Search results for: dual antiplatelet therapy (DAPT)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2751

Search results for: dual antiplatelet therapy (DAPT)

1521 A CD40 Variant is Associated with Systemic Bone Loss Among Patients with Rheumatoid Arthritis

Authors: Rim Sghiri, Samia Al Shouli, Hana Benhassine, Nejla Elamri, Zahid Shakoor, Foued Slama, Adel Almogren, Hala Zeglaoui, Elyes Bouajina, Ramzi Zemni

Abstract:

Objectives: Little is known about genes predisposing to systemic bone loss (SBL) in rheumatoid arthritis (RA). Therefore, we examined the association between SBL and a variant of CD40 gene, which is known to play a critical role in both immune response and bone homeostasis among patients with RA. Methods: CD40 rs48104850 was genotyped in 176 adult RA patients. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA). Results: Low BMD was observed in 116 (65.9%) patients. Among them, 60 (34.1%) had low femoral neck (FN) Z score, 72 (40.9%) had low total femur (TF) Z score, and 105 (59.6%) had low lumbar spine (LS) Z score. CD40 rs4810485 was found to be associated with reduced TF Z score with the CD40 rs4810485 T allele protecting against reduced TF Z score (OR = 0.40, 95% CI = 0.23-0.68, p = 0.0005). This association was confirmed in the multivariate logistic regression analysis (OR=0.31, 95% CI= 0.16-0.59, p=3.84 x 10₋₄). Moreover, median FN BMD was reduced among RA patients with CD40 rs4810485 GG genotype compared to RA patients harbouring CD40 rs4810485 TT and GT genotypes (0.788± 0.136 versus 0.826± 0.146g/cm², p=0.001). Conclusion: This study, for the first time ever, demonstrated an association between a CD40 genetic variant and SBL among patients with RA.

Keywords: rheumatoid arthritis, CD40 gene, bone mineral density, systemic bone loss, rs48104850

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1520 The Most Desirable Individual Relationship

Authors: Ali Babaei

Abstract:

There is a significant relationship between Soul Faculties and human relationships. Man has at least three levels of relationship according to three levels of his Faculties: individual (with himself), dual (with another) and collective (with others). Since all human actions are organized by the type of use of their internal faculties, their "hierarchy of relations" is related to the "hierarchy of their Faculties." In the final explanation based on the ontology of Islamic wisdom, one can consider the hierarchy of human Faculties in three levels: 1. senses, 2. intellect and heart, and 3. Soul. The best relationship, in the individual one is that every human being, with healthy senses, achieves both the intellectual growth and the perfection of the heart, which we call "Clear-headed" and "Good-hearted.” The result of human evolution in this two aspects will lead to the development of a powerful personality which can be interpreted as "spiritual prosperity"; having a great soul is the result of such evolution. A smart brain without a "Good-heart"ince can lead to criminality; and mere "Good-heart"ince" without "Clear-head"ince leads to "naivety". “clear-head”ince is achieved through thoughtfulness and study, and "Good-heart"ince through love and worship. So the best way to achieve perfection in a personal relationship is to have a dependable appearance, a coherent thinking

Keywords: Ontology , good-heartince, wisdom, relationship, clear-head”ince, criminality, naivety

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1519 The Impact of Dog-Assisted Wellbeing Intervention on Student Motivation and Affective Engagement in the Primary and Secondary School Setting

Authors: Yvonne Howard

Abstract:

This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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1518 Facade Design Impact on the Urban Landscape

Authors: Seyyed Hossein Alavi, Soudabe Mehri Talarposhti

Abstract:

Passages urban landscape is made up of various components that the component parts of the whole and vice versa has relationships. In today’s cities, we have not seen a dual relationship and only one side of the equation which is the relationships of the component parts are considered. However, the effect of the component to whole is stronger and also longer. This means that every time the outer shell of the building was constructed instant impact on the viewers while it takes a long time to understand the impact of the building in its environment and basically, it seems city portrait has the sensory and untouchable effect on observer. Today, building facades are designated individually and in isolation from the context. Designers are familiar with the details of the facade, but they are not informed with the science of combination and its impact on portrait. The importance of city and also more important than that, the city portrait haven’t confirmed for those involved in the building and authorities and the construction been changed to a market for more glaring taste of designers and attracting more business and the city and its landscape has been forgotten. This essay is an attempt to collect a part of the principles and definitions needed on perspective issues and portrait, and it is hoped that it will open arena for more research and studies in this field and other related fields.

Keywords: facade, urban housing, urban design, sustainable architecture

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1517 The Anesthesia Considerations in Robotic Mastectomies

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

Abstract:

Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

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1516 Unique Interprofessional Mental Health Education Model: A Pre/Post Survey

Authors: Michele L. Tilstra, Tiffany J. Peets

Abstract:

Interprofessional collaboration in behavioral healthcare education is increasingly recognized for its value in training students to address diverse client needs. While interprofessional education (IPE) is well-documented in occupational therapy education to address physical health, limited research exists on collaboration with counselors to address mental health concerns and the psychosocial needs of individuals receiving care. Counseling education literature primarily examines the collaboration of counseling students with psychiatrists, psychologists, social workers, and marriage and family therapists. This pretest/posttest survey research study explored changes in attitudes toward interprofessional teams among 56 Master of Occupational Therapy (MOT) (n = 42) and Counseling and Human Development (CHD) (n = 14) students participating in the Counselors and Occupational Therapists Professionally Engaged in the Community (COPE) program. The COPE program was designed to strengthen the behavioral health workforce in high-need and high-demand areas. Students accepted into the COPE program were divided into small MOT/CHD groups to complete multiple interprofessional multicultural learning modules using videos, case studies, and online discussion board posts. The online modules encouraged reflection on various behavioral healthcare roles, benefits of team-based care, cultural humility, current mental health challenges, personal biases, power imbalances, and advocacy for underserved populations. Using the Student Perceptions of Interprofessional Clinical Education- Revision 2 (SPICE-R2) scale, students completed pretest and posttest surveys using a 5-point Likert scale (Strongly Agree = 5 to Strongly Disagree = 1) to evaluate their attitudes toward interprofessional teamwork and collaboration. The SPICE-R2 measured three different factors: interprofessional teamwork and team-based practice (Team), roles/responsibilities for collaborative practice (Roles), and patient outcomes from collaborative practice (Outcomes). The mean total scores for all students improved from 4.25 (pretest) to 4.43 (posttest), Team from 4.66 to 4.58, Roles from 3.88 to 4.30, and Outcomes from 4.08 to 4.36. A paired t-test analysis for the total mean scores resulted in a t-statistic of 2.54, which exceeded both one-tail and two-tail critical values, indicating statistical significance (p = .001). When the factors of the SPICE-R2 were analyzed separately, only the Roles (t Stat=4.08, p =.0001) and Outcomes (t Stat=3.13, p = .002) were statistically significant. The item ‘I understand the roles of other health professionals’ showed the most improvement from a mean score for all students of 3.76 (pretest) to 4.46 (posttest). The significant improvement in students' attitudes toward interprofessional teams suggests that the unique integration of OT and CHD students in the COPE program effectively develops a better understanding of the collaborative roles necessary for holistic client care. These results support the importance of IPE through structured, engaging interprofessional experiences. These experiences are essential for enhancing students' readiness for collaborative practice and align with accreditation standards requiring interprofessional education in OT and CHD programs to prepare practitioners for team-based care. The findings contribute to the growing body of evidence supporting the integration of IPE in behavioral healthcare curricula to improve holistic client care and encourage students to engage in collaborative practice across healthcare settings.

Keywords: behavioral healthcare, counseling education, interprofessional education, mental health education, occupational therapy education

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1515 Design and Analysis of Highly Efficient and Reliable Single-Phase Transformerless Inverter for PV Systems

Authors: L. Ashok Kumar, N. Sujith Kumar

Abstract:

Most of the PV systems are designed with transformer for safety purpose with galvanic isolation. However, the transformer is big, heavy and expensive. Also, it reduces the overall frequency of the conversion stage. Generally PV inverter with transformer is having efficiency around 92%–94% only. To overcome these problems, transformerless PV system is introduced. It is smaller, lighter, cheaper and higher in efficiency. However, dangerous leakage current will flow between PV array and the grid due to the stray capacitance. There are different types of configurations available for transformerless inverters like H5, H6, HERIC, oH5, and Dual paralleled buck inverter. But each configuration is suffering from its own disadvantages like high conduction losses, shoot-through issues of switches, dead-time requirements at zero crossing instants of grid voltage to avoid grid shoot-through faults and MOSFET reverse recovery issues. The main objective of the proposed transformerless inverter is to address two key issues: One key issue for a transformerless inverter is that it is necessary to achieve high efficiency compared to other existing inverter topologies. Another key issue is that the inverter configuration should not have any shoot-through issues for higher reliability.

Keywords: grid-connected, photovoltaic (PV) systems, transformerless inverter, stray capacitance, common-mode, leakage current, pulse width modulation (PWM)

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1514 Oncolytic Efficacy of Thymidine Kinase-Deleted Vaccinia Virus Strain Tiantan (oncoVV-TT) in Glioma

Authors: Seyedeh Nasim Mirbahari, Taha Azad, Mehdi Totonchi

Abstract:

Oncolytic viruses, which only replicate in tumor cells, are being extensively studied for their use in cancer therapy. A particular virus known as the vaccinia virus, a member of the poxvirus family, has demonstrated oncolytic abilities glioma. Treating Glioma with traditional methods such as chemotherapy and radiotherapy is quite challenging. Even though oncolytic viruses have shown immense potential in cancer treatment, their effectiveness in glioblastoma treatment is still low. Therefore, there is a need to improve and optimize immunotherapies for better results. In this study, we have designed oncoVV-TT, which can more effectively target tumor cells while minimizing replication in normal cells by replacing the thymidine kinase gene with a luc-p2a-GFP gene expression cassette. Human glioblastoma cell line U251 MG, rat glioblastoma cell line C6, and non-tumor cell line HFF were plated at 105 cells in a 12-well plates in 2 mL of DMEM-F2 medium with 10% FBS added to each well. Then incubated at 37°C. After 16 hours, the cells were treated with oncoVV-TT at an MOI of 0.01, 0.1 and left in the incubator for a further 24, 48, 72 and 96 hours. Viral replication assay, fluorescence imaging and viability tests, including trypan blue and crystal violet, were conducted to evaluate the cytotoxic effect of oncoVV-TT. The finding shows that oncoVV-TT had significantly higher cytotoxic activity and proliferation rates in tumor cells in a dose and time-dependent manner, with the strongest effect observed in U251 MG. To conclude, oncoVV-TT has the potential to be a promising oncolytic virus for cancer treatment, with a more cytotoxic effect in human glioblastoma cells versus rat glioma cells. To assess the effectiveness of vaccinia virus-mediated viral therapy, we have tested U251mg and C6 tumor cell lines taken from human and rat gliomas, respectively. The study evaluated oncoVV-TT's ability to replicate and lyse cells and analyzed the survival rates of the tested cell lines when treated with different doses of oncoVV-TT. Additionally, we compared the sensitivity of human and mouse glioma cell lines to the oncolytic vaccinia virus. All experiments regarding viruses were conducted under biosafety level 2. We engineered a Vaccinia-based oncolytic virus called oncoVV-TT to replicate specifically in tumor cells. To propagate the oncoVV-TT virus, HeLa cells (5 × 104/well) were plated in 24-well plates and incubated overnight to attach to the bottom of the wells. Subsequently, 10 MOI virus was added. After 48 h, cells were harvested by scraping, and viruses were collected by 3 sequential freezing and thawing cycles followed by removal of cell debris by centrifugation (1500 rpm, 5 min). The supernatant was stored at −80 ◦C for the following experiments. To measure the replication of the virus in Hela, cells (5 × 104/well) were plated in 24-well plates and incubated overnight to attach to the bottom of the wells. Subsequently, 5 MOI virus or equal dilution of PBS was added. At the treatment time of 0 h, 24 h, 48 h, 72 h and 96 h, the viral titers were determined under the fluorescence microscope (BZ-X700; Keyence, Osaka, Japan). Fluorescence intensity was quantified using the imagej software according to the manufacturer’s protocol. For the isolation of single-virus clones, HeLa cells seeded in six-well plates (5×105 cells/well). After 24 h (100% confluent), the cells were infected with a 10-fold dilution series of TianTan green fluorescent protein (GFP)virus and incubated for 4 h. To examine the cytotoxic effect of oncoVV-TT virus ofn U251mg and C6 cell, trypan blue and crystal violet assay was used.

Keywords: oncolytic virus, immune therapy, glioma, vaccinia virus

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1513 Stability Analysis of Three-Dimensional Flow and Heat Transfer over a Permeable Shrinking Surface in a Cu-Water Nanofluid

Authors: Roslinda Nazar, Amin Noor, Khamisah Jafar, Ioan Pop

Abstract:

In this paper, the steady laminar three-dimensional boundary layer flow and heat transfer of a copper (Cu)-water nanofluid in the vicinity of a permeable shrinking flat surface in an otherwise quiescent fluid is studied. The nanofluid mathematical model in which the effect of the nanoparticle volume fraction is taken into account is considered. The governing nonlinear partial differential equations are transformed into a system of nonlinear ordinary differential equations using a similarity transformation which is then solved numerically using the function bvp4c from Matlab. Dual solutions (upper and lower branch solutions) are found for the similarity boundary layer equations for a certain range of the suction parameter. A stability analysis has been performed to show which branch solutions are stable and physically realizable. The numerical results for the skin friction coefficient and the local Nusselt number as well as the velocity and temperature profiles are obtained, presented and discussed in detail for a range of various governing parameters.

Keywords: heat transfer, nanofluid, shrinking surface, stability analysis, three-dimensional flow

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1512 Optimization of Reliability and Communicability of a Random Two-Dimensional Point Patterns Using Delaunay Triangulation

Authors: Sopheak Sorn, Kwok Yip Szeto

Abstract:

Reliability is one of the important measures of how well the system meets its design objective, and mathematically is the probability that a complex system will perform satisfactorily. When the system is described by a network of N components (nodes) and their L connection (links), the reliability of the system becomes a network design problem that is an NP-hard combinatorial optimization problem. In this paper, we address the network design problem for a random point set’s pattern in two dimensions. We make use of a Voronoi construction with each cell containing exactly one point in the point pattern and compute the reliability of the Voronoi’s dual, i.e. the Delaunay graph. We further investigate the communicability of the Delaunay network. We find that there is a positive correlation and a negative correlation between the homogeneity of a Delaunay's degree distribution with its reliability and its communicability respectively. Based on the correlations, we alter the communicability and the reliability by performing random edge flips, which preserve the number of links and nodes in the network but can increase the communicability in a Delaunay network at the cost of its reliability. This transformation is later used to optimize a Delaunay network with the optimum geometric mean between communicability and reliability. We also discuss the importance of the edge flips in the evolution of real soap froth in two dimensions.

Keywords: Communicability, Delaunay triangulation, Edge Flip, Reliability, Two dimensional network, Voronio

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1511 Interventions for Children with Autism Using Interactive Technologies

Authors: Maria Hopkins, Sarah Koch, Fred Biasini

Abstract:

Autism is lifelong disorder that affects one out of every 110 Americans. The deficits that accompany Autism Spectrum Disorders (ASD), such as abnormal behaviors and social incompetence, often make it extremely difficult for these individuals to gain functional independence from caregivers. These long-term implications necessitate an immediate effort to improve social skills among children with an ASD. Any technology that could teach individuals with ASD necessary social skills would not only be invaluable for the individuals affected, but could also effect a massive saving to society in treatment programs. The overall purpose of the first study was to develop, implement, and evaluate an avatar tutor for social skills training in children with ASD. “Face Say” was developed as a colorful computer program that contains several different activities designed to teach children specific social skills, such as eye gaze, joint attention, and facial recognition. The children with ASD were asked to attend to FaceSay or a control painting computer game for six weeks. Children with ASD who received the training had an increase in emotion recognition, F(1, 48) = 23.04, p < 0.001 (adjusted Ms 8.70 and 6.79, respectively) compared to the control group. In addition, children who received the FaceSay training had higher post-test scored in facial recognition, F(1, 48) = 5.09, p < 0.05 (adjusted Ms: 38.11 and 33.37, respectively) compared to controls. The findings provide information about the benefits of computer-based training for children with ASD. Recent research suggests the value of also using socially assistive robots with children who have an ASD. Researchers investigating robots as tools for therapy in ASD have reported increased engagement, increased levels of attention, and novel social behaviors when robots are part of the social interaction. The overall goal of the second study was to develop a social robot designed to teach children specific social skills such as emotion recognition. The robot is approachable, with both an animal-like appearance and features of a human face (i.e., eyes, eyebrows, mouth). The feasibility of the robot is being investigated in children ages 7-12 to explore whether the social robot is capable of forming different facial expressions to accurately display emotions similar to those observed in the human face. The findings of this study will be used to create a potentially effective and cost efficient therapy for improving the cognitive-emotional skills of children with autism. Implications and study findings using the robot as an intervention tool will be discussed.

Keywords: autism, intervention, technology, emotions

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1510 Content of Trace Elements in Agricultural Soils from Central and Eastern Europe

Authors: S. Krustev, V. Angelova, K. Ivanov, P. Zaprjanova

Abstract:

Approximately a dozen trace elements are vital for the development of all plants and some other elements are significant for some species. Heavy metals do not belong to this group of elements that are essential to plants, but some of them such as copper and zinc, have a dual effect on their growth. Concentration levels of these elements in the different regions of the world vary considerably. Their high concentrations in some parts of Central and Eastern Europe cause concern for human health and degrade the quality of agricultural produce from these areas. This study aims to compare the prevalence and levels of the major trace elements in some rural areas of Central and Eastern Europe. Soil samples from different regions of the Czech Republic, Slovakia, Austria, Hungary, Serbia, Romania, Bulgaria and Greece far from large industrial centers have been studied. The main methods for their determination are the atomic spectral techniques – atomic absorption and plasma atomic emission. As a result of this study, data on microelements levels in soils of 17 points from the main grain-producing regions of Central and Eastern Europe are presented and systematized. The content of trace elements was in the range of 5.0-84.1 mg.kg⁻¹ for Cu, 0.3-1.4 mg.kg⁻¹ for Cd, 26.1-225.5 mg.kg⁻¹ for Zn, 235.5-788.6 mg.kg⁻¹ for Mn and 4.1-25.8 mg.kg⁻¹ for Pb.

Keywords: trace elements, heavy metals, agricultural soils, Central and Eastern Europe

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1509 Association of Work Pattern with the Well-Being and Happiness: Evidence from Married Women Working in Delhi, India

Authors: Kanchan Negi

Abstract:

Background: Modern work culture has driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and well-being (including happiness) in a sample of working women. Method: Primary data of 360 currently married women working in the education, health, banking and IT sector in Delhi, India, were analysed. Logistic regression was used to estimate physical and psychological well-being and happiness across work characteristics. Results: Relative to 35–40 hours/week, working longer related to poor well-being (ß=0.75, 95% CI 0.12 to 1.39). Compared with not working weekends, working most or all weekends is related to poor physical (ß=0.34, 95% CI 0.08 to 0.61) and psychological well-being (ß=0.50, 95% CI 0.20 to 0.79). Rigid work patterns (ß=0.17, 95% CI −0.09 to 0.42) are also related to poor well-being. Conclusion: Decreased well-being and unhappiness are significantly linked to strenuous and rigid work patterns, suggesting that modern work culture may contribute to poor well-being. Flexible timings, compensatory holidays, work-from-home, and daycare facilities for young ones must be welcomed by companies to ease the dual burden of homemakers and career makers.

Keywords: happiness, well-being, work pattern, working women

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1508 Novel Low-cost Bubble CPAP as an Alternative Non-invasive Oxygen Therapy for Newborn Infants with Respiratory Distress Syndrome in a Tertiary Level Neonatal Intensive Care Unit in the Philippines: A Single Blind Randomized Controlled Trial

Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

Abstract:

Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

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1507 Dual Reconfigurable Antenna Using Capacitive Coupling Slot and Parasitic Square Ring

Authors: M. Abou Al-alaa, H. A. Elsadek, E. A. Abdallah, E. A. Hashish

Abstract:

A square patch antenna with both frequency and polarization reconfigurability is presented. The antenna consists of a square patch with coplanar feed on the ground plane. On the patch side, there is a parasitic square ring that is responsible for changing the antenna polarization. On the ground plane, there is a rectangular slot. By changing of length of this slot, the antenna resonance frequency can be changed. The antenna operates at 1.57 and 2.45 GHz that used in GPS and Bluetooth applications, respectively. The length of the slot in the proposed antenna is 40 mm, and the antenna operates at the lower frequency (1.57 GHz). By using switches in the ground plane the slot length can be adjust to 24 mm, so the antenna operates at upper frequency (2.45 GHz). Two switches are mounted on the parasitic ring at optimized positions. By switching between the different states of these two switches, the proposed antenna operates with linear polarization (LP) and circular polarization (CP) at each operating frequency. The antenna gain at 1.57 and 2.45 GHz are 5.9 and 7.64 dBi, respectively. The antenna is analyzed using the CST Microwave Studio. The proposed antenna was fabricated and measured. Results comparison shows good agreement. The antenna has applications in several wireless communication systems.

Keywords: microstrip patch antenna, reconfigurable antenna, frequency reconfigurability, polarization reconfigurability, parasitic square ring, linear polarization, circular polarization

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1506 Yoga as a Tool for Public Health

Authors: Divya Kanchibhotla

Abstract:

Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

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1505 Variable Shunt Reactors for Reactive Power Compensation of HV Subsea Cables

Authors: Saeed A. AlGhamdi, Nabil Habli, Vinoj Somasanran

Abstract:

This paper presents an application of 230 kV Variable Shunt Reactors (VSR) used to compensate reactive power of dual 90 KM subsea cables. VSR integrates an on-load tap changer (OLTC) that adjusts reactive power compensation to maintain acceptable bus voltages under variable load profile and network configuration. An automatic voltage regulator (AVR) or a power management system (PMS) that allows VSR rating to be changed in discrete steps typically controls the OLTC. Typical regulation range start as minimum as 20% up to 100% and are available for systems up to 550kV. The regulation speed is normally in the order of seconds per step and approximately a minute from maximum to minimum rating. VSR can be bus or line connected depending on line/cable length and compensation requirements. The flexible reactive compensation ranges achieved by recent VSR technologies have enabled newer facilities design to deploy line connected VSR through either disconnect switches, which saves space and cost, or through circuit breakers. Lines with VSR are typically energized with lower taps (reduced reactive compensation) to minimize or remove the presence of delayed zero crossing.

Keywords: power management, reactive power, subsea cables, variable shunt reactors

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1504 Chronic Hepatitis C Virus Screening: The Role, Strategies and Challenging of Primary Healthcare Faced to Augment and Identify Asymptomatic Infected Patients

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

Abstract:

Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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1503 Court-Annexed Mediation for International Commercial Disputes in Asia: Strengths and Weaknesses

Authors: Thu Thuy Nguyen

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In recent years, mediation has gained a great attention from many jurisdictions thanks to its advantages. With respect to Asia, mediation has a long history of development in this region with various types to amicably settle disputes in civil and commercial issues. The modern mediation system in several Asian countries and territories comprises three main categories, namely court-annexed mediation, mediation within arbitral proceedings and institutional mediation. Court-annexed mediation (or in-court mediation) is mediation conducted by the court in the course of judicial procedures. In dealing with cross-border business disputes, in-court mediation exposes a number of advantages in comparison with two other types of mediation, especially in terms of enforcement of final result. However, the confidentiality of mediation process in subsequent judicial proceedings, qualifications of court judges and the issue of recognition and enforcement of foreign judgment are normally seen as drawbacks of court-annexed mediation as in court-annexed mediation judges will be casts as dual roles as both mediator and ultimate adjudicator in the same dispute. This paper will examine the strengths and weaknesses of in-court mediation in settling transnational business disputes in selected Asian countries, including China, Hong Kong, Japan, Singapore and Vietnam.

Keywords: court-annexed mediation, international commercial disputes, Asia, strengths and weaknesses

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1502 Horticulture Therapy: A Healing Tool for Combating Depression

Authors: Eric Spruth, Lindsey Herbert, Danielle DiCristofano, Isis Violet Spruth, Drake Von Spruth

Abstract:

Turning dreams into reality, the lifelong passion of Mr. Spruth and the company is to transform garbage-filled courtyards into flourishing flower and vegetable gardens, bringing light, hope, and wellness to not just the space but to the populations served within these public and private spaces. As an Expressive Art Therapist at Cook County Jail, Eric Spruth has implemented gardening projects, mobile radish carts, plant fostering systems, and large-scale murals. Lindsey Herbert, the Manager of Operations and Events at the International Museum of Surgical Science, supports gardening projects with Mr. Spruth along the front lawn of the museum, which will eventually accumulate into a community wellness garden. Mr. Spruth and Ms. Herbert both have dedicated efforts towards fostering awareness of hope and help and accountability for physical and mental wellbeing. Medicinal plants can rightfully be called one of nature’s wonderful healing tools with therapeutic powers. They can inhibit and kill bacteria, lower blood pressure, blood cholesterol, and blood sugar, prevent blood clotting, boost the immune system, and serve as a digestive aid. Some plants have the ability to stimulate the lymphatic system, which expedites the removal of waste products from the body to fight off evil toxins. Many plants are considered effective antioxidants to protect cells against free radical damage, serving to prevent some forms of cancer, heart disease, strokes, and viral infections. Garlic alone can provide us with over two hundred unusual chemicals that have the capability of protecting the human body from a wide variety of diseases. Besides the medicinal qualities of plants, plant and vegetable gardens also have an echoing effect on non-participants to look at something beautiful rather than a concrete courtyard or an unkempt lawn in front of a beautiful building. Plants also purify spaces and affect mood with color therapy. Collective gardening can foster a sense of community and purpose. Additionally, by recognizing the ever-evolving planet with global warming, horticulture therapy teaches important lessons in responsibility, accountability, and sustainability. Growing local food provides an opportunity to be involved in your own mental and physical health and gives you a chance for your own self-resilience, combating depression and a lack of nutrition. In adolescents, the process of watering and caring for plants can teach important life lessons that transcend beyond the garden by providing knowledge on how to care for yourself and how to be an active member of society. It also gives a sense of purpose and pride in transforming a small seed into a plant that can be consumed or enjoyed by others. Mr. Spruth and Ms. Herbert recognize the importance of bringing more green spaces to urban areas, both to serve a nutritional benefit and provide a beautiful transformation to underutilized areas. Gardens can bring beauty, wellness, and hope to dark spaces and provide immeasurable benefits for all.

Keywords: growth, hope, mental health, sustainability, transformation, wellness

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1501 Intensive Multidisciplinary Feeding Intervention for a Toddler with In-Utero Drug Exposure

Authors: Leandra Prempeh, Emily Malugen

Abstract:

Prenatal drug exposure can have a molecular impact on the hypothalamic and reward genes that regulate feeding behavior. This can impact feeding regulation, resulting in feeding difficulties and growth failure. This was potentially seen in “McKayla,” a 19- month old girl with a history of in-utero drug exposure, patent ductus arteriosus, and gastroesophageal reflux disease who presented for intensive day treatment feeding therapy. She was diagnosed with Avoidant Restrictive Food Intake Disorder, described as total food refusal and meeting 100% of her caloric needs from a gastrostomy tube. The primary goals during intensive feeding therapy were to increase her oral intake and decrease her reliance on supplementation with formula. Several behavioral antecedent manipulations were implemented to establish consistent responding and make progress towards treatment goals. This included multiple modified bolus placements (using underloaded and Nuk brush), reinforcement contingencies, and variety fading before stability was finally achieved. Following, increasing retention of bites then increasing volume and variety were goals targeted. From treatment onset to the last 3 days of treatment, McKayla's rate of rapid acceptance of bite presentations increased significantly from 33.33% to 93.13%, rapid swallowing went from 0.00% to 92.32%, and her percentage of inappropriate mealtime behavior and expels decreased from 58.33% and 100% to 2.31% and 7.68%, respectively. Overall, the treatment team successfully introduced and increased the bite size of 7 pureed foods, generalize the treatment to caregivers with high integrity, and began facilitating tube weaning. She was receiving about 33.42% of her needs by mouth at the time of discharge. Other nutritional concerns addressed during treatment included drinking a nutritionally complete drink out of an open cup and age appropriate growth. McKayla continued to have emesis almost daily, as was her baseline before starting treatment; however, the frequency during mealtime decreased. Overall, McKayla responded well to treatment. She had a very slow response to treatment and required a lot of antecedent manipulations to establish consistent responding. As the literature suggests, [drug]-exposed neonates, like McKayla, may be at increased risk for nutritional and growth challenges that may persist throughout development. This supports the need for longterm follow-up of infant growth.

Keywords: behavioral intervention, feeding problems, in-utero drug exposure, intensive multidisciplinary intervention

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1500 Radio Frequency Heating of Iron-Filled Carbon Nanotubes for Cancer Treatment

Authors: L. Szymanski, S. Wiak, Z. Kolacinski, G. Raniszewski, L. Pietrzak, Z. Staniszewska

Abstract:

There exist more than one hundred different types of cancer, and therefore no particular treatment is offered to people struggling with this disease. The character of treatment proposed to a patient will depend on a variety of factors such as type of the cancer diagnosed, advancement of the disease, its location in the body, as well as personal preferences of a patient. None of the commonly known methods of cancer-fighting is recognised as a perfect cure, however great advances in this field have been made over last few decades. Once a patient is diagnosed with cancer, he is in need of medical care and professional treatment for upcoming months, and in most cases even for years. Among the principal modes of treatment offered by medical centres, one can find radiotherapy, chemotherapy, and surgery. All of them can be applied separately or in combination, and the relative contribution of each is usually determined by medical specialist in agreement with a patient. In addition to the conventional treatment option, every day more complementary and alternative therapies are integrated into mainstream care. There is one promising cancer modality - hyperthermia therapy which is based on exposing body tissues to high temperatures. This treatment is still being investigated and is not widely available in hospitals and oncological centres. There are two kinds of hyperthermia therapies with direct and indirect heating. The first is not commonly used due to low efficiency and invasiveness, while the second is deeply investigated and a variety of methods have been developed, including ultrasounds, infrared sauna, induction heating and magnetic hyperthermia. The aim of this work was to examine possibilities of heating magnetic nanoparticles under the influence of electromagnetic field for cancer treatment. For this purpose, multiwalled carbon nanotubes used as nanocarriers for iron particles were investigated for its heating properties. The samples were subjected to an alternating electromagnetic field with frequency range between 110-619 kHz. Moreover, samples with various concentrations of carbon nanotubes were examined. The lowest frequency of 110 kHz and sample containing 10 wt% of carbon nanotubes occurred to influence the most effective heating process. Description of hyperthermia therapy aiming at enhancing currently available cancer treatment was also presented in this paper. Most widely applied conventional cancer modalities such as radiation or chemotherapy were also described. Methods for overcoming the most common obstacles in conventional cancer modalities, such as invasiveness and lack of selectivity, has been presented in magnetic hyperthermia characteristics, which explained the increasing interest of the treatment.

Keywords: hyperthermia, carbon nanotubes, cancer colon cells, ligands

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1499 Similarity Based Retrieval in Case Based Reasoning for Analysis of Medical Images

Authors: M. Dasgupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: case based reasoning, exudates, retina image, similarity based retrieval

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1498 The Buccal Fat Pad for Closure of Oroantral Communication

Authors: Stefano A. Denes, Riccardo Tieghi, Giovanni Elia

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The buccal fat pad is a well-established tool in oral and maxillofacial surgery and its use has proved of value for the closure of oroantral communications. Oroantral communication may be a common complication after sequestrectomy in "Bisphosphonate-related osteonecrosis of the jaws". We report a clinical case of a 70-year-old female patient in bisphosphonate therapy presented with right maxillary sinusitis and oroantral communication after implants insertion. The buccal fat pad was used to close the defect. The case had an uneventful postoperative healing without dehiscence, infection and necrosis. We postulate that the primary closure of the site with buccal fat pad may ensure a sufficient blood supply and adequate protection for an effective bone-healing response to occur.

Keywords: buccal fat pad, oroantral communication, oral surgery, dehiscence

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1497 Integrating Assurance and Risk Management of Complex Systems

Authors: Odd Ivar Haugen

Abstract:

This paper explores the relationship between assurance, risk, and risk management in the context of complex safety-related systems. It introduces a nuanced understanding of assurance and argues that the foundation for grounds for justified confidence in claims made about a complex system is related to the system behaviour. It emphasises the importance of knowledge as the cornerstone of assurance. The paper addresses the challenges of epistemic and aleatory uncertainties inherent in safety-critical systems. A systems approach is proposed to model emergent properties and complexity using the composition, environment, structure, mechanisms (CESM) metamodel, offering a structured framework for analysing system behaviour. The interplay between assurance and risk management is conceptualised through two models: the domain model and the control model. Assurance and risk management are mutually dependent on each other to reduce uncertainty and control risk levels. This work highlights the dual roles of assurance in risk management, acting as an epistemic actuator on the one side and providing feedback about the strength of the justification on the other. Assurance and risk management have inseparable roles in ensuring safety in complex systems.

Keywords: assurance, CESM metamodel, confidence, emergent properties, knowledge, objectivity, risk, system behaviour, system safety

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1496 Lean Mass and Fat Mass Distribution in Ukrainian Postmenopausal Women with Abdominal Овesity and Metabolic Syndrome

Authors: V. V. Povoroznyuk, Lar. P. Martynyuk, N. I. Dzerovych, Lil. P. Martyntyuk

Abstract:

Objective: Menopause-related changes in female body are associated with the greater risk of metabolic syndrome (MS), which includes obesity, dyslipidemia, impaired glucose tolerance, hypertension. The aim of our study was to reveal peculiarities of fat and lean mass distribution between postmenopausal women with abdominal obesity and with MS. Materials and Methods: The sample consisted of 43 postmenopausal 60 – 69 years old women (age: mean = 64,8; S.D. = 0,4); duration of menopause: mean = 14,5; S.D.= 0,9). The diagnosis of MS was considered according to IDF (2005 yr) criteria. Lean and fat mass distrubution were measured by dual-energy X-ray absortiometry, and were compared for the cohorts with and without MS. Data were analyzed using Statistical Package 6.0 (Statsoft). Results: Findings revealed that 24 (55,8 %) of postmenopausal women had MS. In patients with and without MS compared, fat mass was higher in the former group (41248,25±2263,89 and 29817,68±2397,78 respectively; F=11,9; p=0,001) and at different body regions also: gynoid fat (6563,72±348,19 and 5115,21±392,43 respectively; F=7,6; p=0,008), android fat (3815,45±200,8128 and 2798,15±282,79 respectively; F=9,06; p=0,004. Lean mass comparing didn’t show significant differences in female with and without MS (42548,0±1239,18 and 40667,53±1223,78 respectively; F=1,1; p=0,29) and at different body regions also. Conclusion: These findings suggest that in postmenopausal women with MS there is prevalence of fat mass without increasing of lean mass quantity in compare to female with abdominal obesity without MS.

Keywords: lean mass, fat mass, овesity, metabolic syndrome, women, postmenopausal period

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1495 Improved Blood Glucose-Insulin Monitoring with Dual-Layer Predictive Control Design

Authors: Vahid Nademi

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In response to widely used wearable medical devices equipped with a continuous glucose monitor (CGM) and insulin pump, the advanced control methods are still demanding to get the full benefit of these devices. Unlike costly clinical trials, implementing effective insulin-glucose control strategies can provide significant contributions to the patients suffering from chronic diseases such as diabetes. This study deals with a key role of two-layer insulin-glucose regulator based on model-predictive-control (MPC) scheme so that the patient’s predicted glucose profile is in compliance with the insulin level injected through insulin pump automatically. It is achieved by iterative optimization algorithm which is called an integrated perturbation analysis and sequential quadratic programming (IPA-SQP) solver for handling uncertainties due to unexpected variations in glucose-insulin values and body’s characteristics. The feasibility evaluation of the discussed control approach is also studied by means of numerical simulations of two case scenarios via measured data. The obtained results are presented to verify the superior and reliable performance of the proposed control scheme with no negative impact on patient safety.

Keywords: blood glucose monitoring, insulin pump, predictive control, optimization

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1494 Management of Pressure Ulcer with a Locally Constructed Negative Pressure Device (NPD) in Traumatic Paraplegia Patients: A Randomized Controlled Clinical Trial

Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

Abstract:

Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

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1493 Other End of the Leash: The Volunteer Handlers Perspective of Animal-Assisted Interventions

Authors: Julie A. Carberry, Victor Maddalena

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Animal-Assisted Interventions (AAIs) have existed in various forms for centuries. In the past 30 years, there has been a dramatic increase in popularity. AAIs are now part of the lives of persons of all ages in many types of institutions. Anecdotal evidence of the benefits of AAIs have led to widespread adoption, yet there remains a lack of solid research base for support. The research question was, what are the lived experiences of AAI volunteer handlers are? An interpretive phenomenological methodology was used for this qualitative study. Data were collected from 1 - 2 hour-long semi-structured interviews and 1 observational field visit. All interviews were conducted, transcribed, and coded for themes by the principal investigator. Participants must have been an active St. John Ambulance Therapy Dog Program volunteer for a least one year. In total, 14 volunteer handlers, along with some of their dogs, were included. The St. John Ambulance is a not for profit organization that provides training and community services to Canadians. The Therapy Dog Program is 1 of the 4 nationally recognized core community service programs. The program incorporates dogs in the otherwise traditional therapeutic intervention of friendly visitation with clients. The lack of formal objectives and goals, and a trained therapist defines the program as an Animal-Assisted Activity (AAA), which is a type of AAI. Since the animals incorporated are dogs, the program is specifically a Canine-Assisted Activity (CAA), which is a type of Canine-Assisted Intervention (CAI). Six themes emerged from the analysis of the data: (a) a win-win-win situation for all parties involved – volunteer handlers, clients, and the dogs, (b) being on the other end of the leash: functions of the role of volunteer handler, (c) the importance of socialization: from spreading smiles to creating meaningful connections, (d) the role of the dog: initiating interaction and providing comfort, (e) an opportunity to feel good and destress, and (f) altruism versus personal rewards. Other insights were found regarding the program, clients, and staff. Possible implications from this research include increased organizational recruitment and retention of volunteer handlers and as well as increased support for CAAs and other CAIs that incorporate teams of volunteer handlers and their dogs. This support could, in turn, add overall support for the acceptance and broad implementation of AAIs as an alternative and or complementary non-pharmaceutical therapeutic intervention.

Keywords: animal-assisted activity, animal-assisted intervention, canine-assisted activity, canine-assisted intervention, perspective, qualitative, volunteer handler

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1492 Developing High-Definition Flood Inundation Maps (HD-Fims) Using Raster Adjustment with Scenario Profiles (RASPTM)

Authors: Robert Jacobsen

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Flood inundation maps (FIMs) are an essential tool in communicating flood threat scenarios to the public as well as in floodplain governance. With an increasing demand for online raster FIMs, the FIM State-of-the-Practice (SOP) is rapidly advancing to meet the dual requirements for high-resolution and high-accuracy—or High-Definition. Importantly, today’s technology also enables the resolution of problems of local—neighborhood-scale—bias errors that often occur in FIMs, even with the use of SOP two-dimensional flood modeling. To facilitate the development of HD-FIMs, a new GIS method--Raster Adjustment with Scenario Profiles, RASPTM—is described for adjusting kernel raster FIMs to match refined scenario profiles. With RASPTM, flood professionals can prepare HD-FIMs for a wide range of scenarios with available kernel rasters, including kernel rasters prepared from vector FIMs. The paper provides detailed procedures for RASPTM, along with an example of applying RASPTM to prepare an HD-FIM for the August 2016 Flood in Louisiana using both an SOP kernel raster and a kernel raster derived from an older vector-based flood insurance rate map. The accuracy of the HD-FIMs achieved with the application of RASPTM to the two kernel rasters is evaluated.

Keywords: hydrology, mapping, high-definition, inundation

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