Search results for: severity of illness

Authors: Wencong Lu, Abdul Latif, Raza Ullah, Subhan Ullah

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Agricultural production is subject to risk and the attitudes of producers toward risk, in turn, may be affected by certain socioeconomic characteristics of producers. Although, it is important to assess the risk attitude of farmers and their perception towards different calamitous risk sources for better understanding of their risk management adoption decisions, to the best of our knowledge no studies have been carried out to analyze the risk attitude and risk perceptions in the context of tobacco production in Pakistan. Therefore the study in hand is conducted with an attempt to overcome the gap in existing literature by analyzing different catastrophic risk sources faced by tobacco growers, their attitude towards risk and the effect of socioeconomic and demographic characteristics, farmers’ participation in contract farming and off-farm diversification on their risk attitude and risk perception. Around 78% of Pakistan’s entire tobacco crop and nearly all of the country’s Flue-Cured Virginia (FCV) tobacco is produced in Khyber Pakhtunkhwa (KPK) province alone. The yield/hectare of tobacco produced in KPK province is 14% higher than the global average and 22 % higher than national average. Khyber Pakhtunkhwa province was selected as main study area as nearly all of the country’s Flue-Cured Virginia (FCV) tobacco is produced in Khyber Pakhtunkhwa (KPK) province alone. Six districts were purposely selected based on their contribution in overall production for the last five years which accounts for more than 94.84% of the tobacco production in KPK province. Specific objectives taken into considerations for this study are the risk attitude of the farmers for growing FCV tobacco crop, farmers’ risk perception for different risk sources related to tobacco production (as far as the incidence and severity of each risk source is concerned) and the effect of socioeconomic characteristics, contract farming participation and off-farm diversification (income) on the risk attitude and risk perception of FCV tobacco growers.

Keywords: risk attitude, risk perception, contract farming, off-farm diversification, probit model

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Authors: Dassou Nagassou

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Recent increase in frequency and severity of climatic impacts throughout the world has put a particular emphasis on the urgency to address the anthropogenic greenhouse gas emissions. The latter, mainly composed of carbon dioxide are responsible for the global warming of planet earth. Despite efforts to transition towards a zero-emission economy, manufacturing industries, electricity generation power plants, and transportation sectors continue to encounter challenges which hinder their progress towards a full decarbonization. The growing energy demand from both developed and under-developed economies exacerbates the situation and as a result, more carbon dioxide is discharged into the atmosphere. This situation imposes a lot of constraints on industries which are involved i.e., manufacturing industries, transportation, and electricity generation which must navigate the stringent environmental regulations in order to remain profitable. Existing solutions such as energy efficiencies, green materials (life cycle analysis), and many more have fallen short to address the problem due to their inadaptation to existing infrastructures, low efficiencies, and prohibitive costs. The proposed technology exploits the synergistic interaction between solar radiation and plasma to boost a direct decomposition of the molecules of carbon dioxide while producing alternative fuels which can be used to sustain on-site high-temperature processes via 100% solar energy harvesting in the form of photons and electricity. The advantages of this technology and its ability to be easily integrated into existing systems make it appealing for the industry which can now afford to fast track on the path towards full decarbonization, thanks to the solar plasma reactor. Despite the promising experimental results which proved the viability of this concept, solar-plasma reactors require further investigations to understand the synergistic interactions between plasma and solar radiation for a potential technology scale-up.

Keywords: solar, non-equilibrium, plasma, reactor, greenhouse-gases, solar-fuels

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Authors: Ammaarah Gamieldien

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Depression is a very common and serious mental illness that has a significant impact on both the social and economic aspects of sufferers worldwide. This study aimed to investigate the association between body mass index (BMI), blood pressure, and lipid profiles with mental health symptoms in university students. Secondary objectives included the associations between the variables (BMI, blood pressure, and lipids) with themselves, as they are key factors in cardiometabolic disease. Sixty-three (63) students participated in the study. Thirty-two (32) were assigned to the control group (minimal-mild depressive symptoms), while 31 were assigned to the depressive group (moderate to severe depressive symptoms). Montgomery-Asberg Depression Rating Scale (MADRS) and Beck Depression Inventory (BDI) were used to assess depressive scores. Anthropometric measurements such as weight (kg), height (m), waist circumference (WC), and hip circumference were measured. Body mass index (BMI) and ratios such as waist-to-hip ratio (WHR) and waist-to-height ratio (WtHR) were also calculated. Blood pressure was measured using an automated AfriMedics blood pressure machine, while lipids were measured using a CardioChek plus analyzer machine. Statistics were analyzed via the SPSS statistics program. There were no significant associations between anthropometric measurements and depressive scores (p > 0.05). There were no significant correlations between lipid profiles and depression when running a Spearman’s rho correlation (P > 0.05). However, total cholesterol and LDL-C were negatively associated with depression, and triglycerides were positively associated with depression after running a point-biserial correlation (P < 0.05). Overall, there were no significant associations between blood pressure measurements and depression (P > 0.05). However, there was a significant moderate positive correlation between systolic blood pressure and MADRS scores in males (P < 0.05). Depressive scores positively and strongly correlated to how long it takes participants to fall asleep. There were also significant associations with regard to the secondary objectives. This study indicates the importance of determining the prevalence of depression among university students in South Africa. If the prevalence and factors associated with depression are addressed, depressive symptoms in university students may be improved.

Keywords: depression, blood pressure, body mass index, lipid profiles, mental health symptoms

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Authors: Bindu I. Somarajan, Viney Gupta, Gagandeep Kaur Walia, Jasbir Kaur, Sunil Kumar, Shikha Gupta, Abadh K. Chaurasia, Dinesh Gupa, Abhinav Kaushik, Aditi Mehta, Vipin Gupta, Arundhati Sharma

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Background: Juvenile onset primary open angle glaucoma (JOAG), affects individuals under the age of 40 years. Studies on a few families of JOAG, that led to the discovery of the Myocilin gene, reported the disease to have an autosomal dominant pattern of inheritance. However, sporadic forms of JOAG been seen to be more common in some populations. Most pathological homozygous mutations in the CYP1B1 gene associated with JOAG have been seen among sporadic cases. Given the higher prevalence of sporadic JOAG cases in our population, we aimed to look for common mutations E229K and R368H, the two most common variants in the CYP1B1 gene associated with glaucoma. Objective: To determine the frequency and evaluate genotype phenotype correlation of CYP1B1 E229K and R368H mutations in a cohort of 120 sporadic Juvenile open angle glaucoma patients.Methods: Unrelated JOAG patients whose first degree relatives had been examined and found to be unaffected were included in the study. The patients and their parents were screened for E229K and R368H mutations. The phenotypic characteristics were compared between probands with and with out these mutations by SPSS v16. Results: Out of 120 JOAG patients included in the study, the E229K mutation was seen in 9 probands (7.5%) and R368H in 7 (5.8%). The average age of onset of the disease (p=0.3) and the highest untreated IOP (p=0.4) among those carrying mutations was not significantly different from those who did not have these mutations. The proportion of probands with angle dysgenesis among those with E229K and R368H mutations was 70% (11 out of 16) in comparison to 65% (67 out of 104) of those who did not harbour these mutations (p=0.56). Similarly the probands with moderate to high myopia among those with E229K and R368H mutations was 20% (3 out of 16) in comparison to 18% (18 out of 104) of those who did not harbour these mutations(p=0.59). Conclusion: The frequency of E229K and R368H mutations of the CYP1B1 gene is low even among sporadic JOAG patients. Moreover there is no clinical correlation between the presence of these mutations and disease severity

Keywords: CYP1B1, gene, IOP, JOAG, mutation

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Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

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Authors: Durjoy Lahiri, Vishal Madhukar Sawale, Ashwani Bhat, Souvik Dubey, Gautam Das, Biman Kanti Roy, Suparna Chatterjee, Goutam Gangopadhyay

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Crossed aphasia has been an area of considerable interest for cognitive researchers as it offers a fascinating insight into cerebral lateralization for language function. We conducted an observational study in the stroke unit of a tertiary care neurology teaching hospital in eastern India on subjects with crossed aphasia over a period of four years. During the study period, we detected twelve cases of crossed aphasia in strongly right-handed patients, caused by ischemic stroke. The age, gender, vernacular language and educational status of the patients were noted. Aphasia type and severity were assessed using Bengali version of Western Aphasia Battery (validated). Computed tomography, magnetic resonance imaging and angiography were used to evaluate the location and extent of the ischemic lesion in brain. Our series of 12 cases of crossed aphasia included 7 male and 5 female with mean age being 58.6 years. Eight patients were found to have Broca’s aphasia, 3 had trans-cortical motor aphasia and 1 patient suffered from global aphasia. Nine patients were having very severe aphasia and 3 suffered from mild aphasia. Mirror-image type of crossed aphasia was found in 3 patients, whereas 9 had anomalous variety. In our study crossed aphasia was found to be more frequent in males. Anomalous pattern was more common than mirror-image. Majority of the patients had motor-type aphasia and no patient was found to have pure comprehension deficit. We hypothesize that in Bengali-speaking right-handed population, lexical-semantic system of the language network remains loyal to the left hemisphere even if the phonological output system is anomalously located in the right hemisphere.

Keywords: aphasia, crossed, lateralization, language function, vascular

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Authors: B. Yermekbayeva, A. Gulyayaev, T. Nurgozhin, C. Bektur

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Cytisine aminophosphonate under the name "Cytafat" was approved for clinical trials in Republic of Kazakhstan as a putative liver protecting drug for the treatment of acute toxic hepatitis. A method of conducting the clinical trial is a double blind study. Total number of patients -71, aged from 16 to 56 years. Research on healthy volunteers determined the maximal tolerable doze of "Cytafat" as 200 mg/kg. Side effects when administered at high dozes (100-200 mg/kg) are tachycardia and increase of arterial blood pressure. The drug is tested in the treatment of 28 patients with a syndrome of hepatocellular failure (a poisoning with substitutes of alcohol, rat poison, or medical products). "Cytafat" was intravenously administered at a dose of 10 mg/kg in 200 ml of 5 % glucose solution once daily. The number of administrations: 1-3. In the comparison group, 23 patients were treated intravenously once a day with “Essenciale H” at a dose of 10 ml. 20 patients received a placebo (10 ml of glucose intravenously). In all cases of toxic hepatopathology the significant positive clinical effect of the testing drug distinguishable from placebo and surpassing the alternative was observed. Within a day after administration a sharp reduction of cytolitic syndrome parameters (ALT, AST, alkaline phosphatase, thymol turbidity test, GGT) was registered, a reduction of the severity of cholestatic syndrome (bilirubin decreased) was recorded, significantly decreased indices of lipid peroxidation. The following day, in all cases the positive dynamics was determined with ultrasound study (reduction of diffuse changes and events of reactive pancreatitis), hepatomegaly disappeared. Normalization of all parameters occurred in 2-3 times faster, than when using the drug "Essenciale H" and placebo. Average term of elimination of toxic hepatopathy when using the drug "Cytafat" -2,8 days, "Essenciale H" -7,2 days, and placebo -10,6 days. The new drug "Cytafat" has expressed cytoprotective properties.

Keywords: cytisine, cytoprotection, hepatopathy, hepatoprotection

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Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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Authors: Chakrit Chotamonsak

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This study was analyzed changes in temperature and precipitation extremes in northern Thailand for the period 1981-2011.The study includes an analysis of the average and trends of changes in temperature and precipitation using 22 climate indices, related to the intensity, frequency and duration of extreme climate events. The results showed that the averaged trend of maximum, minimum and mean temperature is likely to increase over the study area in rate of 0.5, 0.9 and 0.7 °C in last 30 years. Changes in temperature at nighttime, then rising at a rate higher daytime is resulting to decline of diurnal temperature range throughout the area. Trend of changes in average precipitation during the year 1981-2011 is expected to increase at an average rate of 21%. The intensity of extreme temperature events is increasing almost all station. In particular, the changes of the night were unusually hot has intensified throughout the region. In some provinces such as Chiang Mai and Lampang are likely be faced with the severity of hot days and hot nights in increasing rate. Frequency of extreme temperature events are likely to increase each station, especially hot days, and hot nights are increasing at a rate of 2.38 and 3.58 days per decade. Changes in the cold days and cold nights are declining at a rate of 0.82 and 3.03 days per decade. The duration of extreme temperature events is expected to increase the events hot in every station. An average of 17.8 days per decade for the number of consecutive cold winter nights likely shortens the rate of 2.90 days per decade. The analysis of the precipitation indices reveals the intensity of extreme precipitation is increasing almost across the region. The intensify expressed the heavy rain in one day (Rx1day) and very heavy rain accumulated in 5 days (RX5day) which is likely to increase, and very heavy rainfall is likely to increase in intensity. Frequency of extreme precipitation events is likely to increase over the station. The average frequency of heavy precipitation events increased xxx days per decade. The duration of extreme precipitation events, such as the consecutive dry days are likely to reduce the numbers almost all station while the consecutive wet days tends to increase and decrease at different numbers in different areas.

Keywords: climate extreme, temperature extreme, precipitation extreme, Northern Thailand

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: Mengfei Peng, Serajus Salaheen, Debabrata Biswas

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Lactobacillus casei found in the human intestine and mouth is commonly applied for dairy production. Recently, it was found that some byproducts produced by Lactobacillus exhibited antimicrobial activities against multiple bacteria. Meanwhile, introduction of prebiotic-like foods (e.g. cocoa) or probiotics or both of them as food supplements in human diets as well as in farm animal feeds is believed to be an effective ways in control/reduce the colonization of foodborne bacterial pathogens infection in the gut environment. We hypothesized that cocoa may stimulate the production antimicrobial components of Lactobacillus casei and may potentially inhibit/reduce the colonization and infection of foodborne bacterial pathogens in the gut. Mixed culture of L. casei (LC) with enterohemorrhagic E. coli EDL933 (EHEC), Salmonella Typhimurium LT2 (ST), or Listeria monocytogenes LM2 (LM) showed that LC could competitively exclude (100%) them within 72 h. Further, investigation of cell-free culture supernatant (CFCS) revealed that the antimicrobial effects of LC came from CFCS. CFCS of LC eliminated (100%) EHEC, ST, and LM within 72 h, and 2 h CFCS treatment increased the hydrophobicity of EHEC (5.10 folds), ST (8.48 folds), and LM (2.03 folds). In addition, LC cells exhibited more inhibitive effects than CFCS on cell adhesive and invasive activities of EHEC (52.14% & 90.45%), ST (66.89% & 93.83%), and LM (61.10% & 83.40%). Two clusters of poly-peptides in CFCS were identified by SDS-PAGE, the molecular weights of which are ≈5 KD and 40-45 KD. LC CFCS with overnight growth in the presence of 3% strengthened all of the antimicrobial activities (growth inhibition, outer membrane disruption, and cell infective ability reduction). Liquid chromatography/Mass spectrometry analysis detected 5 unique components in class of flavonoids in LC CFCS with overnight 3% cocoa supplement. Furthermore, qPCR results showed that CFCSs up-regulated the expression level of genes responsible for flagellin synthesis and motility, but down-regulated genes for specific binding and invasion-associated proteins synthesis. The stimulatory effects of cocoa in producing bioactive components of probiotics may aid prevention of foodborne illness caused by major foodborne enteric bacterial pathogens.

Keywords: foodborne pathogens, probiotics, prebiotics, pathogen exclusion

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Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

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Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

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Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: In carbon monoxide (CO) intoxication, the pathophysiology of delayed neurological sequelae (DNS) is very complex and remains poorly understood. And predicting whether patients who exhibit resolved acute symptoms have escaped or will experience DNS represents a very important clinical issue. Brain magnetic resonance (MR) imaging has been conducted to assess the severity of brain damage as an objective method to predict prognosis. And co-ingestion of a second poison in patients with intentional CO poisoning occurs in almost one-half of patients. Among patients with co-ingestions, 66% ingested ethanol. We assessed the effects of ethanol on neurologic sequelae prevalence in acute CO intoxication by means of abnormal lesion in brain MR. Method: This study was conducted retrospectively by collecting data for patients who visited an emergency medical center during a period of 5 years. The enrollment criteria were diagnosis of acute CO poisoning and the measurement of the serum ethanol level and history of taking a brain MR during admission period. Official readout data by radiologist are used to decide whether abnormal lesion is existed or not. The enrolled patients were divided into two groups: patients with abnormal lesion and without abnormal lesion in Brain MR. A standardized extraction using medical record was performed; Mann Whitney U test and logistic regression analysis were performed. Result: A total of 112 patients were enrolled, and 68 patients presented abnormal brain lesion on MR. The abnormal brain lesion group had lower serum ethanol level (mean, 20.14 vs 46.71 mg/dL) (p-value<0.001). In addition, univariate logistic regression analysis showed the serum ethanol level (OR, 0.99; 95% CI, 0.98 -1.00) was independently associated with the development of abnormal lesion in brain MR. Conclusion: Ethanol could have neuroprotective effect in acute CO intoxication by sedative effect in stressful situation and mitigative effect in neuro-inflammatory reaction.

Keywords: carbon monoxide, delayed neuropsychological sequelae, ethanol, intoxication, magnetic resonance

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Suresh Hettiarachchi, Conrad Wasko, Ashish Sharma

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The ever changing and expanding urban landscape increases the stress on urban systems to support and maintain safe and functional living spaces. Flooding presents one of the more serious threats to this safety, putting a larger number of people in harm’s way in congested urban settings. Climate change is adding to this stress by creating a dichotomy in the urban flood response. On the one hand, climate change is causing storms to intensify, resulting in more destructive, rarer floods, while on the other hand, longer dry periods are decreasing the severity of more frequent, less intense floods. This variability is creating a need to be more agile and innovative in how we design for and manage urban flooding. Here, we argue that to cope with this challenge climate change brings, we need to move towards urban flood management through resilience rather than flood prevention. We also argue that dealing with the larger variation in flood response to climate change means that we need to look at flooding from all aspects rather than the single-dimensional focus of flood depths and extents. In essence, we need to rethink how we manage flooding in the urban space. This change in our thought process and approach to flood management requires a practical way to assess and quantify resilience that is built into the urban landscape so that informed decision-making can support the required changes in planning and infrastructure design. Towards that end, we propose a Simple Urban Flood Resilience Index (SUFRI) based on a robust definition of resilience as a tool to assess flood resilience. The application of a simple resilience index such as the SUFRI can provide a practical tool that considers urban flood management in a multi-dimensional way and can present solutions that were not previously considered. When such an index is grounded on a clear and relevant definition of resilience, it can be a reliable and defensible way to assess and assist the process of adapting to the increasing challenges in urban flood management with climate change.

Keywords: urban flood resilience, climate change, flood management, flood modelling

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Authors: Richard Adu Antwako

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Coastal wetland destruction and its consequences have recently taken the center stage of global discussions. This phenomenon is no gray area to humanity as coastal wetland-human interaction seems inevitably ingrained in the earliest civilizations, amidst the demanding use of its resources to meet their necessities. The severity of coastal wetland destruction parallels with growing civilizations, and it is against this backdrop that, this paper interrogated the causes of coastal wetland destruction in Harper City in Liberia, compared the degree of coastal wetland stressors to the non-equilibrium thermodynamic scale as well as suggested an integrated coastal zone management to address the problems. Literature complemented the primary data gleaned via global positioning system devices, field observation, questionnaire, and interviews. Multi-sampling techniques were used to generate data from the sand miners, institutional heads, fisherfolk, community-based groups, and other stakeholders. Non-equilibrium thermodynamic theory remains vibrant in discerning the ecological stability, and it would be employed to further understand the coastal wetland destruction in Harper City, Liberia and to measure the coastal wetland stresses-amplitude and elasticity. The non-equilibrium thermodynamics postulates that the coastal wetlands are capable of assimilating resources (inputs), as well as discharging products (outputs). However, the input-output relationship exceedingly stretches beyond the thresholds of the coastal wetlands, leading to coastal wetland disequilibrium. Findings revealed that the sand mining, mangrove removal, and crude dumping have transformed the coastal wetlands, resulting in water pollution, flooding, habitat loss and disfigured beaches in Harper City in Liberia. This paper demonstrates that the coastal wetlands are converted into developmental projects and agricultural fields, thus, endangering the future society against nature.

Keywords: amplitude, crude dumping, elasticity, non-equilibrium thermodynamics, wetland destruction

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Authors: Debit Datta, Jeffrey J. Coleman, Scott A. Enebak, Lori G. Eckhardt

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Loblolly pine (Pinus taeda) is a leading productive timber species in the southeastern USA. Over the past three years, an emerging threat is expressed by successive needle defoliation followed by stunted growth and tree mortality in loblolly pine plantations. Considering economic significance, it has now become a rising concern among landowners, forest managers, and forest health state cooperators. However, the symptoms of the disease were perplexed somewhat with root disease(s) and recurrently attributed to invasive Phytophthora species due to the similarity of disease nature and devastation. Therefore, the study investigated the potential causal agent of this disease and characterized the fungi associated with loblolly pine needle defoliation in the southeastern USA. Besides, 70 trees were selected at seven long-term monitoring plots at Chatom, Alabama, to monitor and record the annual disease incidence and severity. Based on colony morphology and ITS-rDNA sequence data, a total of 28 species of fungi representing 17 families have been recovered from diseased loblolly pine needles. The native brown-spot pathogen, Lecanosticta acicola, was the species most frequently recovered from unhealthy loblolly pine needles in combination with some other common needle cast and rust pathogen(s). Identification was confirmed using morphological similarity and amplification of translation elongation factor 1-alpha gene region of interest. Tagged trees were consistently found chlorotic and defoliated from 2019 to 2020. The current emergence of the brown-spot pathogen causing loblolly pine mortality necessitates the investigation of the role of changing climatic conditions, which might be associated with increased pathogen pressure to loblolly pines in the southeastern USA.

Keywords: brown-spot needle blight, loblolly pine, needle defoliation, plantation forestry

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Authors: Khaled Barkaoui

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Research on second-language (L2) learning tends to focus on comparing students with different levels of proficiency at one point in time. However, to understand L2 development, we need more longitudinal research. In this study, we adopt a longitudinal approach to examine changes in three indicators of L2 ability, complexity, accuracy, and fluency (CAF), as reflected in the writing of L2 learners when writing on different tasks before and after a period L2 instruction. Each of 85 Chinese learners of English at three levels of English language proficiency responded to two writing tasks (independent and integrated) before and after nine months of English-language study in China. Each essay (N= 276) was analyzed in terms of numerous CAF indices using both computer coding and human rating: number of words written, number of errors per 100 words, ratings of error severity, global syntactic complexity (MLS), complexity by coordination (T/S), complexity by subordination (C/T), clausal complexity (MLC), phrasal complexity (NP density), syntactic variety, lexical density, lexical variation, lexical sophistication, and lexical bundles. Results were then compared statistically across tasks, L2 proficiency levels, and time. Overall, task type had significant effects on fluency and some syntactic complexity indices (complexity by coordination, structural variety, clausal complexity, phrase complexity) and lexical density, sophistication, and bundles, but not accuracy. L2 proficiency had significant effects on fluency, accuracy, and lexical variation, but not syntactic complexity. Finally, fluency, frequency of errors, but not accuracy ratings, syntactic complexity indices (clausal complexity, global complexity, complexity by subordination, phrase complexity, structural variety) and lexical complexity (lexical density, variation, and sophistication) exhibited significant changes after instruction, particularly for the independent task. We discuss the findings and their implications for assessment, instruction, and research on CAF in the context of L2 writing.

Keywords: second language writing, Fluency, accuracy, complexity, longitudinal

Procedia PDF Downloads 148

Authors: Chris Phan, Yong Seok Park

Abstract:

The Toyota Camry is one of the best-selling cars in America. It is economical, reliable, and most importantly, safe. These attributes allowed the Camry to be the trustworthy choice when choosing dependable vehicle. However, a new finding brought question to the Camry’s safety. Since 1997, the Camry received a “good” rating on its moderate overlap front crash test through the Insurance Institute of Highway Safety. In 2012, the Insurance Institute of Highway Safety introduced a frontal small overlap crash test into the overall evaluation of vehicle occupant safety test. The 2012 Camry received a “poor” rating on this new test, while the 2015 Camry redeemed itself with a “good” rating once again. This study aims to find a possible solution that Toyota implemented to reduce the severity of a frontal small overlap crash in the Camry during a mid-cycle update. The purpose of this study is to analyze and evaluate the performance of various A-pillar shapes as energy absorbing structures in improving passenger safety in a frontal crash. First, A-pillar structures of the 2012 and 2015 Camry were modeled using CAD software, namely SolidWorks. Then, a crash test simulation using ANSYS software, was applied to the A-pillars to analyze the behavior of the structures in similar conditions. Finally, the results were compared to safety values of cabin intrusion to determine the crashworthy behaviors of both A-pillar structures by measuring total deformation. This study highlights that it is possible that Toyota improved the shape of the A-pillar in the 2015 Camry in order to receive a “good” rating from the IIHS safety evaluation once again. These findings can possibly be used to increase safety performance in future vehicles to decrease passenger injury or fatality.

Keywords: A-pillar, Crashworthiness, Design Synthesis, Finite Element Analysis

Procedia PDF Downloads 109

Authors: Neşe Alkan

Abstract:

Purpose: The point that applied/clinical psychology, which is the practice and research discipline of the mental health field, has reached today can be summarized as the necessity of handling the psychological well-being of people from multiple perspectives and the goal of moving it to a higher level. Clients' subjective assessment of their own condition and wellbeing is an integral part of evidence-based interventions. There is a need for tools through which clients can evaluate the effectiveness of the psychotherapy/intervention performed with them and their contribution to the wellbeing and wellbeing of this process in a valid and reliable manner. The aim of this research is to meet this need, to test the reliability and validity of the index in Turkish, and explore its usability in the practices of both researchers and psychotherapists. Method: A total of 213 adults aged between 18-54, 69.5% working and 29.5% university students, were included in the study. Along with their demographic information, the participants were administered a set of scales: wellbeing, life satisfaction, spiritual satisfaction, shopping addiction, and loneliness, namely via an online platform. The construct validity of the wellbeing scale was tested with exploratory and confirmatory factor analyses, convergent and discriminant validity were tested with two-way full and partial correlation analyses and, measurement invariance was tested with one-way analysis of variance. Results: Factor analyzes showed that the scale consisted of six dimensions as it is in its original structure. The internal consistency of the scale was found to be Cronbach α = .82. Two-way correlation analyzes revealed that the wellbeing scale total score was positively correlated with general life satisfaction (r = .62) and spiritual satisfaction (r = .29), as expected. It was negatively correlated with loneliness (r = -.51) and shopping addiction (r = -.15). While the scale score did not vary by gender, previous illness, or nicotine addiction, it was found that the total wellbeing scale scores of the participants who had used antidepressant medication during the past year were lower than those who did not use antidepressant medication (F(1,204) = 7.713, p = .005). Conclusion: It has been concluded that the 12-item wellbeing scale consisting of six dimensions can be used in research and health sciences practices as a valid and reliable measurement tool. Further research which examines the reliability and validity of the scale in different widely used languages such as Spanish and Chinese is recommended.

Keywords: wellbeing, intervention effectiveness, reliability and validity, effectiveness

Procedia PDF Downloads 173

Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Razia Sultana, Md Faroque Miah

Abstract:

Mental health remains a significant global public health challenge, profoundly affecting millions worldwide. In Bangladesh, the situation is dire, with the National Mental Health Survey 2018-19 indicating that 19% of adults suffer from any kind of mental disorders, including severe mental disorder of around 2%. Despite these high prevalence rates, there is a substantial treatment gap in low- and middle-income countries, including Bangladesh, where up to 92% of individuals with mental illnesses do not receive adequate care. This gap is exacerbated by social barriers such as stigma, discrimination, social exclusion, poverty, homelessness, and human rights violations. To address these challenges, the SAJIDA Foundation launched the Proshanti in November 2022. Proshanti is a community based supportive housing intervention designed to provide cost-effective, sustainable, long-term care for individuals with chronic mental illnesses. It aims to rehabilitate participants by improving their mental health, quality of life, and equipping them with skills necessary for independent living and social mobility. Currently, Proshanti operates seven houses in Manikganj and Habiganj districts of Bangladesh, accommodating up to 40 individuals. Over a two-year period, individuals have received personalized support from trained personal assistants and care coordinators, regular health checkups, and opportunities for vocational training and community engagement. In this presentation, we will present the outcome of such intervention on individual’s functionality, quality of life and psychological health generated from 24 months of journey. Additionally, a qualitative approach will be employed to understand the facilitators and barriers of program implementation. The Proshanti program represents a promising model for addressing the significant mental health treatment gap in Bangladesh at the community level. Our findings will provide crucial insights into the program's feasibility, effectiveness, and the factors influencing its implementation, potentially guiding future mental health interventions in similar contexts.

Keywords: mental health, community based supportive housing, treatment gap, bangladesh

Procedia PDF Downloads 35

Authors: D. Dannehl, Z. Taylor, J. Suhl, L. Miranda, R., Ulrichs, C., Salazar, E. Fitz-Rodriguez, I. Lopez-Cruz, A. Rojano-Aguilar, G. Navas-Gomez, U. Schmidt

Abstract:

Growing environmental and sustainability concerns have driven continual modernization of horticultural practices, especially for urban farming. Controlled environment and soilless production methods are increasing in popularity because of their efficient resource use and intensive cropping capabilities. However, some popular substrates used for hydroponic cultivation, particularly rock wool, represent a large environmental burden in regard to their manufacture and disposal. Substrate-less hydroponic systems are effective in producing short cropping cycle plants such as lettuce or herbs, but less information is available for the production of plants with larger root-systems and longer cropping times. Here, we investigated the viability of a hybrid aeroponic/nutrient film technique (AP/NFT) system for the cultivation of greenhouse tomatoes (Solanum lycopersicum ‘Panovy’). The plants grown in the AP/NFT system had a more compact phenotype, accumulated more Na⁺ and less P and S than the rock wool grown counterparts. Due to forced irrigation interruptions, we propose that the differences observed were cofounded by the differing severity of water-stress for plants with and without substrate. They may also be caused by a higher root zone temperature predominant in plants exposed to AP/NFT. However, leaf area, stem diameter, and number of trusses did not differ significantly. The same was found for leaf pigments and plant photosynthetic efficiency. Overall, the AP/NFT system appears to be viable for the production of greenhouse tomato, enabling the environment to be relieved by way of lessening rock wool usage.

Keywords: closed aeroponic systems, fruit quality, nutrient dynamics, substrate waste reduction, urban farming systems, water savings

Procedia PDF Downloads 263

Authors: Adinarayana S., Sudhakar I.

Abstract:

Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor. Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyser are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time wave form

Procedia PDF Downloads 381

Authors: Abdul Sattar Jamali, Imdad Ali Memon, Maqsood Ahmed Memon

Abstract:

Quality of production near to zero defects is an objective of every manufacturing and service organization. In order to maintain and improve the quality by reduction in defects, Statistical tools are being used by any organizations. There are many statistical tools are available to assess the quality. Keeping in view the importance of many statistical tools, traditional 7QC tools has been used in any manufacturing and automobile Industry. Therefore, the 7QC tools have been successfully applied at one of the Automobile Company Pakistan. Preliminary survey has been done for the implementation of 7QC tool in the assembly line of Automobile Industry. During preliminary survey two inspection points were decided to collect the data, which are Chassis line and trim line. The data for defects at Chassis line and trim line were collected for reduction in defects which ultimately improve productivity. Every 7QC tools has its benefits observed from the results. The flow charts developed for better understanding about inspection point for data collection. The check sheets developed for helps for defects data collection. Histogram represents the severity level of defects. Pareto charts show the cumulative effect of defects. The Cause and Effect diagrams developed for finding the root causes of each defects. Scatter diagram developed the relation of defects increasing or decreasing. The P-Control charts developed for showing out of control points beyond the limits for corrective actions. The successful implementation of 7QC tools at the inspection points at Automobile Industry concluded that the considerable amount of reduction on defects level, as in Chassis line from 132 defects to 13 defects. The total 90% defects were reduced in Chassis Line. In Trim line defects were reduced from 157 defects to 28 defects. The total 82% defects were reduced in Trim Line. As the Automobile Company exercised only few of the 7 QC tools, not fully getting the fruits by the application of 7 QC tools. Therefore, it is suggested the company may need to manage a mechanism for the application of 7 QC tools at every section.

Keywords: check sheet, cause and effect diagram, control chart, histogram

Procedia PDF Downloads 318

Authors: Vasileiou Apostolos, Theodosiou Chrysa, Tsitroulis Ioannis, Maris Fotios

Abstract:

The severity of extreme phenomena is due to their ability to cause severe damage in a small amount of time. It has been observed that floods affect the greatest number of people and induce the biggest damage when compared to the total of annual natural disasters. The detection of potential flood-prone areas constitutes one of the fundamental components of the European Natural Disaster Management Policy, directly connected to the European Directive 2007/60. The aim of the present paper is to develop a new methodology that combines geographical information, fuzzy logic and multi-criteria evaluation methods so that the most vulnerable areas are defined. Therefore, ten factors related to geophysical, morphological, climatological/meteorological and hydrological characteristics of the basin were selected. Afterwards, two models were created to detect the areas pronest to flooding. The first model defined the gravitas of each factor using Analytical Hierarchy Process (AHP) and the final map of possible flood spots were created using GIS and Boolean Algebra. The second model made use of the fuzzy logic and GIS combination and a respective map was created. The application area of the aforementioned methodologies was in Ardas basin due to the frequent and important floods that have taken place these last years. Then, the results were compared to the already observed floods. The result analysis shows that both models can detect with great precision possible flood spots. As the fuzzy logic model is less time-consuming, it is considered the ideal model to apply to other areas. The said results are capable of contributing to the delineation of high risk areas and to the creation of successful management plans dealing with floods.

Keywords: analytical hierarchy process, flood prone areas, fuzzy logic, geographic information system

Procedia PDF Downloads 370

Authors: Farhad Fakoursevom

Abstract:

Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

Procedia PDF Downloads 92

Authors: Adi Narayana S Sudhakar. I

Abstract:

Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor .Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyzer are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non-drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time spectrum accelerometer

Procedia PDF Downloads 447

Authors: Sherif Sabri, Suzy Fawzi, Sanaa Abdelshafy, Ayman Nagah

Abstract:

Introduction: Static derangements in lactate homeostasis during ICU stay have become established as a clinically useful marker of increased risk of hospital and ICU mortality. Lactate indices or kinetic alteration of the anaerobic metabolism make it a potential parameter to evaluate disease severity and intervention adequacy. This is an inexpensive and simple clinical parameter that can be obtained by a minimally invasive means. Aim of work: Comparing the predictive value of dynamic indices of hyperlactatemia in the first twenty four hours of intensive care unit (ICU) admission with other static values are more commonly used. Patients and Methods: This study included 40 critically ill patients above 18 years old of both sexes with Hyperlactamia (≥ 2 m mol/L). Patients were divided into septic group (n=20) and low oxygen transport group (n=20), which include all causes of low-O2. Six lactate indices specifically relating to the first 24 hours of ICU admission were considered, three static indices and three dynamic indices. Results: There were no statistically significant differences among the two groups regarding age, most of the laboratory results including ABG and the need for mechanical ventilation. Admission lactate was significantly higher in low-oxygen transport group than the septic group [37.5±11.4 versus 30.6±7.8 P-value 0.034]. Maximum lactate was significantly higher in low-oxygen transport group than the septic group P-value (0.044). On the other hand absolute lactate (mg) was higher in septic group P-value (< 0.001). Percentage change of lactate was higher in the septic group (47.8±11.3) than the low-oxygen transport group (26.1±12.6) with highly significant P-value (< 0.001). Lastly, time weighted lactate was higher in the low-oxygen transport group (1.72±0.81) than the septic group (1.05±0.8) with significant P-value (0.012). There were statistically significant differences regarding lactate indices in survivors and non survivors, whether in septic or low-oxygen transport group. Conclusion: In critically ill patients, time weighted lactate and percent in lactate change in the first 24 hours can be an independent predictive factor in ICU mortality. Also, a rising compared to a falling blood lactate concentration over the first 24 hours can be associated with significant increase in the risk of mortality.

Keywords: critically ill patients, lactate indices, mortality in intensive care, anaerobic metabolism

Procedia PDF Downloads 237

Authors: Sadaf H. Khan, Jyoti Kumar

Abstract:

Sick Building Syndrome (SBS) is a situation in which inhabitants of a building develop illness symptoms or get infected with a chronic disease as a result of the building in which they reside or work. Certain symptoms tend to get more severe as an individual spends more time in the building; however, they generally improve with time or even disappear when they leave that space. Though ‘Design of Built-Spaces’ is a crucial factor in regulating these symptoms but it still needs to be identified further as to what specific design features of a ‘Built-Space’ trigger sick building syndrome (SBS). Much of the research work present to date is focused on the physiological or physical sickness caused due to inappropriate built-space design. In this paper, the psychological aspects of sick building syndrome (SBS) will be investigated across the adult population, more specifically graduate students in India trying to settle in back to their previous physical work environments, i.e., campus, classrooms, hostels, after a very long hold which lasted more than a year due to lockdowns during Covid-19 crisis all over the world. The study will follow an analytical approach and the data will be collected through self-reported online surveys. The purpose of this study is to enquire causal agents, diagnosable symptoms and remedial design of built spaces which can enhance the productive level of built environments and better facilitate the inhabitants by improving their psychological wellbeing, which is the most uprising concern. The fact that SBS symptoms can be studied only within the initial few weeks as an occupant starts interacting with a built-environment and leaves as the occupant leaves that space or zone, the post-lockdown incoming of students back to their respective campuses provides an opportunity to clearly draw multiple conclusions of the relationship that exist between the Design of Built-Spaces and Psychological Sickness Syndrome associated with it. The study will be one of a kind approach for understanding and formulating methods to improve psychological wellbeing within a built-setting by better identifying factors associated with these psychological symptoms, including anxiety, mental fatigue, reduced attention span and reduced memory span as refined symptoms of SBS discussed in 1987 by Molhave within his study.

Keywords: built-environment psychology, built-space design, healthcare architecture, psychological wellbeing

Procedia PDF Downloads 165

Authors: Pei-Chen Wu

Abstract:

Both preexisting cross-sectional and longitudinal studies of personality-depression relationship have suffered from one main limitation: they ignored the stability of the construct of interest (e.g., personality and depression) can be expected to influence the estimate of the association between personality and depression. To address this limitation, the Trait-State-Occasion (TSO) modeling was adopted to analyze the sources of variance of the focused constructs. A TSO modeling was operated by partitioning a state variance into time-invariant (trait) and time-variant (occasion) components. Within a TSO framework, it is possible to predict change on the part of construct that really changes (i.e., time-variant variance), when controlling the trait variances. 750 high school students were followed for 4 waves over six-month intervals. The baseline data (T1) were collected from the senior high schools (aged 14 to 15 years). Participants were given Beck Depression Inventory and Big Five Inventory at each assessment. TSO modeling revealed that 70~78% of the variance in personality (five constructs) was stable over follow-up period; however, 57~61% of the variance in depression was stable. For personality construct, there were 7.6% to 8.4% of the total variance from the autoregressive occasion factors; for depression construct there were 15.2% to 18.1% of the total variance from the autoregressive occasion factors. Additionally, results showed that when controlling initial symptom severity, the time-invariant components of all five dimensions of personality were predictive of change in depression (Extraversion: B= .32, Openness: B = -.21, Agreeableness: B = -.27, Conscientious: B = -.36, Neuroticism: B = .39). Because five dimensions of personality shared some variance, the models in which all five dimensions of personality were simultaneous to predict change in depression were investigated. The time-invariant components of five dimensions were still significant predictors for change in depression (Extraversion: B = .30, Openness: B = -.24, Agreeableness: B = -.28, Conscientious: B = -.35, Neuroticism: B = .42). In sum, the majority of the variability of personality was stable over 2 years. Individuals with the greater tendency of Extraversion and Neuroticism have higher degrees of depression; individuals with the greater tendency of Openness, Agreeableness and Conscientious have lower degrees of depression.

Keywords: assessment, depression, personality, trait-state-occasion model

Procedia PDF Downloads 172