Search results for: recurrent event
364 A Microcosm Study on the Response of Phytoplankton and Bacterial Community of the Subarctic Northeast Atlantic Ocean to Oil Pollution under Projected Atmospheric CO₂ Conditions
Authors: Afiq Mohd Fahmi, Tony Gutierrez, Sebastian Hennige
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Increasing amounts of CO₂ entering the marine environment, also known as ocean acidification, is documented as having harmful impacts on a variety of marine organisms. When considering the future risk of hydrocarbon pollution, which is generally detrimental to marine life as well, this needs to consider how OA-induced changes to microbial communities will compound this since hydrocarbon degradation is influenced by the community-level microbial response. This study aims to evaluate the effects of increased atmospheric CO₂ conditions and oil enrichment on the phytoplankton-associated bacterial communities. Faroe Shetland Channel (FSC) is a subarctic region in the northeast Atlantic where crude oil extraction has recently been expanded. In the event of a major oil spill in this region, it is vital that we understand the response of the bacterial community and its consequence on primary production within this region—some phytoplankton communities found in the ocean harbor hydrocarbon-degrading bacteria that are associated with its psychosphere. Surface water containing phytoplankton and bacteria from FSC were cultured in ambient and elevated atmospheric CO₂ conditions for 4 days of acclimation in microcosms before introducing 1% (v/v) of crude oil into the microcosms to simulate oil spill conditions at sea. It was found that elevated CO₂ conditions do not significantly affect the chl a concentration, and exposure to crude oil detrimentally affected chl a concentration up to 10 days after exposure to crude oil. The diversity and richness of the bacterial community were not significantly affected by both CO₂ treatment and oil enrichment. The increase in the relative abundance of known hydrocarbon degraders such as Oleispira, Marinobacter and Halomonas indicates potential for biodegradation of crude oil, while the resilience of dominant taxa Colwellia, unclassified Gammaproteobacteria, unclassified Rnodobacteria and unclassified Halomonadaceae could be associated with the recovery of microalgal community 13 days after oil exposure. Therefore, the microbial community from the subsurface of FSC has the potential to recover from crude oil pollution even under elevated CO₂ (750 ppm) conditions.Keywords: phytoplankton, bacteria, crude oil, ocean acidification
Procedia PDF Downloads 229363 Examining Predictive Coding in the Hierarchy of Visual Perception in the Autism Spectrum Using Fast Periodic Visual Stimulation
Authors: Min L. Stewart, Patrick Johnston
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Predictive coding has been proposed as a general explanatory framework for understanding the neural mechanisms of perception. As such, an underweighting of perceptual priors has been hypothesised to underpin a range of differences in inferential and sensory processing in autism spectrum disorders. However, empirical evidence to support this has not been well established. The present study uses an electroencephalography paradigm involving changes of facial identity and person category (actors etc.) to explore how levels of autistic traits (AT) affect predictive coding at multiple stages in the visual processing hierarchy. The study uses a rapid serial presentation of faces, with hierarchically structured sequences involving both periodic and aperiodic repetitions of different stimulus attributes (i.e., person identity and person category) in order to induce contextual expectations relating to these attributes. It investigates two main predictions: (1) significantly larger and late neural responses to change of expected visual sequences in high-relative to low-AT, and (2) significantly reduced neural responses to violations of contextually induced expectation in high- relative to low-AT. Preliminary frequency analysis data comparing high and low-AT show greater and later event-related-potentials (ERPs) in occipitotemporal areas and prefrontal areas in high-AT than in low-AT for periodic changes of facial identity and person category but smaller ERPs over the same areas in response to aperiodic changes of identity and category. The research advances our understanding of how abnormalities in predictive coding might underpin aberrant perceptual experience in autism spectrum. This is the first stage of a research project that will inform clinical practitioners in developing better diagnostic tests and interventions for people with autism.Keywords: hierarchical visual processing, face processing, perceptual hierarchy, prediction error, predictive coding
Procedia PDF Downloads 104362 Attitudes of Gratitude: An Analysis of 30 Cancer Patient Narratives Published by Leading U.S. Cancer Care Centers
Authors: Maria L. McLeod
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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers –The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, ten from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting repeated use of specific metaphors and tropes while charting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals with university affiliations, that emphasizes an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. Thus, the use of anecdotal evidence presented in patient narratives could be perceived as being in conflict with this evidence-based model, as the patient stories are not an accurate representation of scientific outcomes related to developing cancer, cancer reoccurrence, or cancer outcomes. The representative patient narratives tend to exclude or downplay adverse responses to treatment, survival rates, integrative and/or complementary cancer treatments, cancer prevention and causes, and barriers to treatment, such as the limitation of insurance plans, costs of treatment, and/or other issues related to access, potentially contributing to false narratives and inaccurate notions of cancer prevention, cancer care treatment and the potential for a cure. Both quantitative and qualitative findings demonstrate that cancer patient stories featured on the blogsites of the nation’s top cancer care centers deemphasize patient agency and, instead, emphasize deference and gratitude toward the institutions where the featured patients received treatment. Along these lines, language choices reflect positive framing of the cancer experience. Accompanying portrait photos of healthy appearing subjects as well as positive-framed headlines, subheads, and pull quotes function similarly, reflecting hopeful, transformative experiences and outcomes over hardship and suffering. Although patient narratives include real, factual scientific details and descriptions of actual events, the stories lack references to more negative realities of cancer diagnosis and treatment. Instead, they emphasize the triumph of survival by which the cancer care center, in the savior/hero role, enables the patient’s success, represented as a cathartic medical journey.Keywords: cancer framing, cancer stories, medical gaze, patient narratives
Procedia PDF Downloads 153361 Implementation of an Economic – Probabilistic Model to Risk Analysis of ERP Project in Technological Innovation Firms – A Case Study of ICT Industry in Iran
Authors: Reza Heidari, Maryam Amiri
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In a technological world, many countries have a tendency to fortifying their companies and technological infrastructures. Also, one of the most important requirements for developing technology is innovation, and then, all companies are struggling to consider innovation as a basic principle. Since, the expansion of a product need to combine different technologies, therefore, different innovative projects would be run in the firms as a base of technology development. In such an environment, enterprise resource planning (ERP) has special significance in order to develop and strengthen of innovations. In this article, an economic-probabilistic analysis was provided to perform an implementation project of ERP in the technological innovation (TI) based firms. The used model in this article assesses simultaneously both risk and economic analysis in view of the probability of each event that is jointly between economical approach and risk investigation approach. To provide an economic-probabilistic analysis of risk of the project, activities and milestones in the cash flow were extracted. Also, probability of occurrence of each of them was assessed. Since, Resources planning in an innovative firm is the object of this project. Therefore, we extracted various risks that are in relation with innovative project and then they were evaluated in the form of cash flow. This model, by considering risks affecting the project and the probability of each of them and assign them to the project's cash flow categories, presents an adjusted cash flow based on Net Present Value (NPV) and with probabilistic simulation approach. Indeed, this model presented economic analysis of the project based on risks-adjusted. Then, it measures NPV of the project, by concerning that these risks which have the most effect on technological innovation projects, and in the following measures probability associated with the NPV for each category. As a result of application of presented model in the information and communication technology (ICT) industry, provided an appropriate analysis of feasibility of the project from the point of view of cash flow based on risk impact on the project. Obtained results can be given to decision makers until they can practically have a systematically analysis of the possibility of the project with an economic approach and as moderated.Keywords: cash flow categorization, economic evaluation, probabilistic, risk assessment, technological innovation
Procedia PDF Downloads 399360 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia
Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam
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Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia
Procedia PDF Downloads 98359 Preparedness for Microbial Forensics Evidence Collection on Best Practice
Authors: Victor Ananth Paramananth, Rashid Muniginin, Mahaya Abd Rahman, Siti Afifah Ismail
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Safety issues, scene protection, and appropriate evidence collection must be handled in any bio crime scene. There will be a scene or multi-scene to be cordoned for investigation in any bio-incident or bio crime event. Evidence collection is critical in determining the type of microbial or toxin, its lethality, and its source. As a consequence, from the start of the investigation, a proper sampling method is required. The most significant challenges for the crime scene officer would be deciding where to obtain samples, the best sampling method, and the sample sizes needed. Since there could be evidence in liquid, viscous, or powder shape at a crime scene, crime scene officers have difficulty determining which tools to use for sampling. To maximize sample collection, the appropriate tools for sampling methods are necessary. This study aims to assist the crime scene officer in collecting liquid, viscous, and powder biological samples in sufficient quantity while preserving sample quality. Observational tests on sample collection using liquid, viscous, and powder samples for adequate quantity and sample quality were performed using UV light in this research. The density of the light emission varies upon the method of collection and sample types. The best tools for collecting sufficient amounts of liquid, viscous, and powdered samples can be identified by observing UV light. Instead of active microorganisms, the invisible powder is used to assess sufficient sample collection during a crime scene investigation using various collection tools. The liquid, powdered and viscous samples collected using different tools were analyzed using Fourier transform infrared - attenuate total reflection (FTIR-ATR). FTIR spectroscopy is commonly used for rapid discrimination, classification, and identification of intact microbial cells. The liquid, viscous and powdered samples collected using various tools have been successfully observed using UV light. Furthermore, FTIR-ATR analysis showed that collected samples are sufficient in quantity while preserving their quality.Keywords: biological sample, crime scene, collection tool, UV light, forensic
Procedia PDF Downloads 191358 Expression of DNMT Enzymes-Regulated miRNAs Involving in Epigenetic Event of Tumor and Margin Tissues in Patients with Breast Cancer
Authors: Fatemeh Zeinali Sehrig
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Background: miRNAs play an important role in the post-transcriptional regulation of genes, including genes involved in DNA methylation (DNMTs), and are also important regulators of oncogenic pathways. The study of microRNAs and DNMTs in breast cancer allows the development of targeted treatments and early detection of this cancer. Methods and Materials: Clinical Patients and Samples: Institutional guidelines, including ethical approval and informed consent, were followed by the Ethics Committee (Ethics code: IR.IAU.TABRIZ.REC.1401.063) of Tabriz Azad University, Tabriz, Iran. In this study, tissues of 100 patients with breast cancer and tissues of 100 healthy women were collected from Noor Nejat Hospital in Tabriz. The basic characteristics of the patients with breast cancer included: 1)Tumor grade(Grade 3 = 5%, Grade 2 = 87.5%, Grade 1 = 7.5%), 2)Lymph node(Yes = 87.5%, No = 12.5%), 3)Family cancer history(Yes = 47.5%, No = 41.3%, Unknown = 11.2%), 4) Abortion history(Yes = 36.2%).In silico methods (data gathering, process, and build networks): Gene Expression Omnibus (GEO), a high-throughput genomic database, was queried for miRNAs expression profiles in breast cancer. For Experimental protocol Tissue Processing, Total RNA isolation, complementary DNA(cDNA) synthesis, and quantitative real time PCR (QRT-PCR) analysis were performed. Results: In the present study, we found significant (p.value<0.05) changes in the expression level of miRNAs and DNMTs in patients with breast cancer. In bioinformatics studies, the GEO microarray data set, similar to qPCR results, showed a decreased expression of miRNAs and increased expression of DNMTs in breast cancer. Conclusion: According to the results of the present study, which showed a decrease in the expression of miRNAs and DNMTs in breast cancer, it can be said that these genes can be used as important diagnostic and therapeutic biomarkers in breast cancer.Keywords: gene expression omnibus, microarray dataset, breast cancer, miRNA, DNMT (DNA methyltransferases)
Procedia PDF Downloads 21357 Verification and Proposal of Information Processing Model Using EEG-Based Brain Activity Monitoring
Authors: Toshitaka Higashino, Naoki Wakamiya
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Human beings perform a task by perceiving information from outside, recognizing them, and responding them. There have been various attempts to analyze and understand internal processes behind the reaction to a given stimulus by conducting psychological experiments and analysis from multiple perspectives. Among these, we focused on Model Human Processor (MHP). However, it was built based on psychological experiments and thus the relation with brain activity was unclear so far. To verify the validity of the MHP and propose our model from a viewpoint of neuroscience, EEG (Electroencephalography) measurements are performed during experiments in this study. More specifically, first, experiments were conducted where Latin alphabet characters were used as visual stimuli. In addition to response time, ERPs (event-related potentials) such as N100 and P300 were measured by using EEG. By comparing cycle time predicted by the MHP and latency of ERPs, it was found that N100, related to perception of stimuli, appeared at the end of the perceptual processor. Furthermore, by conducting an additional experiment, it was revealed that P300, related to decision making, appeared during the response decision process, not at the end. Second, by experiments using Japanese Hiragana characters, i.e. Japan's own phonetic symbols, those findings were confirmed. Finally, Japanese Kanji characters were used as more complicated visual stimuli. A Kanji character usually has several readings and several meanings. Despite the difference, a reading-related task and a meaning-related task exhibited similar results, meaning that they involved similar information processing processes of the brain. Based on those results, our model was proposed which reflects response time and ERP latency. It consists of three processors: the perception processor from an input of a stimulus to appearance of N100, the cognitive processor from N100 to P300, and the decision-action processor from P300 to response. Using our model, an application system which reflects brain activity can be established.Keywords: brain activity, EEG, information processing model, model human processor
Procedia PDF Downloads 93356 Occurrence of Pharmaceutical Compounds in an Urban Lake
Authors: J. D. Villanueva, N. Peyraube, I. Allan, G. D. Salvosa, M. Reid, C. Harman, K. D. Salvosa, J. M. V. Castro, M. V. O. Espaldon, J. B. Sevilla-Nastor, P. Le Coustumer
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The main objectives of this research are to (1) assess the occurrence of the pharmaceutical compounds and (2) present the environmental challenges posed by the existence of these pharmaceutical compounds in the surface water. These pharmaceuticals were measured in Napindan Lake, Philippines. This lake is not only a major tributary of the Pasig River (an estuary) and Laguna Lake (freshwater). It also joins these two important surface waters of the National Capital Region. Pharmaceutical compounds such as Atenolol, Carbamazepine, and two other over the counter medicines: Cetirizine, and Ibuprofen were measured in Napindan Lake. Atenolol is a beta blocker that helps in lowering hypertensions. Carbamazepine is an anticonvulsant used as treatment for epilepsy and neuropathic pain. Cetirizine is an antihistamine that can relieve allergies. Ibuprofen is a non-steroidal anti-inflammatory drug normally used to relieve pains. Three different climatological conditions with corresponding hydro physico chemical characteristics were considered. First, was during a dry season with a simultaneous dredging. Second was during a transition period from dry to wet season. Finally, the third was during a continuous wet event. Based from the results of the study, most of these pharmaceuticals can be found in Napindan Lake. This is a proof that these pharmaceutical compounds are being released to a natural surface water. Even though climatological conditions were different, concentrations of these pharmaceuticals can still be detected. This implies that there is an incessant supply of these pharmaceutical compounds in Napindan Lake. Chronic exposure to these compounds even at low concentrations can lead to possible environmental and health risks. Given this information and since consistent occurrence of these compounds can be expected, the main challenge, at present, is on how to control the sources of these pharmaceutical compounds. Primarily, there is a need to manage the disposal of the pharmaceutical compounds. Yet, the main question is how to? This study would like to present the challenges and institutional roles in helping manage the pharmaceutical disposals in a developing country like the Philippines.Keywords: atenolol, carbamazepine, cetirizine, ibuprofen, institutional roles, Napindan lake, pharmaceutical compound disposal management, surface water, urban lake
Procedia PDF Downloads 157355 The Importance and Feasibility of Hospital Interventions for Patient Aggression and Violence Against Physicians in China: A Delphi Study
Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic
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Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.Keywords: patient aggression and violence, hospital interventions, feasibility, importance
Procedia PDF Downloads 87354 Integrated Risk Assessment of Storm Surge and Climate Change for the Coastal Infrastructure
Authors: Sergey V. Vinogradov
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Coastal communities are presently facing increased vulnerabilities due to rising sea levels and shifts in global climate patterns, a trend expected to escalate in the long run. To address the needs of government entities, the public sector, and private enterprises, there is an urgent need to thoroughly investigate, assess, and manage the present and projected risks associated with coastal flooding, including storm surges, sea level rise, and nuisance flooding. In response to these challenges, a practical approach to evaluating storm surge inundation risks has been developed. This methodology offers an integrated assessment of potential flood risk in targeted coastal areas. The physical modeling framework involves simulating synthetic storms and utilizing hydrodynamic models that align with projected future climate and ocean conditions. Both publicly available and site-specific data form the basis for a risk assessment methodology designed to translate inundation model outputs into statistically significant projections of expected financial and operational consequences. This integrated approach produces measurable indicators of impacts stemming from floods, encompassing economic and other dimensions. By establishing connections between the frequency of modeled flood events and their consequences across a spectrum of potential future climate conditions, our methodology generates probabilistic risk assessments. These assessments not only account for future uncertainty but also yield comparable metrics, such as expected annual losses for each inundation event. These metrics furnish stakeholders with a dependable dataset to guide strategic planning and inform investments in mitigation. Importantly, the model's adaptability ensures its relevance across diverse coastal environments, even in instances where site-specific data for analysis may be limited.Keywords: climate, coastal, surge, risk
Procedia PDF Downloads 50353 Tsunami Wave Height and Flow Velocity Calculations Based on Density Measurements of Boulders: Case Studies from Anegada and Pakarang Cape
Authors: Zakiul Fuady, Michaela Spiske
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Inundation events, such as storms and tsunamis can leave onshore sedimentary evidence like sand deposits or large boulders. These deposits store indirect information on the related inundation parameters (e.g., flow velocity, flow depth, wave height). One tool to reveal these parameters are inverse models that use the physical characteristics of the deposits to refer to the magnitude of inundation. This study used boulders of the 2004 Indian Ocean Tsunami from Thailand (Pakarang Cape) and form a historical tsunami event that inundated the outer British Virgin Islands (Anegada). For the largest boulder found in Pakarang Cape with a volume of 26.48 m³ the required tsunami wave height is 0.44 m and storm wave height are 1.75 m (for a bulk density of 1.74 g/cm³. In Pakarang Cape the highest tsunami wave height is 0.45 m and storm wave height are 1.8 m for transporting a 20.07 m³ boulder. On Anegada, the largest boulder with a diameter of 2.7 m is the asingle coral head (species Diploria sp.) with a bulk density of 1.61 g/cm³, and requires a minimum tsunami wave height of 0.31 m and storm wave height of 1.25 m. The highest required tsunami wave height on Anegada is 2.12 m for a boulder with a bulk density of 2.46 g/cm³ (volume 0.0819 m³) and the highest storm wave height is 5.48 m (volume 0.216 m³) from the same bulk density and the coral type is limestone. Generally, the higher the bulk density, volume, and weight of the boulders, the higher the minimum tsunami and storm wave heights required to initiate transport. It requires 4.05 m/s flow velocity by Nott’s equation (2003) and 3.57 m/s by Nandasena et al. (2011) to transport the largest boulder in Pakarang Cape, whereas on Anegada, it requires 3.41 m/s to transport a boulder with diameter 2.7 m for both equations. Thus, boulder equations need to be handled with caution because they make many assumptions and simplifications. Second, the physical boulder parameters, such as density and volume need to be determined carefully to minimize any errors.Keywords: tsunami wave height, storm wave height, flow velocity, boulders, Anegada, Pakarang Cape
Procedia PDF Downloads 229352 Inelastic and Elastic Taping in Plantar Pressure of Runners Pronators: Clinical Trial
Authors: Liana Gomide, Juliana Rodrigues
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The morphology of the foot defines its mode of operation and a biomechanical reform indispensable for a symmetrical distribution of plantar pressures in order not to overload some of its components in isolation. High plantar pressures at specific points in the foot may be a causal factor in several orthopedic disorders that affect the feet such as pain and stress fracture. With digital baro-podometry equipment one can observe an intensity of pressures along the entire foot and quantify some of the movements, such as a subtalar pronation present in the midfoot region. Although, they are involved in microtraumas. In clinical practice, excessive movement has been limited with the use of different taping techniques applied on the plantar arch. Thus, the objective of the present study was to analyze and compare the influence of the inelastic and elastic taping on the distribution of plantar pressure of runners pronators. This is a randomized clinical trial and blind-crossover. Twenty (20) male subjects, mean age 33 ± 7 years old, mean body mass of 71 ± 7 kg, mean height of 174 ± 6 cm, were included in the study. A data collection was carried out by a single research through barop-odometry equipment - Tekscan, model F-scan mobile. The tests were performed at three different times. In the first, an initial barop-odometric evaluation was performed, without a bandage application, with edges at a speed of 9.0 km/h. In the second and third moments, the inelastic or elastic taping was applied consecutively, according to the definition defined in the randomization. As results, it was observed that both as inelastic and elastic taping, provided significant reductions in contact pressure and peak pressure values when compared to the moment without a taping. However, an elastic taping was more effective in decreasing contact pressure (no bandage = 714 ± 201, elastic taping = 690 ± 210 and inelastic taping = 716 ± 180) and no peak pressure in the midfoot region (no bandage = 1490 ± 42, elastic taping = 1273 ± 323 and inelastic taping = 1487 ± 437). It is possible to conclude that it is an elastic taping provided by pressure in the middle region, thereby reducing the subtalar pronunciation event during the run.Keywords: elastic taping, inelastic taping, running, subtalar pronation
Procedia PDF Downloads 145351 Effects of Branched-Chain Amino Acid Supplementation on Sarcopenic Patients with Liver Cirrhosis
Authors: Deepak Nathiya1, Ramesh Roop Rai, Pratima Singh1, Preeti Raj1, Supriya Suman, Balvir Singh Tomar
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Background: Sarcopenia is a catabolic state in liver cirrhosis (LC), accelerated with a breakdown of skeletal muscle to release amino acids which adversely affects survival, health-related quality of life, and response to any underlying disease. The primary objective of the study was to investigate the long-term effect of branched-chain amino acids (BCAA) supplementations on parameters associated with improved prognosis in sarcopenic patients with LC, as well as to evaluate its impact on cirrhotic-related events. Methods: We carried out a 24 week, single-center, randomized, open-label, controlled, two cohort parallel-group intervention trial comparing the efficacy of BCAA against lactoalbumin (L-ALB) on 106 sarcopenic liver cirrhotics. The BCAA (intervention) group was treated with 7.2 g BCAA per whereas, the lactoalbumin group was also given 6.3 g of L-Albumin. The primary outcome was to assess the impact of BCAA on parameters of sarcopenia: muscle mass, muscle strength, and physical performance. The secondary outcomes were to study combined survival and maintenance of liver function changes in laboratory and clinical markers in the duration of six months. Results: Treatment with BCAA leads to significant improvement in sarcopenic parameters: muscle strength, muscle function, and muscle mass. The total cirrhotic-related complications and cumulative event-free survival occurred fewer in the BCAA group than in the L-ALB group. Prognostic markers also improved significantly in the study. Conclusion: The current clinical trial demonstrated that long-term BCAAs supplementation improved sarcopenia and prognostic markers in patients with advanced liver cirrhosis.Keywords: sarcopenia, liver cirrhosis, BCAA, quality of life
Procedia PDF Downloads 130350 Demographic Profile, Risk Factors and In-hospital Outcomes of Acute Coronary Syndrome (ACS) in Young Population, in Pakistan-Single Center Real World Experience
Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan
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Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome
Procedia PDF Downloads 155349 Home Garden: A Food-Based Strategy to Achieve Sustainable Impact on Household Nutrition of Resource-Poor Families in Nepal
Authors: Purushottam P. Khatiwada, Bikash Paudel, Ram B. Rana, Parshuram Biswakarma, Roshan Pudasaini
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Nepal has been putting its efforts into securing food and nutrition security for its citizens adopting different models and approaches. Home Garden approach, that integrates vegetables, fruits, small livestock, poultry along with other components like fish, honeybee, mushroom, spices for the promotion of nutritional security of resource-poor and disadvantaged groups was implemented during March 2009 to July 2013 spreading over 16 districts of Nepal covering 115 farmers groups, directly working with 3500 households. Sustained long-term impact of development interventions targeted to the resource-poor and disadvantaged groups has been a recurrent issue for donors, policymakers and practitioners alike. Considering the issue, a post-project evaluation was carried out in a selected project group (Dangibari of Jhapa) after four years of project completion in 2017 in order to evaluate the impact and understand the factors associated with its success. Qualitative information was collected through focus group discussion with group members and associated local institutions. For quantitative information, a quick survey was carried out to the same group members only selecting few indicators. The results are compared with the data obtained from the baseline study conducted by the project in March 2009. The impact of project intervention was evident as compared to the benchmarks established during the baseline, even after four years of project completion. The area under home garden is increased to 729 m² from 386 m² and average food self-sufficiency months increased to 10.22 from 8.11. Seven to eleven fruit species are maintained in the home gardens. An average number of vegetable species grown increased to 15.85 from 9.86. It has resulted in an increase in vegetables self-sufficient month to 8.74 from 4.74 and a huge increase in cash income NPR 6142.8 (USD 59.6) from NPR 385.7 (USD 3.9) from the sale of surplus vegetables. Coaching and mentoring including nutrition sensitization by the project staff at the beginning, inputs and technical support during the project implementation phase and projects effort on the institutional building of disadvantaged farmers were the key drivers of home garden sustainability and expansion. Specifically, package of home garden management trainings provided by the project staff, availability of group funds for buying inputs even after the project, uniting home garden group members in a cooperative, resource leveraging by local institutions through group lobbying, farmers innovations for maintaining home garden diversity and continuous backstopping support by few active members as local resource persons to other members are some additional factors contributing to sustain and/or improve the home garden status by the resource-poor and disadvantaged group.Keywords: food-based nutrition, home garden, resource-poor and disadvantaged group, sustained impact
Procedia PDF Downloads 132348 Associated Risks of Spontaneous Lung Collapse after Shoulder Surgery: A Literature Review
Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho
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Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.Keywords: rotator cuff repair, decompression, pressure, complication
Procedia PDF Downloads 61347 Overall Assessment of Human Research and Ethics Committees in the United Arab Emirates
Authors: Mahera Abdulrahman, Satish Chandrasekhar Nair
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Growing demand for human health research in the United Arab Emirates (UAE) has prompted the need to develop a robust research ethics oversight, particularly given the large unskilled-worker immigrant population and the elderly citizens utilizing health services. Examination of the structure, function, practices and outcomes of the human research ethics committees (HREC) was conducted using two survey instruments, reliable and validated. Results indicate that in the absence of a national ethics regulatory body, the individual emirate’s governed 21 HRECs covering health facilities and academic institutions in the UAE. Among the HRECs, 86% followed International Council for Harmonization-Good Clinical Practice guidelines, 57% have been in operation for more than five years, 81% reviewed proposals within eight weeks, 48% reviewed for clinical and scientific merit apart from ethics, and 43% handled more than 50 research proposals per year. However, researcher recognition, funding transparency, adverse event reporting systems were widespread in less than one-third of all HRECs. Surprisingly, intellectual property right was not included as a research output. Research was incorporated into the vision and mission statements of many (62%) organizations and, mechanisms such as research publications, collaborations, and recognitions were employed as key performance indicators to measure research output. In spite, resources to generate research output such as dedicated budget (19%), support staff (19%) and continuous training and mentoring program for medical residents and HREC members were somehow lacking. HREC structure and operations in the UAE are similar to other regions of the world, resources allocation for efficient, quality monitoring, continuous training, and the creation of a clinical research network are needed to strengthen the clinical research enterprise to scale up for the future. It is anticipated that the results of this study will benefit investigators, regulators, pharmaceutical sponsors and the policy makers in the region.Keywords: institutional review board, ethics committee, human research ethics, United Arab Emirates (UAE)
Procedia PDF Downloads 218346 Working Without a Safety Net: Exploring Struggles and Dilemmas Faced by Greek Orthodox Married Clergy Through a Mental Health Lens, in the Australian Context
Authors: Catherine Constantinidis (Nee Tsacalos)
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This paper presents one aspect of the larger Masters qualitative study exploring the roles of married Greek Orthodox clergy, the Priest and Presbytera, under the wing of the Greek Orthodox Archdiocese of Australia. This ground breaking research necessitated the creation of primary data within a phenomenological paradigm drawing from lived experiences of the Priests and Presbyteres in contemporary society. As a Social Worker, a bilingual (Greek/English) Mental Health practitioner and a Presbytera, the questions constantly raised and pondered are: Who do the Priest and Presbytera turn to when they experience difficulties or problems? Where do they go for support? What is in place for their emotional and psychological health and well-being? Who cares for the spiritual carer? Who is there to catch our falling clergy and their wives? What is their 'safety net'? Identified phenomena of angst, stress, frustration and confusion experienced by the Priest and (by extension) the Presbytera, within their position, coupled with basic assumptions, perceptions and expectations about their roles, the role of the organisation (the Church), and their role as spouse often caused confusion and in some cases conflict. Unpacking this complex and multi-dimensional relationship highlighted not only the roller coaster of emotions, potentially affecting their physical and mental health, but also the impact on the interwoven relationships of marriage and ministry. The author considers these phenomena in the light of bilingual cultural and religious organisational practice frameworks, specifically the Greek Orthodox Church, whilst filtering these findings through a mental health lens. One could argue that it is an expectation that clergy (and by default their wives) take on the responsibility to be kind, nurturing and supportive to others. However, when it comes to taking care of self, they are not nearly as kind. This research looks at a recurrent theme throughout the interviews where all participants talked about limited support systems and poor self care strategies and the impact this has on their ministry, mental, emotional, and physical health and ultimately on their relationships with self and others. The struggle all participants encountered at some point in their ministry was physical, spiritual and psychological burn out. The overall aim of the researcher is to provide a voice for the Priest and the Presbytera painting a clearer picture of these roles and facilitating an awareness of struggles and dilemmas faced in their ministry. It is hoped these identified gaps in self care strategies and support systems will provide solid foundations for building a culturally sensitive, empathetic and effective support system framework, incorporating the spiritual and psychological well-being of the Priest and Presbytera, a ‘safety net’. A supplementary aim is to inform and guide ministry practice frameworks for clergy, spouses, the church hierarchy and religious organisations on a local and global platform incorporating some sort of self-care system.Keywords: care for the carer, mental health, Priest, Presbytera, religion, support system
Procedia PDF Downloads 387345 A Study of Social and Cultural Context for Tourism Management by Community Kamchanoad District, Amphoe Ban Dung, Udon Thani Province
Authors: Phusit Phukamchanoad, Chutchai Ditchareon, Suwaree Yordchim
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This research was to study on background and social and cultural context of Kamchanoad community for sustainable tourism management. All data was collected through in-depth interview with village headmen, community committees, teacher, monks, Kamchanoad forest field officers and respected senior citizen above 60 years old in the community who have lived there for more than 40 years. Altogether there were 30 participants for this research. After analyzing the data, content from interview and discussion, Kamchanoad has both high land and low land in the region as well as swamps that are very capable of freshwater animals’ conservation. Kamchanoad is also good for agriculture and animal farming. 80% of Kamchanoad’s land are forest, freshwater and rice farms. Kamchanoad was officially set up as community in 1994 as “Baan Nonmuang”. Inhabitants in Kamchanoad make a living by farming based on sufficiency economy. They have rice farm, eucalyptus farm, cassava farm and rubber tree farm. Local people in Kamchanoad still believe in the myth of Srisutto Naga. They are still religious and love to preserve their traditional way of life. In order to understand how to create successful tourism business in Kamchanoad, we have to study closely on local culture and traditions. Outstanding event in Kamchanoad is the worship of Grand Srisutto, which is on the full-moon day of 6th month or Visakhabucha Day. Other big events are also celebration at the end of Buddhist lent, Naga firework, New Year celebration, Boon Mahachart, Songkran, Buddhist Lent, Boon Katin and Loy Kratong. Buddhism is the main religion in Kamchanoad. The promotion of tourism in Kamchanoad is expected to help spreading more income for this region. More infrastructures will be provided for local people as well as funding for youth support and people activities.Keywords: social and culture area, tourism management, Kamchanoad Community, Udon Thani Province
Procedia PDF Downloads 212344 Food for Thought: Preparing the Brain to Eat New Foods through “Messy” Play
Authors: L. Bernabeo, T. Loftus
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Many children often experience phases of picky eating, food aversions and/or avoidance. For families with children who have special needs, these experiences are often exacerbated, which can lead to feelings that negatively impact a caregiver’s relationship with their child. Within the scope of speech language pathology practice, knowledge of both emotional and feeding development is key. This paper will explore the significance of “messy play” within typical feeding development, and the challenges that may arise if a child does not have the opportunity to engage in this type of exploratory play. This paper will consider several contributing factors that can result in a “picky eater.” Further, research has shown that individuals with special needs, including autism, possess a neurological makeup that differs from that of a typical individual. Because autism is a disorder of relating and communicating due to differences in the limbic system, an individual with special needs may respond to a typical feeding experience as if it is a traumatic event. As a result, broadening one’s dietary repertoire may seem to be an insurmountable challenge. This paper suggests that introducing new foods through exploratory play can help broaden and strengthen diets, as well as improve the feeding experience, of individuals with autism. The DIRFloortimeⓇ methodology stresses the importance of following a child's lead. Within this developmental model, there is a special focus on a person’s individual differences, including the unique way they process the world around them, as well as the significance of therapy occurring within the context of a strong and motivating relationship. Using this child-centered approach, we can support our children in expanding their diets, while simultaneously building upon their cognitive and creative development through playful and respectful interactions that include exposure to foods that differ in color, texture, and smell. Further, this paper explores the importance of exploration, self-feeding and messy play on brain development, both in the context of typically developing individuals and those with disordered development.Keywords: development, feeding, floortime, sensory
Procedia PDF Downloads 111343 Gene Expression Analysis for Corals / Zooxanthellae under High Seawater Temperature Stress
Authors: Haruka Ito, Toru Maruyama, Michihiro Ito, Chuya Shinzato, Hiroyuki Fujimura, Yoshikatsu Nakano, Shoichiro Suda, Sachiyo Aburatani, Haruko Takeyama
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Clarifying symbiotic relationships is one of the most important theme for understanding the marine eco-system. Coral reef has been regarded as an important environmental resource. Coral holobiont composed by coral, symbiotic microalgae zooxanthellae, and bacteria have complexed relationship. Zooxanthellae mainly supply organic matter to the host corals through their photosynthetic activity. The symbiotic relationship is indispensable for corals but may easily collapses due to the rise of seawater temperature. However, the molecular mechanism how seawater temperature influences their relationships still remain unclear. In this study, the transcriptomic analysis has applied to elucidate the coral-zooxanthellae relationships under high seawater temperature stress. To observe reactions of corals and zooxanthellae against the rise of seawater temperature, meta-gene expression in coral have been analyzed. The branches from six different colonies of a stony coral, Acropora tenuis, were sampled at nine times by 2016 at two locations, Ishikawabaru and South of Sesoko Island, Okinawa, Japan. The mRNAs extracted from the branches including zooxanthellae were sequenced by illumina HiSeq. Gene Set Enrichment Analysis (GSEA) based on hyper geometric distribution was performed. The seawater temperature at 2016 summer was unusually high, which was caused by El Niño event, and the number of zooxanthellae in coral was decreased in August. GSEA derived the several specific genes expressed in A. tenuis under heat stress conditions. The upregulated genes under heat stress highly related with infection immunity. The downregulated genes significantly contained cell cycle related genes. Thu, it is considered that heat stress cause disorder in cell metabolism of A. tenuis, resulting in serious influence to coral holobiont.Keywords: coral, symbiosis, thermal stress response, transcriptome analysis
Procedia PDF Downloads 265342 Transboundary Pollution after Natural Disasters: Scenario Analyses for Uranium at Kyrgyzstan-Uzbekistan Border
Authors: Fengqing Li, Petra Schneider
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Failure of tailings management facilities (TMF) of radioactive residues is an enormous challenge worldwide and can result in major catastrophes. Particularly in transboundary regions, such failure is most likely to lead to international conflict. This risk occurs in Kyrgyzstan and Uzbekistan, where the current major challenge is the quantification of impacts due to pollution from uranium legacy sites and especially the impact on river basins after natural hazards (i.e., landslides). By means of GoldSim, a probabilistic simulation model, the amount of tailing material that flows into the river networks of Mailuu Suu in Kyrgyzstan after pond failure was simulated for three scenarios, namely 10%, 20%, and 30% of material inputs. Based on Muskingum-Cunge flood routing procedure, the peak value of uranium flood wave along the river network was simulated. Among the 23 TMF, 19 ponds are close to the river networks. The spatiotemporal distributions of uranium along the river networks were then simulated for all the 19 ponds under three scenarios. Taking the TP7 which is 30 km far from the Kyrgyzstan-Uzbekistan border as one example, the uranium concentration decreased continuously along the longitudinal gradient of the river network, the concentration of uranium was observed at the border after 45 min of the pond failure and the highest value was detected after 69 min. The highest concentration of uranium at the border were 16.5, 33, and 47.5 mg/L under scenarios of 10%, 20%, and 30% of material inputs, respectively. In comparison to the guideline value of uranium in drinking water (i.e., 30 µg/L) provided by the World Health Organization, the observed concentrations of uranium at the border were 550‒1583 times higher. In order to mitigate the transboundary impact of a radioactive pollutant release, an integrated framework consisting of three major strategies were proposed. Among, the short-term strategy can be used in case of emergency event, the medium-term strategy allows both countries handling the TMF efficiently based on the benefit-sharing concept, and the long-term strategy intends to rehabilitate the site through the relocation of all TMF.Keywords: Central Asia, contaminant transport modelling, radioactive residue, transboundary conflict
Procedia PDF Downloads 110341 Approaches to Inducing Obsessional Stress in Obsessive-Compulsive Disorder (OCD): An Empirical Study with Patients Undergoing Transcranial Magnetic Stimulation (TMS) Therapy
Authors: Lucia Liu, Matthew Koziol
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Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation
Procedia PDF Downloads 48340 Development of Pre-Mitigation Measures and Its Impact on Life-Cycle Cost of Facilities: Indian Scenario
Authors: Mahima Shrivastava, Soumya Kar, B. Swetha Malika, Lalu Saheb, M. Muthu Kumar, P. V. Ponambala Moorthi
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Natural hazards and manmade destruction causes both economic and societal losses. Generalized pre-mitigation strategies introduced and adopted for prevention of disaster all over the world are capable of augmenting the resiliency and optimizing the life-cycle cost of facilities. In countries like India where varied topographical feature exists requires location specific mitigation measures and strategies to be followed for better enhancement by event-driven and code-driven approaches. Present state of vindication measures followed and adopted, lags dominance in accomplishing the required development. In addition, serious concern and debate over climate change plays a vital role in enhancing the need and requirement for the development of time bound adaptive mitigation measures. For the development of long-term sustainable policies incorporation of future climatic variation is inevitable. This will further assist in assessing the impact brought about by the climate change on life-cycle cost of facilities. This paper develops more definite region specific and time bound pre-mitigation measures, by reviewing the present state of mitigation measures in India and all over the world for improving life-cycle cost of facilities. For the development of region specific adoptive measures, Indian regions were divided based on multiple-calamity prone regions and geo-referencing tools were used to incorporate the effect of climate changes on life-cycle cost assessment. This study puts forward significant effort in establishing sustainable policies and helps decision makers in planning for pre-mitigation measures for different regions. It will further contribute towards evaluating the life cycle cost of facilities by adopting the developed measures.Keywords: climate change, geo-referencing tools, life-cycle cost, multiple-calamity prone regions, pre-mitigation strategies, sustainable policies
Procedia PDF Downloads 372339 Predicting Factors for Occurrence of Cardiac Arrest in Critical, Emergency and Urgency Patients in an Emergency Department
Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh
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Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.Keywords: cardiac arrest, predicting factor, emergency department, emergency patient
Procedia PDF Downloads 158338 Impact of Social Media in Shaping Perceptions on Filipino Muslim Identity
Authors: Anna Rhodora A. Solar, Jan Emil N. Langomez
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Social Media plays a crucial role in influencing Philippine public opinion with regard to a variety of socio-political issues. This became evident in the massacre of 44 members of the Special Action Force (SAF 44) tasked by the Philippine government to capture one of the US Federal Bureau of Investigation’s most wanted terrorists. The incident was said to be perpetrated by members of the Moro Islamic Liberation Front and the Bangsamoro Islamic Freedom Fighters. Part of the online discourse within Philippine cyberspace sparked intense debates on Filipino Muslim identity, with several Facebook viral posts linking Islam as a factor to the tragic event. Facebook is considered to be the most popular social media platform in the Philippines. As such, this begs the question of the extent to which social media, specifically Facebook, shape the perceptions of Filipinos on Filipino Muslims. This study utilizes Habermas’ theory of communicative action as it offers an explanation on how public sphere such as social media could be a network for communicating information and points of view through free and open dialogue among equal citizens to come to an understanding or common perception. However, the paper argues that communicative action which is aimed at reaching understanding free from force, and strategic action which is aimed at convincing someone through argumentation may not necessarily be mutually exclusive since reaching an understanding can also be considered as a result of convincing someone through argumentation. Moreover, actors may clash one another in their ideas before reaching common understanding, hence the presence of force. Utilizing content analysis on the Facebook posts with Islamic component that went viral after the massacre of the SAF 44, this paper argues that framing the image of Filipino Muslims through Facebook reflects both communicative and strategic actions. Moreover, comment threads on viral posts manifest force albeit implicit.Keywords: communication, Muslim, Philippines, social media
Procedia PDF Downloads 395337 Acupuncture in the Treatment of Parkinson's Disease-Related Fatigue: A Pilot Randomized, Controlled Study
Authors: Keng H. Kong, Louis C. Tan, Wing L. Aw, Kay Y. Tay
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Background: Fatigue is a common problem in patients with Parkinson's disease, with reported prevalence of up to 70%. Fatigue can be disabling and has adverse effects on patients' quality of life. There is currently no satisfactory treatment of fatigue. Acupuncture is effective in the treatment of fatigue, especially that related to cancer. Its role in Parkinson's disease-related fatigue is uncertain. Aims: To evaluate the clinical efficacy of acupuncture treatment in Parkinson's disease-related fatigue. Hypothesis: We hypothesize that acupuncture is effective in alleviating Parkinson's disease-related fatigue. Design: A single center, randomized, controlled study with two parallel arms. Participants: Forty participants with idiopathic Parkinson's disease will be enrolled. Interventions: Participants will be randomized to receive verum (real) acupuncture or placebo acupuncture. The retractable non-invasive sham needle will be used in the placebo group. The intervention will be administered twice a week for five weeks. Main outcome measures: The primary outcome will be the change in general fatigue score of the multidimensional fatigue inventory at week 5. Secondary outcome measures include other subscales of the multidimensional fatigue inventory, movement disorders society-unified Parkinson's disease rating scale, Parkinson's disease questionnaire-39 and geriatric depression scale. All outcome measures will be assessed at baseline (week 0), completion of intervention (week 5) and 4 weeks after completion of intervention (week 9). Results: To date, 23 participants have been recruited and nine have completed the study. The mean age is 63.5±14.2 years, mean duration of Parkinson’s disease is 6.4±1.8 years and mean MDS-UPDRS score is 8.3±2.8. The mean general fatigue score of the multidimensional fatigue inventory is 13.5±4.6. No significant adverse event related to acupuncture is noted. Potential significance: If the results are as expected, this study will provide preliminary scientific evidence for the efficacy of acupuncture in Parkinson's Disease-related fatigue, and opens the door for a larger multicentre trial to be performed. In the longer term, it may lead to the integration of acupuncture in the care of patients with Parkinson's disease.Keywords: acupuncture, fatigue, Parkinson's disease, trial
Procedia PDF Downloads 300336 Debris Flow Mapping Using Geographical Information System Based Model and Geospatial Data in Middle Himalayas
Authors: Anand Malik
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The Himalayas with high tectonic activities poses a great threat to human life and property. Climate change is another reason which triggering extreme events multiple fold effect on high mountain glacial environment, rock falls, landslides, debris flows, flash flood and snow avalanches. One such extreme event of cloud burst along with breach of moraine dammed Chorabri Lake occurred from June 14 to June 17, 2013, triggered flooding of Saraswati and Mandakini rivers in the Kedarnath Valley of Rudraprayag district of Uttrakhand state of India. As a result, huge volume of water with its high velocity created a catastrophe of the century, which resulted into loss of large number of human/animals, pilgrimage, tourism, agriculture and property. Thus a comprehensive assessment of debris flow hazards requires GIS-based modeling using numerical methods. The aim of present study is to focus on analysis and mapping of debris flow movements using geospatial data with flow-r (developed by team at IGAR, University of Lausanne). The model is based on combined probabilistic and energetic algorithms for the assessment of spreading of flow with maximum run out distances. Aster Digital Elevation Model (DEM) with 30m x 30m cell size (resolution) is used as main geospatial data for preparing the run out assessment, while Landsat data is used to analyze land use land cover change in the study area. The results of the study area show that model can be applied with great accuracy as the model is very useful in determining debris flow areas. The results are compared with existing available landslides/debris flow maps. ArcGIS software is used in preparing run out susceptibility maps which can be used in debris flow mitigation and future land use planning.Keywords: debris flow, geospatial data, GIS based modeling, flow-R
Procedia PDF Downloads 265335 Comparative Public Administration: A Case Study of ASEAN Member States
Authors: Nattapol Pourprasert
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This research is to study qualitative research having two objectives: 1. to study comparison of private sector of government to compare with ASEAN Member States, 2. to study trend of private enterprise administration of ASEAN Member States. The results are: (1) Thai people focus on personal resource administrative system, (2) Indonesia focuses on official system by good administrative principles, (3) Malaysia focuses on technology development to service people, (4) Philippines focuses on operation system development, (5) Singapore focuses on public service development, (6) Brunei Darussalam focuses on equality in government service of people, (7) Vietnam focuses on creating government labor base and develop testing and administration of operation test, (8) Myanmar focuses on human resources development, (9) Laos focuses on form of local administration, (10) Cambodia focuses on policy revolution in personal resources. The result of the second part of the study are: (1) Thailand created government personnel to be power under qualitative official structural event, (2) Indonesia has Bureaucracy Reform Roadmap of Bureaucracy Reform and National Development Plan Medium Term, (3) Malaysia has database for people service, (4) Philippines follows up control of units operation by government policy, (5) Singapore created reliability, participation of people to set government policy people’s demand, (6) Brunei Darussalam has social welfare to people, (7) Vietnam revolved testing system and administration including manpower base construction of government effectively, (8) Myanmar creates high rank administrators to develop country, (9) Laos distributes power to locality, and (10) Cambodia revolved personnel resource policy.Keywords: public administration development, ASEAN member states, private sector, government
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