Search results for: physical therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7464

Search results for: physical therapy

6414 The Effect of Using Water Wireless Aqua Com System on the Development of Dolphin Kick Movements on the Female Swimming Team at the Faculty of Physical Education

Authors: Wisal Alrabadi

Abstract:

The study's goal was to see how the use of water wireless Aqua Com System and its accompanying music affected the Female Swimming Team at the Faculty of Physical Education's development of dolphin kick movements. To that end, a training program consisting of (12) training units spread out over four weeks, three units per week, was created and applied to a study sample of (10) students from the swimming pool enrolled in the first semester of the academic year 2022. Pre-measuring and timing the movements of dolphins kicking with and without fins above and below, measuring the water's surface over a distance of 25 meters. The results showed that there are statistically significant differences in favor of telemetry from the start within the limits of the area specified for a distance of 15 m after the comparison between the pre and post-measurement using the test (T) of the double samples, and this indicates the impact of the training program using the Aqua Com System in the swimming team(Female) at Faculty of Physical Education, and in light of this a set of recommendations was developed.

Keywords: aqua com system training program, accompanying music, dolphin kick movements, swimming team female

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6413 Therapeutic Application of Light and Electromagnetic Fields to Reduce Hyper-Inflammation Triggered by COVID-19

Authors: Blanche Aguida, Marootpong Pooam, Nathalie Jourdan, Margaret Ahmad

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COVID-19-related morbidity is associated with exaggerated inflammation and cytokine production in the lungs, leading to acute respiratory failure. The cellular mechanisms underlying these so-called ‘cytokine storms’ are regulated through the Toll-like receptor 4 (TLR4) signaling pathway and by reactive oxygen species (ROS). Both light (photobiomodulation) and magnetic fields (e.g., pulsed electromagnetic field) stimulation are non-invasive therapies known to confer anti-inflammatory effects and regulate ROS signaling pathways. Here we show that daily exposure to two 10-minute intervals of moderate-intensity infra-red light significantly lowered the inflammatory response induced via the TLR4 receptor signaling pathway in human cell cultures. Anti-inflammatory effects were likewise achieved by electromagnetic field exposure of cells to daily 10-minute intervals of either pulsed electromagnetic fields (PEMF) or to low-level static magnetic fields. Because current illumination and electromagnetic field therapies have no known side effects and are already approved for some medical uses, we have here developed protocols for verification in clinical trials of COVID 19 infection. These treatments are affordable, simple to implement, and may help to resolve the acute respiratory distress of COVID 19 patients both in the home and in the hospital.

Keywords: COVID 19, electromagnetic fields therapy, inflammation, photobiomodulation therapy

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6412 Reframing Physical Activity for Health

Authors: M. Roberts

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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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6411 Reduction of the Risk of Secondary Cancer Induction Using VMAT for Head and Neck Cancer

Authors: Jalil ur Rehman, Ramesh C, Tailor, Isa Khan, Jahanzeeb Ashraf, Muhammad Afzal, Geofferry S. Ibbott

Abstract:

The purpose of this analysis is to estimate secondary cancer risks after VMAT compared to other modalities of head and neck radiotherapy (IMRT, 3DCRT). Computer tomography (CT) scans of Radiological Physics Center (RPC) head and neck phantom were acquired with CT scanner and exported via DICOM to the treatment planning system (TPS). Treatment planning was done using four arc (182-178 and 180-184, clockwise and anticlockwise) for volumetric modulated arc therapy (VMAT) , Nine fields (200, 240, 280, 320,0,40,80,120 and 160), which has been commonly used at MD Anderson Cancer Center Houston for intensity modulated radiation therapy (IMRT) and four fields for three dimensional radiation therapy (3DCRT) were used. True beam linear accelerator of 6MV photon energy was used for dose delivery, and dose calculation was done with CC convolution algorithm with prescription dose of 6.6 Gy. Primary Target Volume (PTV) coverage, mean and maximal doses, DVHs and volumes receiving more than 2 Gy and 3.8 Gy of OARs were calculated and compared. Absolute point dose and planar dose were measured with thermoluminescent dosimeters (TLDs) and GafChromic EBT2 film, respectively. Quality Assurance of VMAT and IMRT were performed by using ArcCHECK method with gamma index criteria of 3%/3mm dose difference to distance to agreement (DD/DTA). PTV coverage was found 90.80 %, 95.80 % and 95.82 % for 3DCRT, IMRT and VMAT respectively. VMAT delivered the lowest maximal doses to esophagus (2.3 Gy), brain (4.0 Gy) and thyroid (2.3 Gy) compared to all other studied techniques. In comparison, maximal doses for 3DCRT were found higher than VMAT for all studied OARs. Whereas, IMRT delivered maximal higher doses 26%, 5% and 26% for esophagus, normal brain and thyroid, respectively, compared to VMAT. It was noted that esophagus volume receiving more than 2 Gy was 3.6 % for VMAT, 23.6 % for IMRT and up to 100 % for 3DCRT. Good agreement was observed between measured doses and those calculated with TPS. The averages relative standard errors (RSE) of three deliveries within eight TLD capsule locations were, 0.9%, 0.8% and 0.6% for 3DCRT, IMRT and VMAT, respectively. The gamma analysis for all plans met the ±5%/3 mm criteria (over 90% passed) and results of QA were greater than 98%. The calculations for maximal doses and volumes of OARs suggest that the estimated risk of secondary cancer induction after VMAT is considerably lower than IMRT and 3DCRT.

Keywords: RPC, 3DCRT, IMRT, VMAT, EBT2 film, TLD

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6410 Negative Self-Awareness and Its Effect on Crime

Authors: Guinevere Servis

Abstract:

This paper hypothesizes that withdrawal from positive self-awareness, and the increase of counterfactual-thinking and self-handicapping can help provide ample justification for an individual before, during and/or after committing a crime. The understanding of who someone is, one’s perspective on the world, and why they think the way they do is key to therapy in preventing recidivism. Developing habits to escape self-awareness, by using self-handicapping and counterfactual ideologies, may provide the necessary thinking patterns to decide disobeying the law is a worthy act to pursue. An increase in self-awareness is hypothesized to decrease the likelihood of recidivism, and ways of thinking that withdraw from self awareness can increase the likelihood of it. Especially for those who have been disadvantaged in life and disobeyed the law, self-handicapping and counterfactual thinking can also help to justify one's wrongdoing. The understanding of how a criminal views their disadvantages in the world, and one’s thinking patterns are hypothesized to help one better understand the entire scope on why a crime was committed and thus reduce the likelihood of recidivism. Utilizing therapy for prisoners to increase self-awareness of both thought and action can lead to a healthy, happier life and reduce the likelihood of reoffending. By discussing the terms associated with self-awareness theory and other psychological topics such as self-handicapping, counterfactual thinking, this paper argues the actions towards increasing positive self-awareness can help decrease likelihood of recidivism. Adversely, hypothesizing that increasing the ways of thinking that withdraw one from self-awareness, through counterfactual thinking and self-handicapping, can inherently increase the likelihood of recidivism. Evaluating these findings to further understand the needed changes in correctional institutions is fundamental to reducing crime, benefiting the criminal, the victim(s) and their family, and the state.

Keywords: crime, self-awareness theory, correctional institutions, self-regulate, counterfactual thinking, recidivism

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6409 The Relationship between Vitamin D and Vitamin B12 Concentrations in Cataract Patients (Senile vs Diabetic)

Authors: Ali Showail Ali Alasmari

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Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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6408 Healthcare in COVID-19 and It’s Impact on Children with Cochlear Implants

Authors: Amirreza Razzaghipour, Mahdi Khalili

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References from the World Health Organization and the Center for Disease Control for deceleration the spread of the Novel COVID-19, comprises social estrangement, frequent handwashing, and covering your mouth when around others. As hearing healthcare specialists, the influence of existenceinvoluntary to boundary social interactions on persons with hearing impairment was significant for us to understand. We found ourselves delaying cochlear implant (CI) surgeries. All children, and chiefly those with hearing loss, are susceptible to reductions in spoken communication. Hearing plans, such as cochlear implants, provide children with hearing loss access to spoken communication and provision language development. when provided early and used consistently, these supplies help children with hearing loss to engage in spoken connections. Cochlear implant (CI) is a standard medical-surgical treatment for bilateral severe to profound hearing loss with no advantage with the hearing aid. Hearing is one of the most important senses in humans. Pediatric hearing loss establishes one of the most important public health challenges. Children with hearing loss are recognized early and habilitated via hearing aids or with cochlear implants (CIs). Suitable care and maintenance as well as continuous auditory verbal therapy (AVT) are also essential in reaching for the successful attainment of language acquisition. Children with hearing loss posture important challenges to their parents, particularly when there is limited admission to their hearing care providers. The disruption in the routine of their hearing and therapy follow-up services has had substantial effects on the children as well as their parents.

Keywords: healthcare, covid-19, cochlear implants, spoken communication, hearing loss

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6407 Competence on Learning Delivery Modes and Performance of Physical Education Teachers in Senior High Schools in Davao

Authors: Juvanie C. Lapesigue

Abstract:

Worldwide school closures result from a significant public health crisis that has affected the nation and the entire world. It has affected students, educators, educational organizations globally, and many other aspects of society. Academic institutions worldwide teach students using diverse approaches of various learning delivery modes. This paper investigates the competence and performance of physical education teachers using various learning delivery modes, including Distance learning, Blended Learning, and Homeschooling during online distance education. To identify the Gap between their age generation using various learning delivery that affects teachers' preparation for distance learning and evaluates how these modalities impact teachers’ competence and performance in the case of a pandemic. The respondents were the Senior High School teachers of the Department of Education who taught in Davao City before and during the pandemic. Purposive sampling was utilized on 61 Senior High School Teachers in Davao City Philippines. The result indicated that teaching performance based on pedagogy and assessment has significantly affected teaching performance in teaching physical education, particularly those Non-PE teachers teaching physical education subjects. It should be supplied with enhancement training workshops to help them be more successful in preparation in terms of teaching pedagogy and assessment in the following norm. Hence, a proposed unique training design for non-P.E. Teachers has been created to improve the teachers’ performance in terms of pedagogy and assessment in teaching P.E subjects in various learning delivery modes in the next normal.

Keywords: distance learning, learning delivery modes, P.E teachers, senior high school, teaching competence, teaching performance

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6406 Gene Expression Meta-Analysis of Potential Shared and Unique Pathways Between Autoimmune Diseases Under anti-TNFα Therapy

Authors: Charalabos Antonatos, Mariza Panoutsopoulou, Georgios K. Georgakilas, Evangelos Evangelou, Yiannis Vasilopoulos

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The extended tissue damage and severe clinical outcomes of autoimmune diseases, accompanied by the high annual costs to the overall health care system, highlight the need for an efficient therapy. Increasing knowledge over the pathophysiology of specific chronic inflammatory diseases, namely Psoriasis (PsO), Inflammatory Bowel Diseases (IBD) consisting of Crohn’s disease (CD) and Ulcerative colitis (UC), and Rheumatoid Arthritis (RA), has provided insights into the underlying mechanisms that lead to the maintenance of the inflammation, such as Tumor Necrosis Factor alpha (TNF-α). Hence, the anti-TNFα biological agents pose as an ideal therapeutic approach. Despite the efficacy of anti-TNFα agents, several clinical trials have shown that 20-40% of patients do not respond to treatment. Nowadays, high-throughput technologies have been recruited in order to elucidate the complex interactions in multifactorial phenotypes, with the most ubiquitous ones referring to transcriptome quantification analyses. In this context, a random effects meta-analysis of available gene expression cDNA microarray datasets was performed between responders and non-responders to anti-TNFα therapy in patients with IBD, PsO, and RA. Publicly available datasets were systematically searched from inception to 10th of November 2020 and selected for further analysis if they assessed the response to anti-TNFα therapy with clinical score indexes from inflamed biopsies. Specifically, 4 IBD (79 responders/72 non-responders), 3 PsO (40 responders/11 non-responders) and 2 RA (16 responders/6 non-responders) datasetswere selected. After the separate pre-processing of each dataset, 4 separate meta-analyses were conducted; three disease-specific and a single combined meta-analysis on the disease-specific results. The MetaVolcano R package (v.1.8.0) was utilized for a random-effects meta-analysis through theRestricted Maximum Likelihood (RELM) method. The top 1% of the most consistently perturbed genes in the included datasets was highlighted through the TopConfects approach while maintaining a 5% False Discovery Rate (FDR). Genes were considered as Differentialy Expressed (DEGs) as those with P ≤ 0.05, |log2(FC)| ≥ log2(1.25) and perturbed in at least 75% of the included datasets. Over-representation analysis was performed using Gene Ontology and Reactome Pathways for both up- and down-regulated genes in all 4 performed meta-analyses. Protein-Protein interaction networks were also incorporated in the subsequentanalyses with STRING v11.5 and Cytoscape v3.9. Disease-specific meta-analyses detected multiple distinct pro-inflammatory and immune-related down-regulated genes for each disease, such asNFKBIA, IL36, and IRAK1, respectively. Pathway analyses revealed unique and shared pathways between each disease, such as Neutrophil Degranulation and Signaling by Interleukins. The combined meta-analysis unveiled 436 DEGs, 86 out of which were up- and 350 down-regulated, confirming the aforementioned shared pathways and genes, as well as uncovering genes that participate in anti-inflammatory pathways, namely IL-10 signaling. The identification of key biological pathways and regulatory elements is imperative for the accurate prediction of the patient’s response to biological drugs. Meta-analysis of such gene expression data could aid the challenging approach to unravel the complex interactions implicated in the response to anti-TNFα therapy in patients with PsO, IBD, and RA, as well as distinguish gene clusters and pathways that are altered through this heterogeneous phenotype.

Keywords: anti-TNFα, autoimmune, meta-analysis, microarrays

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6405 Study of the Physical Aging of Polyvinyl Chloride (PVC)

Authors: Mohamed Ouazene

Abstract:

The insulating properties of the polymers are widely used in electrical engineering for the production of insulators and various supports, as well as for the insulation of electric cables for medium and high voltage, etc. These polymeric materials have significant advantages both technically and economically. However, although the insulation with polymeric materials has advantages, there are also certain disadvantages such as the influence of the heat which can have a detrimental effect on these materials. Polyvinyl chloride (PVC) is one of the polymers used in a plasticized state in the cable insulation to medium and high voltage. The studied material is polyvinyl chloride (PVC 4000 M) from the Algerian national oil company whose formula is: Industrial PVC 4000 M is in the form of white powder. The test sample is a pastille of 1 mm thick and 1 cm in diameter. The consequences of increasing the temperature of a polymer are modifications; some of them are reversible and others irreversible [1]. The reversible changes do not affect the chemical composition of the polymer, or its structure. They are characterized by transitions and relaxations. The glass transition temperature is an important feature of a polymer. Physical aging of PVC is to maintain the material for a longer or shorter time to its glass transition temperature. The aim of this paper is to study this phenomenon by the method of thermally stimulated depolarization currents. Relaxations within the polymer have been recorded in the form of current peaks. We have found that the intensity decreases for more residence time in the polymer along its glass transition temperature. Furthermore, it is inferred from this work that the phenomenon of physical aging can have important consequences on the properties of the polymer. It leads to a more compact rearrangement of the material and a reconstruction or reinforcement of structural connections.

Keywords: depolarization currents, glass transition temperature, physical aging, polyvinyl chloride (PVC)

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6404 Adolescents’ and Young Adults’ Well-Being, Health, and Loneliness during the COVID-19 Pandemic

Authors: Jessica Hemberg, Amanda Sundqvist, Yulia Korzhina, Lillemor Östman, Sofia Gylfe, Frida Gädda, Lisbet Nyström, Henrik Groundstroem, Pia Nyman-Kurkiala

Abstract:

Purpose: There are large gaps in the literature on COVID-19 pandemic-related mental health outcomes and after-effects specific to adolescents and young adults. The study's aim was to explore adolescents’ and young adults’ experiences of well-being, health, and loneliness during the COVID-19 pandemic. Method: A qualitative exploratory design with qualitative content analysis was used. Twenty-three participants (aged 19-27; four men and 19 women) were interviewed. Results: Four themes emerged: Changed social networks – fewer and closer contacts, changed mental and physical health, increased physical and social loneliness, well-being, internal growth, and need for support. Conclusion: Adolescents’ and young adults’ experiences of well-being, health, and loneliness are subtle and complex. Participants experienced changed social networks, mental and physical health, and well-being. Also, internal growth, need for support, and increased loneliness were seen. Clear information on how to seek help and support from professionals should be made available.

Keywords: adolescents, COVID-19 pandemic, health, interviews, loneliness, qualitative, well-being, young adults

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6403 Health Hazards Among Health Care Workers and Associated Factors in Public Hospitals, Sana'a-Yemen

Authors: Makkia Ahmad Ali Al-Falahi, Abdullah Abdelaziz Muharram

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Background: Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. Objective: To assess the prevalence of occupational health hazards among healthcare workers and associated risk factors in public hospitals in Sana'a City, Yemen. Method: Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. Results: More the half (60.6%) of HCWs aged between 20-30 years, (50.8%) were males, (56.3%) were married, and (45.5%) had a diploma qualification, while (65.2%) of HCWs had less than 6 years of experience. The result showed that the highest prevalence of occupational hazards was (99%), (ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p >0.05). Conclusion and recommendations: The study showed the highest prevalence of occupational hazards; regarding the prevalence of biological hazards exposure to sharp-related injury, the most prevalent physical hazards were slip/trip/and fall. Ergonomic hazards had back or neck pain during work. Chemical hazards were allergic to medical gloves powder. On psychosocial hazards was suffered from verbal and physical harassment. The study concluded by raising awareness among HCWs by conducting training courses to prevent occupational hazards.

Keywords: health workers, occupational hazards, risk factors, the prevalence

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6402 Discrimination during a Resume Audit: The Impact of Job Context in Hiring

Authors: Alexandra Roy

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Building on literature on cognitive matching and social categorization and using the correspondence testing method, we test the interaction effect of person characteristics (Gender with physical attractiveness) and job context (client contact, industry status, coworker contact). As expected, while findings show a strong impact of gender with beauty on hiring chances, job context characteristics have also a significant overall effect of this hiring outcome. Moreover, the rate of positive responses varies according some of the recruiter’s characteristics. Results are robust to various sensitivity checks. Implications of the results, limitations of the study, and directions for future research are discussed.

Keywords: correspondence testing, discrimination, hiring, physical attractiveness

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6401 Review the Concept of Context in Modernization of Rural Architecture Case Study: Baliran Village

Authors: Neda Najafi, Mehran Allalhesabi

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At present, the natural, geographical, physical contexts of the rural textures, which play a crucial role in making the concept behind their body, are not considered in the new designs. Despite the fundamental differences in contexts, this issue has caused that, the new rural textures in our country become similar to each other and the cohesive structure of many villages in the development of rural areas are exposed to deterioration. The villages of northern Iran are not immune from this situation and nothing have remained from their physical characteristic, and the new sections of rural areas are designed heterogeneously and regardless to the concepts behind the region's architecture, which destroys the originality of the environment. The purpose of this study is to extract the concepts and criteria that differentiate the body of the village and reveal its similarity with the same structures. In this way, understanding the underlying values is extremely useful and is considered very important to approach the new model. In the first part, the subject matters of the research (context, village and rural architecture) are defined and then the characteristics of context-oriented rural architecture and criteria that can be examined from the perspective of contextualism approach are presented. In the second part, by selecting 3 samples from the houses of Baliran village, these concepts and criteria have been evaluated in the houses of the village. The results of this study show that the characteristics of contextual rural architecture have the ability to adapt to the body of the village and can be the best model to achieve contextual architecture in this area. Therefore, by using these concepts and criteria, it is possible to achieve a type of architecture that is located along with the past architecture and, with the help of the modern facilities and environmental potentials, creates a logical and correct flow in the physical development of the rural textures.

Keywords: context, village, rural architecture, concepts and criteria of physical contextualism

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6400 Yoga Offers Protection for Premenstrual Syndrome

Authors: Katalin Gocze, Vanda A Nemes, Charlotte Briest

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Introduction: Premenstrual syndrome (PMS) is a psychoneuroendocrinological disorder adversely affecting life-quality for over 80% of hormonally active women. PMS has a negative impact on women’s daily life in terms of work, interpersonal relationships and leisure time activities. The aim of our study was to evaluate the effects of a yoga intervention focusing on the female pelvic area. Materials and methods: 34 women (ages 18-40) with PMS (Premenstrual Syndrome Screening Tool) and no previous experience in yoga were recruited and randomly assigned to either the yoga or the control group. The intervention consisted of 90’ yoga sessions twice a week and a daily 15’ self-practice module with carefully chosen yogic exercises addressing the reproductive organs by toning the pelvic floor and opening the hips as well as relieving stress and improving concentration. Severity of symptoms of PMS was assessed at the beginning and after the 8-week-long intervention. Pre- and post-program data collection included physical and psychological parameters and the evaluation of ACOQ PMS questionnaire and daily symptom diary. Results: Age and educational background were similar in the control and intervention group with an overall mean age of 29.11±4.78 years. PSST scores significantly improved in the yoga group (p=0.002), while difference in the control group’s pre and post-program values were non-significant (p=0.38). Perception and tolerance of anxiety and stress was significantly better after the intervention (p=0.008). As for changes in physical symptoms distinct improvement was registered for breast tenderness (p=0.028) and for meteorism (p=0.015). Discussion: Yoga’s success originates from the synergic positive effects of stress relief and regular physical activity. Benefits (both mental and physical) of strategically planned, focused yoga practice are apparent even after shorter time periods and can help women with PMS manage or eliminate symptoms in order to improve their life-quality.

Keywords: life-quality, physical symptoms, premenstrual syndrome, psychological impact, yoga

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6399 Investigation of the EEG Signal Parameters during Epileptic Seizure Phases in Consequence to the Application of External Healing Therapy on Subjects

Authors: Karan Sharma, Ajay Kumar

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Epileptic seizure is a type of disease due to which electrical charge in the brain flows abruptly resulting in abnormal activity by the subject. One percent of total world population gets epileptic seizure attacks.Due to abrupt flow of charge, EEG (Electroencephalogram) waveforms change. On the display appear a lot of spikes and sharp waves in the EEG signals. Detection of epileptic seizure by using conventional methods is time-consuming. Many methods have been evolved that detect it automatically. The initial part of this paper provides the review of techniques used to detect epileptic seizure automatically. The automatic detection is based on the feature extraction and classification patterns. For better accuracy decomposition of the signal is required before feature extraction. A number of parameters are calculated by the researchers using different techniques e.g. approximate entropy, sample entropy, Fuzzy approximate entropy, intrinsic mode function, cross-correlation etc. to discriminate between a normal signal & an epileptic seizure signal.The main objective of this review paper is to present the variations in the EEG signals at both stages (i) Interictal (recording between the epileptic seizure attacks). (ii) Ictal (recording during the epileptic seizure), using most appropriate methods of analysis to provide better healthcare diagnosis. This research paper then investigates the effects of a noninvasive healing therapy on the subjects by studying the EEG signals using latest signal processing techniques. The study has been conducted with Reiki as a healing technique, beneficial for restoring balance in cases of body mind alterations associated with an epileptic seizure. Reiki is practiced around the world and is recommended for different health services as a treatment approach. Reiki is an energy medicine, specifically a biofield therapy developed in Japan in the early 20th century. It is a system involving the laying on of hands, to stimulate the body’s natural energetic system. Earlier studies have shown an apparent connection between Reiki and the autonomous nervous system. The Reiki sessions are applied by an experienced therapist. EEG signals are measured at baseline, during session and post intervention to bring about effective epileptic seizure control or its elimination altogether.

Keywords: EEG signal, Reiki, time consuming, epileptic seizure

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6398 Physical Activity Rates and Motivational Profiles of Adolescents While Keeping a Daily Leisure-Time Physical Activity Record

Authors: Matt Fullmer, Carol Wilkinson, Keven Prusak, Dennis Eggett, Todd Pennington

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Obesity and chronic health issues are linked to physical inactivity. Physical education (PE) programs in school can play a major role in combating these health-related issues. This study focused on supporting competence through keeping a leisure-time physical activity (LTPA) record as part of PE. Keeping a daily LTPA record may be an effective intervention helping students feel more competent toward exercise, and thus, self-determined (within the context of self-determination theory) to exercise. Little is known about the relationship between daily LTPA records and perceived competence, motivational profiles, and LTPA levels of students enrolled in PE. This study examined the relationship between keeping a daily, online LTPA record and adolescent (a) motivational profiles toward LTPA, (b) perceived competence toward LTPA, and (c) LTPA behaviors. Secondary students (N = 124) in physical education classes completed a baseline questionnaire which consisted of the Behavioural Regulation in Exercise Questionnaire–2, the Perceived Competence Scale, and the Godin Leisure-Time Exercise Questionnaire. For three weeks, the students were assigned to keep the Presidential Active Lifestyle Award Challenge (PALAC) as their online LTPA record. They completed the questionnaire after each week. A 2 (gender) x 4 (trials) repeated measures ANCOVA examined the relationships between recording compliance and motivation, perceived competence, and physical activity. Results showed that recording compliance was not a significant predictor of perceived competence to participate in LTPA. Examining motivational factors, a significant interaction between recording compliance and introjected regulation was found. The more students recorded the less motivated they were by guilt or obligation to exercise in their leisure-time. Also, a significant interaction was found between recording compliance and intrinsic regulation, indicating that the more students recorded the more intrinsically motivated they were to exercise in their leisure-time. Lastly, there was a significant interaction between recording compliance and LTPA. As students kept the LTPA record, girls’ LTPA levels significantly decreased and boys’ LTPA levels significantly increased. The key findings are that, as implemented in this study: a) the lack of PALAC compliance suggests that daily LTPA records may NOT be the most effective intervention for this population, b) keeping a daily LTPA record did NOT help students feel more competent to exercise in their leisure-time, c) a daily LTPA record may help students move towards being more self-determined in their feelings towards LTPA, and d) the outcome of keeping a LTPA record on LTPA behavior is statistically significant, although actual differences may not be practically important.

Keywords: behavioural regulation in exercise questionnaire–2, Godin leisure–time exercise questionnaire, online physical activity log, perceived competence scale, self-determination theory

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6397 Effects of Group Cognitive Restructuring and Rational Emotive Behavioral Therapy on Psychological Distress of Awaiting-Trial Inmates in Correctional Centers in North- West, Nigeria

Authors: Muhammad Shafi'u Adamu

Abstract:

This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

Procedia PDF Downloads 62
6396 Agro-Measures Influence Soil Physical Parameters in Alternative Farming

Authors: Laura Masilionyte, Danute Jablonskyte-Rasce, Kestutis Venslauskas, Zita Kriauciuniene

Abstract:

Alternative farming systems are used to cultivate high-quality food products and sustain the viability and fertility of the soil. Plant nutrition in all ecosystems depends not only on fertilization intensity or soil richness in organic matter but also on soil physical parameters –bulk density, structure, pores with the optimum moisture and air ratio available to plants. The field experiments of alternative (sustainable and organic) farming systems were conducted at Joniskelis Experimental Station of the Lithuanian Research Centre for Agriculture and Forestry in 2006–2016. The soil of the experimental site was Endocalcari-Endohypogleyic Cambisol (CMg-n-w-can). In alternative farming systems, farmyard manure, straw and catch crops for green manure were used for fertilization both in the soil with low and moderate humus contents. It had a more significant effect in the 0–20 cm depth layer on soil moisture than on other physical soil properties. In the agricultural systems, where catch crops were grown, soil physical characteristics did not differ significantly before their biomass incorporation, except for the moisture content, which was lower in rainy periods and higher in drier periods than in the soil of farming systems without catch crops. Soil bulk density and porosity in the topsoil layer were more dependent on soil humus content than on agricultural measures used: in the soil with moderate humus content, compared with the soil with low humus content, bulk density was by 1.4% lower, and porosity by 1.8% higher. The research findings allow to make improvements in alternative farming systems by choosing appropriate combinations of organic fertilizers and catch crops that have a sustainable effect on soil and maintain the sustainability of soil productivity parameters. Rational fertilization systems, securing the stability of soil productivity parameters and crop rotation productivity will promote the development of organic agriculture.

Keywords: agro-measures, soil physical parameters, organic farming, sustainable farming

Procedia PDF Downloads 111
6395 Effect of Coffee Grounds on Physical and Heating Value Properties of Sugarcane Bagasse Pellets

Authors: K. Rattawan, W. Intagun, W. Kanoksilapatham

Abstract:

Objective of this research is to study effect of coffee grounds on physical and heating value properties of sugarcane bagasse pellets. The coffee grounds were tested as an additive for pelletizing process of bagasse pellets. Pelletizing was performed using a Flat–die pellet mill machine. Moisture content of raw materials was controlled at 10-13%. Die temperature range during the process was 75-80 oC. Physical characteristics (bulk density and durability) of the bagasse pellet and pellets with 1-5% coffee ground were determined following the standard assigned by the Pellet Fuel Institute (PFI). The results revealed increasing values of 648±3.4, 659 ± 3.1, 679 ± 3.3 and 685 ± 3.1 kg/m3 (for pellet bulk density); and 98.7 ± 0.11, 99.2 ± 0.26, 99.3 ± 0.19 and 99.4 ± 0.07% (for pellet durability), respectively. In addition, the heating values of the coffee ground supplemented pellets (15.9 ± 1.16, 17.0 ± 1.23 and 18.8 ± 1.34 MJ/kg) were improved comparing to the non-supplemented control (14.9 ± 1.14 MJ/kg), respectively. The results indicated that both the bulk density and durability values of the bagasse pellets were increased with the increasing proportion of the coffee ground additive.

Keywords: bagasse, coffee grounds, pelletizing, heating value, sugar cane bagasse

Procedia PDF Downloads 148
6394 The Comparison of Physical Fitness across Age and Gender in the Lithuanian Primary School Students: Population-Based Cross-Sectional Study

Authors: Arunas Emeljanovas, Brigita Mieziene, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

Abstract:

Background: Gender differences in physical fitness were tracked in many studies with lower effect in preschool children and increasing difference among genders across age. In Lithuania, on a population level, secular trends in physical fitness were regularly observed each ten years for the last two decades for 11-18 years old students. However, there is apparently a lack of such epidemiological studies among primary school students. Assessing and monitoring physical fitness from an early age is of particular importance seeking to develop and strengthen physical abilities of youths for future health benefits. The goal of the current study was to indicate age and gender differences in anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children. Methods: The study included 3456 1-4th grade students from 6 to 10 years. The data reliably represents the population of primary school children in Lithuania. Among them, 1721 (49.8 percent) were boys. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues (2011). Height and weight were measured and body mass index was calculated. Student t test evaluated differences in physical fitness between boys and girls, ANOVA was performed to indicate differences across age. Results: All anthropometric and fitness means that were identified as significantly different were better in boys than in girls and in older than younger students (p < .05). Among anthropometric measures, height was higher in boys aged 7 through 9 years. Weight and BMI differed among boys and girls only at 8 years old. Means of height and weight increased significantly across all ages. Among musculoskeletal fitness tests, means of standing broad jump, throwing a tennis ball and pushing a medicine ball were different between genders within each age group and across all ages. Differences between genders were less likely in motor fitness than in musculoskeletal or cardiorespiratory fitness. Differences in means of shuttle run 10 x 5 test between genders occurred at age 6, 9 and 10 years; running 20 m at age 6 and 9 years, and climbing wall bars at age 9 and 10. Means of Reduced Cooper test representing cardiorespiratory fitness were different between genders within each age group but did not differ among age 6 and 8 as well as 7 and 8 years in boys, and among age 7 and 8 years in girls. Conclusion: In general, the current study confirms gender differences in musculoskeletal, motor and cardiorespiratory fitness found in other studies across the world in primary school and older children. Observed gender differences might be explained by higher physical activity in boys rather than girls. As it is explained by previous literature, older boys and girls had better performances than younger ones, because of the components of fitness change as a function of growth, maturation, development, and interactions among the three processes.

Keywords: primary school children, motor fitness, musculoskeletal fitness, cardiovascular fitness

Procedia PDF Downloads 189
6393 Non-Communicable Diseases: Knowledge, Attitudes and Practices of Risk Factors among Secondary School Students in Sharjah, UAE

Authors: A. Al-Wandi, A. Al-Ali, R. Dali, Y. Al-Karaghouli

Abstract:

Background: Non-communicable diseases (NCDs) have become an alarming health problem across the globe. The risk of developing those diseases begins in childhood and develops gradually under the influence of risk factors including obesity, hypertension, dyslipidemia, cigarette smoking and decreased physical activity. Therefore, this study aims to determine the level of knowledge, attitudes, and practices of the risk factors of lifestyle induced chronic diseases (non-communicable diseases) among secondary school students in Sharjah city. Methods: Five hundred and ninety-one school children, from grades 10 to 12, formed the study sample, using the multistage stratified cluster sampling method. Four governmental schools were chosen, for each gender. Data was collected through a pretested, close-ended questionnaire consisting of five sections; demographics, physical activity, diet, smoking and sleeping patterns. Frequencies and descriptive statistics were used to analyze data through SPSS 23. Results: The data showed 64.6% of students had low knowledge of risk factors of non-communicable diseases. Concerning physical activity, 58.2 % were physically inactive and females being less active than males. More than 2/3 of students didn’t fulfill the recommended daily intake of fruits and vegetables (75.9%). 8% reported to be smokers with cigarettes being the most encountered tobacco product. Conclusion: Our study has demonstrated a low level of knowledge and practices yet, positive attitudes towards risk factors of chronic diseases. We recommend implementation of thorough awareness campaigns through public health education about the risk factors of non-communicable diseases.

Keywords: non-communicable diseases, physical activity, diet, knowledge, attitudes, practices, smoking

Procedia PDF Downloads 209
6392 Effect of Different Oils on Quality of Deep-fried Dough Stick

Authors: Nuntaporn Aukkanit

Abstract:

The aim of this study was to determine the effect of oils on chemical, physical, and sensory properties of deep-fried dough stick. Five kinds of vegetable oil which were used for addition and frying consist of: palm oil, soybean oil, sunflower oil, rice bran oil, and canola oil. The results of this study showed that using different kinds of oil made significant difference in the quality of deep-fried dough stick. Deep-fried dough stick fried with the rice bran oil had the lowest moisture loss and oil absorption (p≤0.05), but it had some unsatisfactory physical properties (color, specific volume, density, and texture) and sensory characteristics. Nonetheless, deep-fried dough stick fried with the sunflower oil had moisture loss and oil absorption slightly more than the rice bran oil, but it had almost higher physical and sensory properties. Deep-fried dough sticks together with the sunflower oil did not have different sensory score from the palm oil, commonly used for production of deep-fried dough stick. These results indicated that addition and frying with the sunflower oil are appropriate for the production of deep-fried dough stick.

Keywords: deep-fried dough stick, palm oil, sunflower oil, rice bran oil

Procedia PDF Downloads 267
6391 Self-Care Behavior and Performance Level Associated with Algerian Chronically Ill Patients

Authors: S. Aberkane, N. Djabali, S. Fafi, A. Baghezza

Abstract:

Chronic illnesses affect many Algerians. It is possible to investigate the impact of illness representations and coping on quality of life and whether illness representations are indirectly associated with quality of life through their influence on coping. This study aims at investigating the relationship between illness perception, coping strategies and quality of life with chronic illness. Illness perceptions are indirectly associated with the quality of life through their influence on coping mediation. A sample of 316 participants with chronic illness living in the region of Batna, Algeria, has been adopted in this study. A correlation statistical analysis is used to determine the relationship between illness perception, coping strategies, and quality of life. Multiple regression analysis was employed to highlight the predictive ability of the dimensions of illness perception and coping strategies on the dependent variables of quality of life, where mediation analysis is considered in the exploration of the indirect effect significance of the mediator. This study provides insights about the relationship between illness perception, coping strategies and quality of life in the considered sample (r = 0.39, p < 0.01). Therefore, it proves that there is an effect of illness identity perception, external and medical attributions related to emotional role, physical functioning, and mental health perceived, and these were fully mediated by the asking for assistance (c’= 0.04, p < 0.05), the guarding (c’= 0.00, p < 0.05), and the task persistence strategy (c’= 0.05, p < 0.05). The findings imply partial support for the common-sense model of illness representations in a chronic illness population. Directions for future research are highlighted, as well as implications for psychotherapeutic interventions which target unhelpful beliefs and maladaptive coping strategies (e.g., cognitive behavioral therapy).

Keywords: chronic illness, coping, illness perception, quality of life, self- regulation model

Procedia PDF Downloads 210
6390 The Investigation of Green Building Certification on the Productivity and Mental and Physical Health of Building's Occupants in Tehran, Iran

Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

Abstract:

Numerous assertions and some empirical evidence imply that 'green' buildings ought to be more productive and healthier (mentally and physiologically) than conventional structures. Since then, empirical data has been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared four green-certified buildings -one residential green building, one green hospital, and one green school- with conventional structures in Tehran, Iran, by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity and physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these buildings against non-green buildings. In addition, ancillary matters -environmental, financial, intellectual, emotional, social, and spiritual dimensions of participants- were indirectly evaluated, and the same results were produced.

Keywords: green building, LEED, productivity, physical and mental health, indoor environmental quality

Procedia PDF Downloads 101
6389 Turning Parameters Affect Time up and Go Test Performance in Pre-Frail Community-Dwelling Elderly

Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

Abstract:

Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

Procedia PDF Downloads 166
6388 The Influense of Alternative Farming Systems on Physical Parameters of the Soil

Authors: L. Masilionyte, S. Maiksteniene

Abstract:

Alternative farming systems are used to cultivate high quality food products and retain the viability and fertility of soil. The field experiments of different farming systems were conducted at Joniškėlis Experimental Station of the Lithuanian Research Centre for Agriculture and Forestry in 2006–2013. The soil of the experimental site was Endocalcari-Endohypogleyic Cambisol (CMg-n-w-can). In different farming systems, farmyard manure, straw and green manure catch crops used for fertilization both in the soil low in humus and in the soil moderate in humus. In the 0–20 cm depth layer, it had a more significant effect on soil moisture than on other physical soil properties. In the agricultural systems, in which catch crops had been grown, soil physical characteristics did not differ significantly before their biomass incorporation, except for the moisture content, which was lower in rainy periods and higher in drier periods than in the soil without catch crops. Soil bulk density and porosity in the topsoil layer were more dependent on soil humus content than on agricultural measures used: in the soil moderate in humus content, compared with the soil low in humus, bulk density was by 1.4 % lower, and porosity by 1.8 % higher. The research findings create a possibility to make improvements in alternative cropping systems by choosing organic fertilizers and catch crops’ combinations that have the sustainable effect on soil and that maintain the sustainability of soil productivity parameters. Rational fertilization systems, securing the stability of soil productivity parameters and crop rotation productivity will promote a development of organic agriculture.

Keywords: agro-measures, soil physical parameters, organic farming, sustainable farming

Procedia PDF Downloads 385
6387 Evaluation of Clinical Decision Support System in Electronic Medical Record System: A Case of Malawi National Art Electronic Medical Record System

Authors: Pachawo Bisani, Goodall Nyirenda

Abstract:

The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.

Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy

Procedia PDF Downloads 67
6386 Extracorporeal Co2 Removal (Ecco2r): An Option for Treatment for Refractory Hypercapnic Respiratory Failure

Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

Abstract:

Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

Procedia PDF Downloads 42
6385 Capnography in Hypoxic Pseudo-Pea May Correlate to the Amount of Required Intervention for Resuscitation

Authors: Yiyuan David Hu, Alex Lindqwister, Samuel B. Klein, Karen Moodie, Norman A. Paradis

Abstract:

Introduction: Pseudo-Pulseless Electrical Activity (p-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Patients in pseudo-PEA carry different prognoses than those in true PEA and may require different therapies. End-tidal carbon dioxide (ET-CO2) has been studied in ventricular fibrillation and true PEA but in p-PEA. We utilized an hypoxic porcine model to characterize the performance of ET-CO2 in resuscitation from p-PEA. Hypothesis: Capnography correlates to the number of required interventions for resuscitation from p-PEA. Methods: Female swine (N = 14) under intravenous anesthesia were instrumented with aortic and right atrial micromanometer pressure. ECG and ET-CO2 were measured continuously. p-PEA was induced by ventilation with 6% oxygen in 94% nitrogen and was defined as a systolic aortic (Ao) pressure less than 40 mmHg. Pigs were grouped based on the interventions required to achieve ROSC: 100%O2, 100%O2 + CPR, 100%O2 + CPR + epinephrine. Results: End tidal CO2 reliably predicted O2 therapy vs CPR-based interventions needed for resuscitation (Figure 1). Pigs who would recover with 100%O2 only had a mean ET-CO2 slope of 0.039 ± 0.013 [ R2 = 0.68], those requiring oxygen + CPR had a slope of -0.15 ± 0.016 [R2 = 0.95], and those requiring oxygen + CPR + epinephrine had a slope of -0.12 ± 0.031 [R2 = 0.79]. Conclusions: In a porcine model of hypoxic p-PEA, measured ET-CO2 appears to be strongly correlated with the required interventions needed for ROSC. If confirmed clinically, these results indicate that ET-CO2 may be useful in guiding therapy in patients suffering p-PEA cardiac arrest.

Keywords: pseudo-PEA, resuscitation, capnography, hypoxic pseudo-PEA

Procedia PDF Downloads 172