboning at interface. Since durability and efficiency of any repair system mainly depend upon the bond between concrete substrate and repair material, the bond between concrete substrate and repair material can be improved by increasing the surface roughness. The surface roughness can be improved by performing surface treatment of the concrete substrate to enhance mechanical interlocking which is one of the basic mechanisms of adhesion between two surfaces. In this research, bond tensile strength of cement-based overlays having substrate surface prepared using different techniques has been characterized. In first step cement based substrate was prepared and then cured for three months. After curing two different types of the surface treatments were performed on this substrate; cutting and sandblasting. In second step overlay was cast on these prepared surfaces, which were cut and sandblasted surfaces. The overlay was also cast on the surface without any treatment. Finally, bond tensile strength of cement-based overlays was evaluated in direct tension test and the results are discussed in this paper.

Keywords: concrete substrate, surface preparation, overlays, bond tensile strength

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Ibtisam Al-Zaru

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Background: Worldwide, depression among coronary artery disease (CAD) patients is considered a serious problem that may cause many complications and negative consequences; particularly serious being increased mortality and morbidity rate. Studying depression among CAD patients in Jordan has not been investigated thoroughly and thus a need for further studies has been a priority. Aims: To assess depression in non-hospitalized Jordanian patients with CAD; to describe the relationship between socio-demographic data, health related factors, and depression; and to examine the best predictors of depression in non-hospitalized Jordanian patients with CAD. Method: A cross-sectional-descriptive design was used to collect data from 174 non-hospitalized Jordanian patients diagnosed with CAD in outpatients’ cardiac clinics, using a self- administered questionnaires and Cardiac Depression Scale. Results: 53.4% of CAD patients reported mild/moderate, and severe depressive symptoms. Significant relationships between depressive symptoms and some demo-clinical characteristics (i.e. being female gender; having of chronic disease and surgical history; being physically inactive, and perceived their sexual activity, physical and psychological as poor). The preceding factors are also found to be statistically significant predictors for depression among this patients’ group. Conclusion: Jordanian patients with CAD had various levels of severity regarding their depressive symptoms. Therefore, health care providers need to introduce depression assessment and treatment in cardiac rehabilitation to control depression and its impact on the patient. Consequently, such control will reduce co-morbidity, mortality, complications and health costs among CAD patients and enhance the quality of their lives.

Keywords: coronary artery disease, predictors, depression, prevalence

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Authors: Thamer Kubat, Riadh Al Mahiadi, Ahmad Shayan

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The alkali-aggregate reaction (AAR) in concrete has a negative influence on the mechanical properties and durability of concrete. Confinement by carbon fiber reinforced polymer (CFRP) is an effective method of treatment for some AAR-affected elements. Eighteen reinforced columns affected by different levels of expansion due to AAR were confined using CFRP to evaluate the effect of expansion level on confinement efficiency. Strength and strain capacities (axial and circumferential) were measured using photogrammetry under uniaxial compressive loading to evaluate the efficiency of CFRP wrapping for the rehabilitation of affected columns. In relation to uniaxial compression capacity, the results indicated that the confinement of AAR-affected columns by one layer of CFRP is sufficient to reach and exceed the load capacity of unaffected sound columns. Parallel to the experimental study, finite element (FE) modeling using ATENA software was employed to predict the behavior of CFRP-confined damaged concrete and determine the possibility of using the model in a parametric study by simulating the number of CFRP layers. A comparison of the experimental results with the results of the theoretical models showed that FE modeling could be used for the prediction of the behavior of confined AAR-damaged concrete.

Keywords: ATENA, carbon fiber reinforced polymer (CFRP), confinement efficiency, finite element (FE)

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Authors: Venus Pagare, Amit Kharat, Dhaval K. Thakkar, Tushar J. Palekar

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Introduction: Chronic low back pain (CLBP) is a major public health problem and is the leading musculoskeletal cause of disability. Altered neuromuscular control of core muscles, particulary transverses abdominis (TrA) is thought to be a contributing factor for the development of CLBP. Therefore, various exercises targeting the TrA are commonly incorporated into the rehabilitation. Objectives: To investigate the effects of 3 different core exercises on activation capacity of TrA muscle in individuals with CLBP as compared with healthy controls. Methodology: Thickness of TrA muscle was measured by ultrasound imaging in 30 patients with CLBP and 30 healthy controls. Measurements were taken during 3 different TrA activation exercises i.e Abdominal drawing in maneuver (ADIM), Abdominal drawing in with straight leg raise (ADSLR) and breathe hold at maximum expiration (ME). Thickness of the muscle at rest (at the end of normal tidal expiration) was taken as a baseline measure. Results: There was a significant difference between the healthy subjects and patients with low back pain with regard to the thickness of TrA at rest and thickness during contraction. ADIM produced a significant increase in the thickness of TrA compared to ADSLR and ME (p<0.001). Also, increase in thickness of TrA was more in the control group than patients with low back pain. Conclusion: CLBP patients exhibited atrophy of TrA muscle with delayed activation. Also, of the various core exercises, ADIM can be an effective method for activation of TrA.

Keywords: LBP, CLBP, ADSLR, ADIM

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Authors: Izabela Zielinska

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Kinesio Taping is classified as physiotherapy method supporting rehabilitation and modulating some physiological processes. It is commonly used in sports medicine and orthopedics. This sensory method has influence on muscle function, pain sensation, intensifies lymphatic system as well as improves microcirculation. The aim of this study was to assess the effect of Kinesio Taping in patients with ongoing treatment of peripheral artery disease (PAD). The study group comprised 60 patients (stadium II B at Fontain's scale). All patients were divided into two groups (30 person/each), where 12 weeks long treadmill training was administrated. In the second group, the Kinesio Taping was applied to support the function of the gastrocnemius muscle. The measurements of distance and time until claudication pain, blood flow of arteries in lower limbs and ankle brachial index were taken under evaluation. Examination performed after Kinesio Taping therapy showed statistically significant increase in gait parameters and muscle strength in patients with intermittent claudication. The Kinesio Taping method has clinically significant effects on enhancement of pain-free distance and time until claudication pain in patients with peripheral artery disease. Kinesio Taping application can be used to support non-invasive treatment in patients with intermittent claudication. Kinesio Taping can be employed as an alternative way of therapy for patients with orthopedic or cardiac contraindications to be treated with treadmill training.

Keywords: intermittent claudication, kinesiotaping, peripheral artery disease, treadmill training

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Authors: L. Almulla

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Native plants are better adapted to the local environment providing a more natural effect on landscape projects; their use will both conserve natural resources and produce sustainable greenery. Continuation of evaluation of additional native plants is essential to increase diversity of plant resources for greenery projects. Therefore, in this project an effort was made to study the mass multiplication of further native plants for greenery applications. Standardization of vegetative propagation methods is essential for conservation and sustainable utilization of native plants in restoration projects. Moreover, these simple propagation methods can be readily adapted by the local nursery sector in Kuwait. In the present study, various treatments were used to mass multiply selected plants using vegetative parts to secure maximum rooting and initial growth. Soft or semi-hardwood cuttings of selected native plants were collected from mother plants and subjected to different treatments. Pennisetum divisum can be vegetatively propagated by cuttings/off-shoots. However, Tamarix aucheriana showed maximum number of rooted cuttings and stronger vigor seedlings with the lowest growth hormone concentration. Standardizing the propagation techniques for the native plant species will add to the rehabilitation and landscape revegetation projects in Kuwait.

Keywords: Kuwait desert, landscape, rooting percentage, vegetative propagation

Procedia PDF Downloads 116

Authors: Andrew Anis Fakhrey Mosaad

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Objectives: Physiotherapy in the intensive care unit (ICU) improves patient outcomes. We aimed to determine the characteristics of physiotherapy practice and critical barriers to applying physiotherapy in ICUs. Materials and Methods: A 54-item survey for determining the characteristics physiotherapists and physiotherapy applications in the ICU was developed. The survey was electronically sent to potential participants through the Turkish Physiotherapy Association network. Sixty-five physiotherapists (47F and 18M; 23–52 years; ICU experience: 6.0±6.2 years) completed the survey. The data were analyzed using quantitative and qualitative methods. Results: The duration of ICU practice was 3.51±2.10 h/day. Positioning (90.8%), active exercises (90.8%), breathing exercises (89.2%), passive exercises (87.7%), and percussion (87.7%) were the most commonly used applications. The barriers were related to physiotherapists (low level of employment and practice, lack of shift); patients (unwillingness, instability, participation restriction); teamwork (lack of awareness and communication); equipment (inadequacy, non-priority to purchase); and legal (reimbursement, lack of direct physiotherapy access, non-recognition of autonomy) procedures. Conclusion: The most common interventions were positioning, active, passive, breathing exercises, and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, teams, equipment, and legal procedures. Physiotherapist employment, service maintenance, and multidisciplinary teamwork should be considered for physiotherapy effectiveness in ICUs.

Keywords: intensive care units, physical therapy, physiotherapy, exercises

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Authors: Eman A. Embaby, Amira A. A. Abdallah

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Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30 min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs. 29.07±2.4 years, weight 63.6±7 vs. 60±7.8 kg, and height 162.73±4 vs. 162.8±6 cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p<0.05) lower frequencies for the right and left ES, and right GM in the last 5 min and significantly higher frequencies for the left RA in the first and last 5min than group B. In addition, the left ES and right EO, ES and GM in group B showed significantly higher frequencies and the left ES in group A showed significantly lower frequencies in the last 5min compared with the first. Moreover, the right RA showed significantly higher frequencies than the left in the last 5min in group B. Finally, there were significant (p<0.05) correlations among the median frequencies of the tested four muscles on the same side and between both sides in both groups. Discussion/Conclusions: Clinical instructors with LBP are more liable to have higher trunk and gluteus-medius muscle fatigue than asymptomatic individuals. Thus, endurance training for these muscles should be included in the rehabilitation of such patients.

Keywords: EMG, fatigability, gluteus-medius, LBP, standing, trunk

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Authors: Balaji Devanathan, Gokul G., Abilash S., Abhishek Yadav, Sudhir K. Gupta

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Background: As an alternative to the traditional autopsy, a virtual autopsy is carried out using scanning and imaging technologies, mainly post-mortem computed tomography (PMCT). This facility aims to supplement traditional autopsy results and reduce or eliminate internal dissection in subsequent autopsies. For emotional and religious reasons, the deceased's relatives have historically disapproved such interior dissection. The non-invasive, objective, and preservative PMCT is what friends and family would rather have than a traditional autopsy. Additionally, it aids in the examination of the technologies and the benefits and drawbacks of each, demonstrating the significance of contemporary imaging in the field of forensic medicine. Results: One hundred falls resulting in fatalities was analysed by the writers. Before the autopsy, each case underwent a PMCT examination using a 16-slice Multi-Slice CT spiral scanner. By using specialised software, MPR and VR reconstructions were carried out following the capture of the raw images. The accurate detection of fractures in the skull, face bones, clavicle, scapula, and vertebra was better observed in comparison to a routine autopsy. The interpretation of pneumothorax, Pneumoperitoneum, pneumocephalus, and hemosiuns are much enhanced by PMCT than traditional autopsy. Conclusion. It is useful to visualise the skeletal damage in fall from height cases using a virtual autopsy based on PMCT. So, the ideal tool in traumatising patients is a virtual autopsy based on PMCT scans. When assessing trauma victims, PMCT should be viewed as an additional helpful tool to traditional autopsy. This is because it can identify additional bone fractures in body parts that are challenging to examine during autopsy, such as posterior regions, which helps the pathologist reconstruct the victim's life and determine the cause of death.

Keywords: PMCT, fall from height, autopsy, fracture

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Authors: Sopian Brahim, Mohd Suhaimi Mohamad, Ezarina Zakaria, Norulhuda Sarnon

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This study aims to explore the practical experience of child welfare case workers and professionalism in the child case management in Malaysia. This paper discusses the specific social work practice competency and challenges faced by child caseworkers in the fieldwork. This research is qualitative with Grounded Theory approach. Four sessions of Focused Group Discussion (FGD) have been conducted involving a total of 27 caseworkers (child protector and probation officers) in the Klang Valley. The study found that the four basic principles of knowledge in child case management namely: 1. Knowledge in child case management, 2. Professional values of caseworkers towards children, 3. skills in managing cases, and 4. Culturally competence practice in child case managemenr. In addition, major challenges faced in the child case management are the capacity and commitment of the family in children's rehabilitation program, the credibility of the case worker are being challenge and challenges in support system from intra and inter-agency. This study is important for policy makers to take into account the capacity and needs of the child's case worker in accordance with national social work competency framework thereby improving case management services for children more systematically in line with national standards.

Keywords: social work practice, child case management, competency-based knowledge, professionalism

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Authors: Sultana Razia

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The number of children whose social, communication and behavior pattern is affected due to mental and developmental conditions is on the rise. Most of these conditions develop to uncontrollable levels because of ignorance and unaware about their child’s condition. The many myths surrounding mental or developmental conditions are a major cause of families of affected children to develop bitterness and to shy off from seeking appropriate help in time. Several early intervention programs have been put in place, and the number of beneficiaries of these programs is increasing by the day. This research seeks to look into early intervention programs and their effectiveness. The purpose of this study was to investigate the effect of early therapeutic intervention for the children with autism spectrum disorder. Participants were 140 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. This study included children who are at age of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disability or medical conditions excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy were provided. The results indicated that early intensive therapeutic intervention improve understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention a positive effect on diminishing symptoms of Autism Spectrum Disorder.

Keywords: M-CHAT, ASD, sensory cheeklist, OT

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Authors: Andres Bautista, Alicia Porras, Juan P. Casas, Maribel Silva

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The Colombian aeronautical industry has stimulated research in the mechanical behavior of materials under different loading conditions aircrafts are generally exposed during its operation. The Calima T-90 is the first military aircraft built in the country, used for primary flight training of Colombian Air Force Pilots, therefore, it may be exposed to adverse operating situations such as hard landings which cause impact loads on the aircraft that might produce the impact fatigue phenomenon. The Calima T-90 structure is mainly manufactured by composites materials generating assemblies and subassemblies of different components of it. The main method of bonding these components is by using adhesive joints. Each type of adhesive bond must be studied on its own since its performance depends on the conditions of the manufacturing process and operating characteristics. This study aims to characterize the typical adhesive joints of the aircraft under usual loads. To this purpose, the evaluation of the effect of adhesive thickness on the mechanical performance of the joint under quasi-static loading conditions, constant amplitude fatigue and cyclic impact fatigue using single lap-joint specimens will be performed. Additionally, using a double cantilever beam specimen, the influence of the thickness of the adhesive on the crack growth rate for mode I delamination failure, as a function of the critical energy release rate will be determined. Finally, an analysis of the fracture surface of the test specimens considering the mechanical interaction between the substrate (composite) and the adhesive, provide insights into the magnitude of the damage, the type of failure mechanism that occurs and its correlation with the way crack propagates under the proposed loading conditions.

Keywords: adhesive, composites, crack propagation, fatigue

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Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

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Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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Authors: Saeed Alshahri

Abstract:

Introduction: Our study aims to estimate the characteristics & causes of TSCI at King Fahad Medical City (KFMC) in Riyadh city in order to hypothesize strategy for primary prevention of traumatic spinal cord injury. Method: Cross-sectional, retrospective study was conducted on all TSCI patients who aged 14 and above and who were admitted to rehabilitation center of King Fahad Medical City from January 2012 to December 2015. Furthermore, a descriptive analysis was conducted while considering factors including age, gender, marital status, educational level and causes of injury and characteristics of injury. Results: Total of 216 patients were admitted during this period, mean age was 28.94, majority of patients were male (86.5%), 71.7% of total patients were high school level of education or less, 68% were single, RTA was the main cause with 90.7% and the main result of TSCI was complete paraplegia 37%. Furthermore, statistically, we found that males are at a low risk of having incomplete paraplegia compared to female (p = 0.035, RRR=0.35). Conclusion: The rate of TSCI related to RTA has increased in Saudi Arabia in previous years despite the government’s efforts to decrease RTA. It’s clear that we need TSCI registry data developed on the basis of international data standards to have a clear idea about the exact etiology of TSCI in Saudi Arabia. This will assist in planning for primary prevention.

Keywords: traumatic spinal cord injury, road traffic accident, Saudi Arabia, spinal cord injury

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Authors: Akbar Darouie, Mamak Joulaie

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In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.

Keywords: hearing impairment, phonology, vowel, consonant

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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