Search results for: long‐term care

Authors: Haslinda Nahazanan, Afshin Asadi, Zainuddin Md. Yusoff, Nik Nor Syahariati Nik Daud

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Mudrocks is considered as a problematic material due to their unexpected behaviour specifically when they are contacting with water or being exposed to the atmosphere. Many instability problems of cutting slopes were found lying on high slaking mudrocks. It has become one of the major concerns to geotechnical engineer as mudrocks cover up to 50% of sedimentary rocks in the geologic records. Mudrocks display properties between soils and rocks which can be very hard to understand. Therefore, this paper aims to review the definition, mineralogy, geo-chemistry, classification and engineering properties of mudrocks. As water has become one of the major factors that will rapidly change the behaviour of mudrocks, a review on the shear strength of mudrocks in Derbyshire has been made using a fully automated hydraulic stress path testing system under three states: dry, short-term inundated and long-term inundated. It can be seen that the strength of mudrocks has deteriorated as it condition changed from dry to short-term inundated and finally to long-term inundated.

Keywords: mudrocks, sedimentary rocks, inundation, shear strength

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Authors: Ellina Zipman

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This research investigates the place of music education in aged care facilities through the implementation of a program of regular piano lessons for residents. Using a qualitative case study methodology, the research explores aged care residents’ experiences in learning to play the piano. Since the aged care homes are unlikely places for formal learning and since older adults, especially in residential care, are not considered likely candidates for learning, this research opens the door for innovative and transformative thinking about where and to whom educational programs can be delivered. By addressing the educational needs of residents in aged care facilities, this research fills the gap in the literature. The research took place in Australia in two of Melbourne’s residential aged care facilities, engaging two residents (a nonagenarian female and an octogenarian male) to participate in 12-months weekly individual piano lessons. The data was collected through video recording of lessons, observations, interviews, emails, and a reflective journal. Data analysis was done using Nvivo and hard copy analysis with identifications of themes. The case studies revealed that passion for music was a major driver in participants’ motivation to engage in a long-term piano lessons program. This participation led to experiences of positive emotions, positive attitude, successes and challenges, the exercise of control, maintaining and building new relationships, improved self-confidence through autonomy and independent skills development, and discovering new identities through finding a new purpose and new roles in life. Speaking through participants’ voices, this research project demonstrates the importance of music education for older adults and hopes to influence transformation in the residential aged care sector.

Keywords: adult music education, quality of life, passion, positive ageing, wellbeing

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Authors: Othman Maklouf, Abdunnaser Tresh

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GPS and inertial navigation system (INS) have complementary qualities that make them ideal use for sensor fusion. The limitations of GPS include occasional high noise content, outages when satellite signals are blocked, interference and low bandwidth. The strengths of GPS include its long-term stability and its capacity to function as a stand-alone navigation system. In contrast, INS is not subject to interference or outages, have high bandwidth and good short-term noise characteristics, but have long-term drift errors and require external information for initialization. A combined system of GPS and INS subsystems can exhibit the robustness, higher bandwidth and better noise characteristics of the inertial system with the long-term stability of GPS. The most common estimation algorithm used in integrated INS/GPS is the Kalman Filter (KF). KF is able to take advantages of these characteristics to provide a common integrated navigation implementation with performance superior to that of either subsystem (GPS or INS). This paper presents a simplified KF algorithm for land vehicle navigation application. In this integration scheme, the GPS derived positions and velocities are used as the update measurements for the INS derived PVA. The KF error state vector in this case includes the navigation parameters as well as the accelerometer and gyroscope error states.

Keywords: GPS, INS, Kalman filter, inertial navigation system

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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Authors: Sudhakar Kadiyala, Sripad R. Naik

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Large cavern in Bhutan Himalayas is being monitored since the construction period. The behavior of the cavern is being monitored for last 16 years. Instrumentation includes measurement of convergence of high walls by geodetic monitoring, load on the support systems with load cells and instrumented bolts. Analysis of the results of instrumentation showed that during the construction period of the cavern, the convergence of the cavern varied from 181 - 233 mm in the unit bay area with maximum convergence rate of 2.80mm/day. Whereas during the operational period the total convergence observed was in the range of 21 to 45 mm during a period of 11.30 years with convergence rate of 0.005 to 0.011 mm/day. During the last five years, there were no instances of high tensile stress recorded by the instrumented bolts. Load on the rock bolts have shown stabilization trend at most of the locations. This paper discusses in detail the results of long-term monitoring using the geotechnical instruments and how the data is being used in 3D numerical model to confirm the stability of the cavern.

Keywords: convergence, displacements, geodetic monitoring, long-term stability

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Authors: Mahmoud Hassan, Walid Oueslati, Damien Rousseliere

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This paper explores the channels through which energy taxes may affect economic growth, using a simultaneous equations model for a balanced panel data of 31 OECD countries over the 1994–2013 period. The empirical results reveal a negative impact of energy taxes on physical investment in the short and long term. This impact is negatively sensitive to the existence and level of public debt. Additionally, the results show that energy taxes have an indirect effect on human capital through their impact on polluting emissions. The taxes on energy products are able to reduce both the flux and the stock of polluting emissions that have a negative impact on human capital skills in the short and long term. Finally, we found that energy taxes could encourage eco-innovation in the short and long term.

Keywords: energy taxes, economic growth, public debt, simultaneous equations model, multiple imputation

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Authors: Meenakshi Srivastava, Anke A. De Boer, Sip Jan Pij

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Teacher’s preparedness towards special educational needs (SEN) of the students in regular schools is an important factor in making education inclusive as a goal to provide education for all. The current study measured the long term effects of an in-service teacher training programme which focused on the inclusion of students with a range of SEN. The programme was on three particular aspects: teachers’ attitudes, their knowledge about SEN and knowledge about teaching methods. A refresher course was also organized for participants of the initial training programme. The long term effects were examined by teachers using a self-report questionnaire (n = 38). The wider effects of the initial training were recorded by interviewing school principals (n = 4). Repeated measures of ANOVA revealed significant effects: more positive attitudes and increased knowledge about SEN among teachers who took the refresher course (n = 18) compared to those who had not (n = 19). Principals also found a more positive attitude, sensitivity and increased awareness about SEN among the participants.

Keywords: inclusion, students with special educational needs, teacher training, follow-up, attitudes change

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Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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Authors: Samira Humaira Habib

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Diabetes has profound effects on individuals and their families. If diabetes is not well monitored and managed, then it leads to long-term complications and a large and growing cost to the health care system. Prevalence and socioeconomic burden of diabetes and relative return of investment for the elimination or the reduction of the burden are much more important regarding its cost burden. Various studies regarding the socioeconomic cost burden of diabetes are well explored in developed countries but almost absent in developing countries like Bangladesh. The main objective of the study is to estimate the total socioeconomic burden of diabetes. It is a prospective longitudinal follow up study which is analytical in nature. Primary and secondary data are collected from patients who are undergoing treatment for diabetes at the out-patient department of Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). Of the 2115 diabetic subjects, females constitute around 50.35% of the study subject, and the rest are male (49.65%). Among the subjects, 1323 are controlled, and 792 are uncontrolled diabetes. Cost analysis of 2115 diabetic patients shows that the total cost of diabetes management and treatment is US$ 903018 with an average of US$ 426.95 per patient. In direct cost, the investigation and medical treatment at hospital along with investigation constitute most of the cost in diabetes. The average cost of a hospital is US$ 311.79, which indicates an alarming warn for diabetic patients. The indirect cost shows that cost of productivity loss (US$ 51110.1) is higher among the all indirect item. All constitute total indirect cost as US$ 69215.7. The incremental cost of intensive management of uncontrolled diabetes is US$ 101.54 per patient and event-free time gained in this group is 0.55 years and the life years gain is 1.19 years. The incremental cost per event-free year gained is US$ 198.12. The incremental cost of intensive management of the controlled group is US$ 89.54 per patient and event-free time gained is 0.68 years, and the life year gain is 1.12 years. The incremental cost per event-free year gained is US$ 223.34. The EuroQoL difference between the groups is found to be 64.04. The cost-effective ratio is found to be US$ 1.64 cost per effect in case of controlled diabetes and US$ 1.69 cost per effect in case of uncontrolled diabetes. So management of diabetes is much more cost-effective. Cost of young type 1 diabetic patient showed upper socioeconomic class, and with the increase of the duration of diabetes, the cost increased also. The dietary pattern showed macronutrients intake and cost are significantly higher in the uncontrolled group than their counterparts. Proper management and control of diabetes can decrease the cost of care for the long term.

Keywords: cost, cost-effective, chronic diseases, diabetes care, burden, Bangladesh

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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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Authors: Pia I. Hautamäki

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Sales has changed. Selling has taken on aspects of relationship marketing and sales force play a critical role in developing long-term relationships between buyers and sellers which is seen to serve the company’s targets and create success for a long run. The purpose of this study was to examine what really matters in buyer-seller encounters and determine what expectations business buyers have. We studied 17 business buyers by a qualitative interview. We found that buyers appreciate encounters where the salesperson face the buyer as a way he or she is as a person, identificate the real needs to improve buyers’ business and build up cooperation for long-term relationship. This study show that personality matters are a key elements when satisfying business buyers’ expectations.

Keywords: business buyer-seller encounters, customer expectations, perceived similarity, personal selling, personality types

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Authors: Avigail Moor

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A decline in women’s sexual desire over the course of long-term relationships, relative to men’s, has been frequently noted. Yet, while there is ample evidence that this change in women is quite common, it is still generally pathologized. Moreover, little is known regarding its true meaning for women and the effect it has on their wellbeing. In light of that, our primary goal was to investigate women's subjective experiences of this reality. Do they connect it to dysfunction in self or marriage, or rather they don't equate love and sex, which for them simply become less connected with time, even as the relationship remains entirely fulfilling? A second goal was to explore how such gender-based differences in sexual desire impact women, and indirectly the couple and partner, in terms of wellbeing and satisfaction from the relationship. In-depth semi-structured interviews were conducted with 15 women in committed long-term relations, aged 25 and over. The findings indicate that for women, there is no contradiction between a loving relation and a decline in spontaneous sexual desire. At the same time, while not rooted in a problem, it does create some. Tension, frustration, conflict, and pressure are some of the negative sequelae that carry adverse effects for women’s wellbeing, the solution to which requires, in their opinion, honest dialogue, mutual respect, and reasonable compromise.

Keywords: gender, sexuality, sexual desire, well being

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Authors: Lemi Tolu

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Background: Postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. Objective: This study assesses the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methodology: An institution-based cross-sectional study was conducted from January 1 to June 30, 2017. The six months of study were used as strata, and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariable logistic regressions were fitted to identify determinants of post-partum family planning uptake. An OR with 95% CIs was calculated, and p values set at 005 were used to determine the statistical significance of associations. Results: Four hundred and twenty-two post-partum women were interviewed. Two hundred sixty-eight (63%) women received counselling on family planning, and 241 (66.8 %) got information about contraception. One hundred and fifty-two (45%) of the women accepted long-term and permanent contraception on their immediate postpartum period before discharge. Contraceptive counselling (OR = 2.13, 95% CI 1.004-3.331), getting information from the health facility (OR = 15.15, 95% CI 1.848-19.242), and partner support (OR = 1.367, 95% CI 1.175-2.771) were significantly associated with long-term and permanent contraception uptake. Conclusion: Postpartum counselling on family planning and provision of contraception information improve immediate postpartum FP acceptance, and, hence postpartum programs need to strengthen such services.

Keywords: contraception, immediate postpartum, long-term family planning, post-partum family planning

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Authors: Marcio Freire Cruz, Naoaki Ono, Shigehiko Kanaya, Carlos Arthur Mattos Teixeira Cavalcante

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The systems that record patient care information, known as Electronic Medical Record (EMR) and those that monitor vital signs of patients, such as heart rate, body temperature, and blood pressure have been extremely valuable for the effectiveness of the patient’s treatment. Several kinds of research have been using data from EMRs and vital signs of patients to predict illnesses. Among them, we highlight those that intend to predict, classify, or, at least identify patterns, of sepsis illness in patients under vital signs monitoring. Sepsis is an organic dysfunction caused by a dysregulated patient's response to an infection that affects millions of people worldwide. Early detection of sepsis is expected to provide a significant improvement in its treatment. Preceding works usually combined medical, statistical, mathematical and computational models to develop detection methods for early prediction, getting higher accuracies, and using the smallest number of variables. Among other techniques, we could find researches using survival analysis, specialist systems, machine learning and deep learning that reached great results. In our research, patients are modeled as points moving each hour in an n-dimensional space where n is the number of vital signs (variables). These points can reach a sepsis target point after some time. For now, the sepsis target point was calculated using the median of all patients’ variables on the sepsis onset. From these points, we calculate for each hour the position vector, the first derivative (velocity vector) and the second derivative (acceleration vector) of the variables to evaluate their behavior. And we construct a prediction model based on a Long Short-Term Memory (LSTM) Network, including these derivatives as explanatory variables. The accuracy of the prediction 6 hours before the time of sepsis, considering only the vital signs reached 83.24% and by including the vectors position, speed, and acceleration, we obtained 94.96%. The data are being collected from Medical Information Mart for Intensive Care (MIMIC) Database, a public database that contains vital signs, laboratory test results, observations, notes, and so on, from more than 60.000 patients.

Keywords: dynamic analysis, long short-term memory, prediction, sepsis

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Authors: Ying Su, Morgan C. Wang

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Long-term time series forecasting is an important research area for automated machine learning (AutoML). Currently, forecasting based on either machine learning or statistical learning is usually built by experts, and it requires significant manual effort, from model construction, feature engineering, and hyper-parameter tuning to the construction of the time series model. Automation is not possible since there are too many human interventions. To overcome these limitations, this article proposed to use recurrent neural networks (RNN) through the memory state of RNN to perform long-term time series prediction. We have shown that this proposed approach is better than the traditional Autoregressive Integrated Moving Average (ARIMA). In addition, we also found it is better than other network systems, including Fully Connected Neural Networks (FNN), Convolutional Neural Networks (CNN), and Nonpooling Convolutional Neural Networks (NPCNN).

Keywords: automated machines learning, autoregressive integrated moving average, neural networks, time series analysis

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Authors: Juhan Kim, Jinsoo Kim

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South Korea cannot import natural gas in any form other than LNG because of the division of South and North Korea. Further, the high proportion of natural gas in the national energy mix makes this resource crucial for energy security in Korea. Expansion of Panama Canal will allow for reducing the cost of shipping between the Far East and U.S East. Panama Canal expansion can have significant impacts on South Korea. Due to this situation, we review the natural gas optimal portfolio by considering the uniqueness of the Korean Natural gas market and expansion of Panama Canal. In order to assess Korea’s natural gas optimal portfolio, we developed natural gas portfolio model. The model comprises two steps. First, to obtain the optimal long-term spot contract ratio, the study examines the price level and the correlation between spot and long-term contracts by using the Markowitz, portfolio model. The optimal long-term spot contract ratio follows the efficient frontier of the cost/risk level related to this price level and degree of correlation. Second, by applying the obtained long-term contract purchase ratio as the constraint in the linear programming portfolio model, we determined the natural gas optimal import portfolio that minimizes total intangible and tangible costs. Using this model, we derived the optimal natural gas portfolio considering the expansion of Panama Canal. Based on these results, we assess the portfolio for natural gas import to Korea from the perspective of energy security and present some relevant policy proposals.

Keywords: natural gas, Panama Canal, portfolio analysis, South Korea

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Authors: Saleh Alagla, Murya Habbash

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The paper investigates whether the board of directors plays a monitoring role or not in CEO compensation for the UK firms during the eve of the recent financial crisis, 2004-2008. The use of heteroscedastic and autocorrelated error consistent estimation of the panel data shows, surprisingly, that four board characteristics variables are found to play a significant role in increasing the level of CEO compensation. This insightful result would suggest evidence of the managerial power theory in general and the cronyism hypothesis in particular. Moreover, the interesting evidence supporting managerial power perspective is that CEO-Chair duality reduces long-term compensation while increasing short-term compensation, thus suggesting that CEOs are risk averse who prefer short-term compensation to long-term compensation. Finally, consistent with the agency perspective board size is found to increase all compensation variables as expected.

Keywords: corporate governance, CEO compensation, board of directors, internal governance mechanisms, agency theory, managerial power theory, cronyism hypothesis

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: A. Raj Kumar, A. Okunseinde, P. Raghavan, V. Kapila

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Stroke is the leading cause of adult disability worldwide. With recent advances in immediate post-stroke care, there is an increasing number of young stroke survivors, under the age of 65 years. While most stroke survivors will regain the ability to walk, they often experience long-term arm and hand motor impairments. Long term upper limb rehabilitation is needed to restore movement and function, and prevent deterioration from complications such as learned non-use and learned bad-use. We have developed a novel virtual coach, a wearable instrumented rehabilitation jacket, to motivate individuals to participate in long-term skill re-learning, that can be personalized to their impairment profile. The jacket can estimate the movements of an individual’s arms using embedded off-the-shelf sensors (e.g., 9-DOF IMU for inertial measurements, flex-sensors for measuring angular orientation of fingers) and a Bluetooth Low Energy (BLE) powered microcontroller (e.g., RFduino) to non-intrusively extract data. The 9-DOF IMU sensors contain 3-axis accelerometer, 3-axis gyroscope, and 3-axis magnetometer to compute the quaternions, which are transmitted to a computer to compute the Euler angles and estimate the angular orientation of the arms. The data are used in a gaming environment to provide visual, and/or haptic feedback for goal-based, augmented-reality training to facilitate re-learning in a cost-effective, evidence-based manner. The full paper will elaborate the technical aspects of communication, interactive gaming environment, and physical aspects of electronics necessary to achieve our stated goal. Moreover, the paper will suggest methods to utilize the proposed system as a cheaper, portable, and versatile system vis-à-vis existing instrumentation to facilitate post-stroke personalized arm rehabilitation.

Keywords: feedback, gaming, Euler angles, rehabilitation, augmented reality

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Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail

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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.

Keywords: urgent care centres, primary care physicians, overcrowding, cost

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: Sneha Thakur, Sanjeev Karmakar

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This paper proposed hybrid Particle Swarm Optimization (PSO) – Long-Short Term Memory (LSTM) model for groundwater level prediction. The evaluation of the performance is realized using the parameters: root mean square error (RMSE) and mean absolute error (MAE). Ground water level forecasting will be very effective for planning water harvesting. Proper calculation of water level forecasting can overcome the problem of drought and flood to some extent. The objective of this work is to develop a ground water level forecasting model using deep learning technique integrated with optimization technique PSO by applying 29 years data of Chhattisgarh state, In-dia. It is important to find the precise forecasting in case of ground water level so that various water resource planning and water harvesting can be managed effectively.

Keywords: long short-term memory, particle swarm optimization, prediction, deep learning, groundwater level

Procedia PDF Downloads 78

Authors: Abu Zafor Sadek

Abstract:

Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

Procedia PDF Downloads 92

Authors: Tafadzwa Shumba, Rose C. Nyatondo, Regret Sunge

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This research analyses the impact of budget deficits on the economic performance of Zimbabwe. The study employs the autoregressive distributed lag (ARDL) confines testing method to co-integration and long-run estimation using time series data from 1980-2018. The Augmented Dick Fuller (ADF) and the Granger approach were used to testing for stationarity and causality among the factors. Co-integration test results affirm a long term association between GDP development rate and descriptive factors. Causality test results show a unidirectional connection between budget shortfall to GDP development and bi-directional causality amid debt and budget deficit. This study also found unidirectional causality from debt to GDP growth rate. ARDL estimates indicate a significantly positive long term and significantly negative short term impact of budget shortfall on GDP. This suggests that budget deficits have a short-run growth retarding effect and a long-run growth-inducing effect. The long-run results follow the Keynesian theory that posits that fiscal deficits result in an increase in GDP growth. Short-run outcomes follow the neoclassical theory. In light of these findings, the government is recommended to minimize financing of recurrent expenditure using a budget deficit. To achieve sustainable growth and development, the government needs to spend an absorbable budget deficit focusing on capital projects such as the development of human capital and infrastructure.

Keywords: ARDL, budget deficit, economic performance, long run

Procedia PDF Downloads 97

Authors: Yuthapoom Thanakijborisut

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This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.

Keywords: consumption insurance, chronic illness, health care, Thailand

Procedia PDF Downloads 238

Authors: Woo-Tai Jung, Sung-Yong Choi, Young-Hwan Park

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The composite pavement system considered in this paper is composed of a functional surface layer, a fiber reinforced asphalt middle layer and a fiber reinforced lean concrete base layer. The mix design of the fiber reinforced lean concrete corresponds to the mix composition of conventional lean concrete but reinforced by fibers. The quasi-absence of research on the durability or long-term performances (fatigue, creep, etc.) of such mix design stresses the necessity to evaluate experimentally the long-term characteristics of this layer composition. This study tests the creep characteristics as one of the long-term characteristics of the fiber reinforced lean concrete layer for composite pavement using a new creep device. The test results reveal that the lean concrete mixed with fiber reinforcement and fly ash develops smaller creep than the conventional lean concrete. The results of the application of the CEB-FIP prediction equation indicate that a modified creep prediction equation should be developed to fit with the new mix design of the layer.

Keywords: creep, lean concrete, pavement, fiber reinforced concrete, base

Procedia PDF Downloads 522

Authors: Saeed Yazdani, Sima Mohamadi Amidabadi, Amir Mohamadi Nejad, Farahnaz Nekoofar

Abstract:

As a result of uncertainty and doubts about the quantity of agricultural products, greater significance has been attached to risk management in the agricultural sector. Normally, farmers seek to minimize risks, and crop diversity has always been a means to reduce risk. The study at hand seeks to explore the long-term impact of crop diversity on income risk reduction. The timeframe of the study is 1998 to 2018. Initially, the Herfindahl index was used to estimate crop diversity in different periods, and next, the Hodrick-Prescott filter was applied to estimate income risk both in nominal and real terms. Finally, using the Vector Error Correction Model (VECM), the long-term impact of crop diversity on two modes of risk for the farmer's income has been estimated. Given the long-term pattern’s results, it is evident that in the long-run, crop diversity can reduce income fluctuations in two nominal and real terms. Moreover, results showed that in case the fluctuation shock affects the agricultural income in the short run, to balance out the shock in nominal and real terms, 4 and 3 cycles are needed respectively. In other words, in each cycle, 25% and 33% of the shock impact can be removed, respectively. Thus, as the results of the error correction coefficient showed, policies need to be put in place to prevent income shocks. In case of a shock, they need to be balanced out in a four-year period, taking inflation into account, and in a three-year period irrespective of the inflation and reparative policies such as insurance services should be developed.

Keywords: risk, long-term model, Herfindahl index, time series model, vector error correction model

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Authors: Xinyi Xu

Abstract:

This study conducts a detailed examination of Asian stock markets over the period from 2008 to 2023, with a focus on the dynamics of cointegration and their relevance for long-term investment strategies. Specifically, we assess the co-movement and potential for pairs trading—a strategy where investors take opposing positions on two stocks, indices, or financial instruments that historically move together. For example, we explore the relationship between the Nikkei 225 (N225), Japan’s benchmark stock index, and the Straits Times Index (STI) of Singapore, as well as the relationship between the Korea Composite Stock Price Index (KS11) and the STI. The methodology includes tests for normality, stationarity, cointegration, and the application of Vector Error Correction Modeling (VECM). Our findings reveal significant long-term relationships between these pairs, indicating opportunities for pairs trading strategies. Furthermore, the research underscores the challenges posed by model instability and the influence of major global incidents, which are identified as structural breaks. These findings pave the way for further exploration into the intricacies of financial market dynamics.

Keywords: normality tests, stationarity, cointegration, VECM, pairs trading

Procedia PDF Downloads 56

Authors: Elie Awwad, Bilal Hamad, Mounir Mabsout, Helmi Khatib

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The paper reports test results on the long-term behavior of sustainable hemp-concrete material prepared in research work conducted at the American University of Beirut. The tests results are in terms of compressive and splitting tensile tests conducted on standard 150x300 mm cylinders. A control mix without fibers, one polypropylene-concrete mix, and ten hemp-concrete mixes were prepared with different percentages of industrial hemp fibers and reduced coarse aggregate contents. The objective was to investigate the strength properties of hemp-reinforced concrete at 1.5 years age as compared with control mixes. The results indicated that both the compressive strength and the splitting tensile strength results of all tested cylinders increased as compared with the 28-days values. Also, the difference between the hemp-concrete samples and the control samples at 28 days was maintained at 1.5 years age indicating that hemp fibers did not exhibit any negative effect on the long-term strength properties of concrete.

Keywords: hemp-reinforced concrete, natural fibers, compressive strength, splitting tensile strength

Procedia PDF Downloads 363

Authors: Alexander Rych

Abstract:

Piql Preservation Services (“Piql”) is a turnkey solution designed for secure, migration-free long- term preservation of digital data. Piql sets an open standard for long- term preservation for the future. It consists of equipment and processes needed for writing and retrieving digital data. Exponentially growing amounts of data demand for logistically effective and cost effective processes. Digital storage media (hard disks, magnetic tape) exhibit limited lifetime. Repetitive data migration to overcome rapid obsolescence of hardware and software bears accelerated risk of data loss, data corruption or even manipulation and adds significant repetitive costs for hardware and software investments. Piql stores any kind of data in its digital as well as analog form securely for 500 years. The medium that provides this is a film reel. Using photosensitive film polyester base, a very stable material that is known for its immutability over hundreds of years, secure and cost-effective long- term preservation can be provided. The film reel itself is stored in a packaging capable of protecting the optical storage medium. These components have undergone extensive testing to ensure longevity of up to 500 years. In addition to its durability, film is a true WORM (write once- read many) medium. It therefore is resistant to editing or manipulation. Being able to store any form of data onto the film makes Piql a superior solution for long-term preservation. Paper documents, images, video or audio sequences – all of those file formats and documents can be preserved in its native file structure. In order to restore the encoded digital data, only a film scanner, a digital camera or any appropriate optical reading device will be needed in the future. Every film reel includes an index section describing the data saved on the film. It also contains a content section carrying meta-data, enabling users in the future to rebuild software in order to read and decode the digital information.

Keywords: digital data, long-term preservation, migration-free, photosensitive film

Procedia PDF Downloads 392