Search results for: rapid access clinic

Authors: Ilma Robo, Saimir Heta, Vera Ostreni, Elsaida Agrushi, Eduart Kapaj

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Introduction: Cyclic hormonal fluctuations are known from literature to have a clinically visible effects on gingival tissue reactions, to the diagnosed processes of gingival inflammation. Materials and methods: At a total of 47 female patients, ad-hock presented at the University Clinic, were recorded data on effect of hormonal oscillations at periodontal treatment protocol. Oral examination was performed on soft tissue of gingiva and the oral mucous membrane, always respecting the air-drying procedure and then checking with free eye differences in oral mucosal relief. After the patients were informed about the study protocol, the purpose of the study and the ongoing procedure, verbal consensus was required. Results: The study was conducted in a total of 47 patients, out of which 13 patients were under the gingivitis classification, and 24 patients under the periodontal classification. Patients included in the study are divided by age, cycle week respectively 1,2,3 and 4.The younger age of female patients is more prone to the appearance of gingivitis, which is further aggravated by the effects of sexual hormones and the effect of the controlled or non-regulated fluctuations of the latter. Conclusions: The healing process is more fuel-intensive in the absence of high hormone levels, as they are these pro-inflammatory hormones, both in or near the ho Younger women are more open to volunteering in studies that record individual and study data that may last in time.

Keywords: gingiva, hormonal oscillations, female patients, mucosa, periodontal non-surgical treatment

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Authors: Mario M. J. Musonda

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Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.

Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management

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Authors: Yevheniia Varyvoda, Douglas Taren

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At the aggregate level, climate variability, the rising number of active violent conflicts, globalization and industrialization of agriculture, the loss in diversity of crop species, the increase in demand for agricultural production, and the adoption of healthy and sustainable dietary patterns are exacerbating factors of food system destabilization. The importance of pseudocereals to fuel and sustain resilient food systems is recognized by leading organizations working to end hunger, particularly for their critical capability to diversify livelihood portfolios and provide plant-sourced healthy nutrition in the face of systemic shocks and stresses. Amaranth, buckwheat, and quinoa are the most promising and used pseudocereals for ensuring food system resilience in the reality of climate change due to their high nutritional profile, good digestibility, palatability, medicinal value, abiotic stress tolerance, pest and disease resistance, rapid growth rate, adaptability to marginal and degraded lands, high genetic variability, low input requirements, and income generation capacity. The study provides the rationale and examples of advancing local and regional food systems' resilience by scaling up the utilization of amaranth, buckwheat, and quinoa along all components of food systems to architect indirect nutrition interventions and climate-smart approaches. Thus, this study aims to explore the drivers for ancient pseudocereal utilization, the potential resilience benefits that can be derived from using them, and the challenges and opportunities for pseudocereal utilization within the food system components. The PSALSAR framework regarding the method for conducting systematic review and meta-analysis for environmental science research was used to answer these research questions. Nevertheless, the utilization of pseudocereals has been slow for a number of reasons, namely the increased production of commercial and major staples such as maize, rice, wheat, soybean, and potato, the displacement due to pressure from imported crops, lack of knowledge about value-adding practices in food supply chain, limited technical knowledge and awareness about nutritional and health benefits, absence of marketing channels and limited access to extension services and information about resilient crops. The success of climate-resilient pathways based on pseudocereal utilization underlines the importance of co-designed activities that use modern technologies, high-value traditional knowledge of underutilized crops, and a strong acknowledgment of cultural norms to increase community-level economic and food system resilience.

Keywords: resilience, pseudocereals, food system, climate change

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Authors: Mohammed Khamis Albalushi

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Background: Somatic symptoms disorders are usually comorbid with depressive disorders despite the fact that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) has been approved by the FDA for mildly resistant depression. From this point, we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report, we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder. Case Report: A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complaints in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedures for somatic treatments; all of them were normal. Then patient was seen by a different psychiatric clinic; multiple anti-depressant and adjuvant anti-psychotic medications were tried, patient still did not improve. The patient was admitted to the hospital for observation and management. Initially, she was preoccupied with her somatic complaint and kept on Fluoxetine and Olanzapine along with that, topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After completing all sessions of rTMS, the patient was recovering from all her symptoms, and no complaints were reported from her. Conclusion: Our case highlights the importance of investigating more thoroughly in rTMS as a treatment option for Persistent Somatic symptoms Disorder.

Keywords: rTMS, somatic symptoms disorder, resistive cases, TMS

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Authors: Nimet Yildirim Tirgil, Ahmed Busnaina, April Z. Gu

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Environmental waters are monitored worldwide to protect people from infectious diseases primarily caused by enteric pathogens. All long, Escherichia coli (E. coli) is a good indicator for potential enteric pathogens in waters. Thus, a rapid and simple detection method for E. coli is very important to predict the pathogen contamination. In this study, to the best of our knowledge, as the first time we developed a rapid, direct and reusable SWCNTs (single walled carbon nanotubes) based biosensor system for sensitive and selective E. coli detection in water samples. We use a novel and newly developed flexible biosensor device which was fabricated by high-rate nanoscale offset printing process using directed assembly and transfer of SWCNTs. By simple directed assembly and non-covalent functionalization, aptamer (biorecognition element that specifically distinguish the E. coli O157:H7 strain from other pathogens) based SWCNTs biosensor system was designed and was further evaluated for environmental applications with simple and cost-effective steps. The two gold electrode terminals and SWCNTs-bridge between them allow continuous resistance response monitoring for the E. coli detection. The detection procedure is based on competitive mode detection. A known concentration of aptamer and E. coli cells were mixed and after a certain time filtered. The rest of free aptamers injected to the system. With hybridization of the free aptamers and their SWCNTs surface immobilized probe DNA (complementary-DNA for E. coli aptamer), we can monitor the resistance difference which is proportional to the amount of the E. coli. Thus, we can detect the E. coli without injecting it directly onto the sensing surface, and we could protect the electrode surface from the aggregation of target bacteria or other pollutants that may come from real wastewater samples. After optimization experiments, the linear detection range was determined from 2 cfu/ml to 10⁵ cfu/ml with higher than 0.98 R² value. The system was regenerated successfully with 5 % SDS solution over 100 times without any significant deterioration of the sensor performance. The developed system had high specificity towards E. coli (less than 20 % signal with other pathogens), and it could be applied to real water samples with 86 to 101 % recovery and 3 to 18 % cv values (n=3).

Keywords: aptamer, E. coli, environmental detection, nanobiosensor, SWCTs

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Authors: Jakia Rajoana

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The key aim of this research is to achieve Sustainable Rural Tourism (SRT) through women’s empowerment in the Sundarbans area of Bangladesh. Women in rural areas in developing countries depend on biomass for their survival and that of their family. Yet they have an unequal access to resources as well as decision making, thus making them more vulnerable to any changes in the environment. Women in the developing countries experience gender inequality which is culturally embedded resulting into women having less access to and control over financial and material resources, information, and also a lack of recognition of their contribution as compared to men. Their disadvantaged social position is augmented by their extreme poverty, little or no power they have over their own lives vis-à-vis the disproportionate burden they bear in reproduction and child-raising. Despite the significance of the need to pay attention to gender related issues in sustainable rural tourism (SRT), research remains rather scant. For instance, there is very little research that illustrates the role of women in tourism in the Sundarbans area. Thus empirically, this research seeks to fill a significant gap by focusing on rural areas and in particular focus on considerably under-researched area, namely the Sundarbans women’s role in tourism. In order to fully comprehend their experiences and life stories, this research will apply the empowerment theory and consider it along with the research on sustainable rural tourism. Since, women’s empowerment can act as a potential tool for SRT development and also examine the role tourism plays in the lives of Sundarbans’ women. Methodologically, this study will follow a qualitative research design using an ethnographic approach. Participant observation, semi- structured interviews, and documentation will be the primary data collection instruments in four communities – Shayamnagar, Koyra, Mongla and Sarankhola – in the Sundarbans area. It is hoped that by focusing on the life stories of these invisible women, research is better able to engage with nuances inherent in marginal and significantly under-researched communities.

Keywords: gender, sustainable rural tourism, women empowerment, Sundarbans

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Authors: Jaouadi Imen, Ben Djemaa Raoudha, Ben Abdallah Hanene

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The access to relevant information that is adapted to users’ needs, preferences and environment is a challenge in many applications running. That causes an appearance of context-aware systems. To facilitate the development of this class of applications, it is necessary that these applications share a common context meta-model. In this article, we will present our context meta-model that is defined using the OMG Meta Object facility (MOF). This meta-model is based on the analysis and synthesis of context concepts proposed in literature.

Keywords: context, meta-model, MOF, awareness system

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Authors: Chi-Chang Lin, Jian-Rong Wu, Jiun-Yan Chiu

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Myopia, ubiquitous symptom that is necessary to correct the eyesight by optical lens struggles many people for their daily life. Recent years, younger people raise interesting on using contact lens because of its convenience and aesthetics. In clinical, the risk of eye infections increases owing to the behavior of incorrectly using contact lens unsupervised cleaning which raising the infection risk of cornea, named ocular keratitis. In order to overcome the identification needs, new detection or analysis method with rapid and more accurate identification for clinical microorganism is importantly needed. In our study, we take advantage of Raman spectroscopy having unique fingerprint for different functional groups as the distinct and fast examination tool on microorganism. As we know, Raman scatting signals are normally too weak for the detection, especially in biological field. Here, we applied special SERS enhancement substrates to generate higher Raman signals. SERS filter we designed in this article that prepared by deposition of silver nanoparticles directly onto cellulose filter surface and suspension nanoparticles - gold nanostars (AuNSs) also be introduced together to achieve better enhancement for lower concentration analyte (i.e., various bacteria). Research targets also focusing on studying the shape effect of synthetic AuNSs, needle-like surface morphology may possible creates more hot-spot for getting higher SERS enhance ability. We utilized new designed SERS technology to distinguish the bacteria from ocular keratitis under strain level, and specific Raman and SERS fingerprint were grouped under pattern recognition process. We reported a new method combined different SERS substrates can be applied for clinical microorganism detection under strain level with simple, rapid preparation and low cost. Our presenting SERS technology not only shows the great potential for clinical bacteria detection but also can be used for environmental pollution and food safety analysis.

Keywords: bacteria, gold nanostars, Raman spectroscopy surface-enhanced Raman scattering filter

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Authors: Jane O`Halloran

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Japanese university students have traditionally shown antipathy towards English due to a generally unsatisfactory language-learning experience at the secondary level with a focus on grammar and translation rather than communication. The situation has become urgent, however, due to the rapid decline in the Japanese population, which will present both difficulties and opportunities as employees will increasingly be forced to use English in the workplace. For university lecturers, the challenge is to overcome the students` apathy and convince them of the need for English in the increasingly diverse workplaces they will be entering. This article will illustrate how English teachers and content teachers at a private science university came together to address this quandary.

Keywords: student motivation, CLIL, globalization, demographics

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Authors: Enrique Claver Cortés, Bartolomé Marco Lajara, Eduardo Sánchez García, Pedro Seva Larrosa, Encarnación Manresa Marhuenda, Lorena Ruiz Fernández, Esther Poveda Pareja

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In recent decades, the analysis of the effects of clustering as an essential factor for the development of innovations and the competitiveness of enterprises has raised great interest in different areas. Nowadays, companies have access to almost all tangible and intangible resources located and/or developed in any country in the world. However, despite the obvious advantages that this situation entails for companies, their geographical location has shown itself, increasingly clearly, to be a fundamental factor that positively influences their innovative performance and competitiveness. Industrial clusters could represent a unique level of analysis, positioned between the individual company and the industry, which makes them an ideal unit of analysis to determine the effects derived from company membership of a cluster. Also, the absorptive capacity (hereinafter 'AC') can mediate the process of innovation development by companies located in a cluster. The transformation and exploitation of knowledge could have a mediating effect between knowledge acquisition and innovative performance. The main objective of this work is to determine the key factors that affect the degree of generation and use of knowledge from the environment by companies and, consequently, their innovative performance and competitiveness. The elements analyzed are the companies' membership of a cluster and the AC. To this end, 30 most relevant papers published on this subject in the "Web of Science" database have been reviewed. Our findings show that, within a cluster, the knowledge coming from the companies' environment can significantly influence their innovative performance and competitiveness, although in this relationship, the degree of access and exploitation of the companies to this knowledge plays a fundamental role, which depends on a series of elements both internal and external to the company.

Keywords: absorptive capacity, clusters, innovation, knowledge

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Authors: Mohammed G. Alotaibi, Sameer Albahkaly, Salwa M. Bahkali, Abdullah M. Alghamdi, Raseel S. Alswidan, Maha Bin Shafi, Sarah Almaiman

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Introduction: Rhinitis is common in Saudi Arabia. Therefore, our study was designed to evaluate the prevalence, triggering factors, severity and progression of rhinitis during pregnancy. Methods: Prospective cross-sectional study was conducted in eight governmental and private medical centers in Riyadh, Saudi Arabia, during June and July 2014. Validated Arabic language self-administered questionnaire was used. Sample size of 260 Saudi pregnant women was calculated by Raosoft sample size calculator. Random sampling was achieved by choosing one and skipping every five patients in the clinic list. Data were coded and entered manually into spreadsheets then transferred to SPSS statistical package version 16.0 for Windows. Consent, Privacy and confidentiality of information were assured. Results: Pregnancy rhinitis was reported 31.2% (CI 25.6 - 37.2%). Symptoms arising in first trimester appeared in 79.2% of PR cases and mostly worsen. The most prevalent symptoms were nasal pruritis (67.5%), followed by sneezing (57.1%), congestion (50.6%), and post nasal drip (46.7%). The major triggering factor was dust (71.4%), followed by Tobacco/Shisha smoke (57.6%) and perfume(47%). Preexisting allergic diseases were markedly associated with developing pregnancy rhinitis. Conclusion: Rhinitis during pregnancy manifested in one third of Saudi pregnant ladies. Nasal pruritus was the most common symptom and dust was the widespread triggering factor.

Keywords: allergy, pregnancy, Rhinitis, sneezing

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Authors: Hamidreza Torabi, Mohsen Moghtaderi

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Introduction: Currently, deep vitrectomy with silicone oil tamponade is the standard treatment method for patients with Rhegmatogenous Retinal Detachment (RRD). After retinal repair, it is necessary to remove silicone oil from the eye, but the appropriate time to remove the oil and complications related to that time has been less studied. The aim of this study was to compare the results of the early removal of silicone oil with the delayed removal of silicone oil in patients with RRD. Method & material: Patients who were referred to the Ophthalmology Clinic of Baqiyatallah Hospital, Tehran, Iran, due to RRD with detached macula in 2021 & 2022 were evaluated. These patients were treated with deep vitrectomy and silicone oil tamponade. Patients whose retinas were attached after the passage of time were candidates for silicone oil removal (SOR) surgery. For patients in the early SOR group, SOR surgery was performed 3-6 months after the initial vitrectomy surgery, and for the late SOR group, SOR was performed after 6 months after the initial vitrectomy surgery. Results: In this study, 60 patients with RRD were evaluated. 23 (38.3%) patients were in the early group, and 37 (61.7%) patients were in the late group. Based on our findings, it was seen that the mean visual acuity of patients based on the Snellen chart in the early group (0.48 ± 0.23 Decimal) was better than the late group (0.33 ± 0.18 Decimal) (P-value=0.009). Retinal re-detachment has happened only in one patient with early SOR. Conclusion: Early removal of silicone oil (less than 6 months) from the eyes of patients undergoing RRD surgery has been associated with better vision results compared to late removal.

Keywords: retinal detachment, vitrectomy, silicone oil, silicone oil removal, visual acuity

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Authors: Thoetchai Peeraphatdit, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham, Niyada Naksuk

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Background: Serum electrolyte abnormalities are a common cause of an acquired prolonged QT syndrome, especially, in the coronary care unit (CCU) setting. Optimal electrolyte ranges among the CCU patients have not been sufficiently investigated. Methods: We identified 8,498 consecutive CCU patients who were admitted to the CCU at Mayo Clinic, Rochester, the USA, from 2004 through 2013. Association between first serum electrolytes and baseline corrected QT intervals (QTc), as well as in-hospital mortality, was tested using multivariate linear regression and logistic regression, respectively. Serum potassium 4.0- < 4.5 mEq/L, ionized calcium (iCa) 4.6-4.8 mg/dL, and magnesium 2.0- < 2.2 mg/dL were used as the reference levels. Results: There was a modest level-dependent relationship between hypokalemia ( < 4.0 mEq/L), hypocalcemia ( < 4.4 mg/dL), and a prolonged QTc interval; serum magnesium did not affect the QTc interval. Association between the serum electrolytes and in-hospital mortality included a U-shaped relationship for serum potassium (adjusted odds ratio (OR) 1.53 and OR 1.91for serum potassium 4.5- < 5.0 and ≥ 5.0 mEq/L, respectively) and an inverted J-shaped relationship for iCa (adjusted OR 2.79 and OR 2.03 for calcium < 4.4 and 4.4- < 4.6 mg/dL, respectively). For serum magnesium, the mortality was greater only among patients with levels ≥ 2.4 mg/dL (adjusted OR 1.40), compared to the reference level. Findings were similar in sensitivity analyses examining the association between mean serum electrolytes and mean QTc intervals, as well as in-hospital mortality. Conclusions: Serum potassium 4.0- < 4.5 mEq/L, iCa ≥ 4.6 mg/dL, and magnesium < 2.4 mg/dL had a neutral effect on QTc intervals and were associated with the lowest in-hospital mortality among the CCU patients.

Keywords: calcium, electrocardiography, long-QT syndrome, magnesium, mortality, potassium

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Authors: Silvia Maria Moya

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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: Hatem Abou-Senna, Essam Radwan

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Transportation agencies and researchers in the past have estimated emissions using one average speed and volume on a long stretch of roadway. Other methods provided better accuracy utilizing annual average estimates. Travel demand models provided an intermediate level of detail through average daily volumes. Currently, higher accuracy can be established utilizing microscopic analyses by splitting the network links into sub-links and utilizing second-by-second trajectories to calculate emissions. The need to accurately quantify transportation-related emissions from vehicles is essential. This paper presents an examination of four different approaches to capture the environmental impacts of vehicular operations on a 10-mile stretch of Interstate 4 (I-4), an urban limited access highway in Orlando, Florida. First, (at the most basic level), emissions were estimated for the entire 10-mile section 'by hand' using one average traffic volume and average speed. Then, three advanced levels of detail were studied using VISSIM/MOVES to analyze smaller links: average speeds and volumes (AVG), second-by-second link drive schedules (LDS), and second-by-second operating mode distributions (OPMODE). This paper analyzes how the various approaches affect predicted emissions of CO, NOx, PM2.5, PM10, and CO2. The results demonstrate that obtaining precise and comprehensive operating mode distributions on a second-by-second basis provides more accurate emission estimates. Specifically, emission rates are highly sensitive to stop-and-go traffic and the associated driving cycles of acceleration, deceleration, and idling. Using the AVG or LDS approach may overestimate or underestimate emissions, respectively, compared to an operating mode distribution approach.

Keywords: limited access highways, MOVES, operating mode distribution (OPMODE), transportation emissions, vehicle specific power (VSP)

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Authors: Purba Biswas, Priyanka Dey

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Worldwide rapid urbanisation has accelerated city expansion in both developed and developing nations. This unprecedented urbanisation trend due to the increasing population and economic growth has caused challenges for the decision-makers in city planning and urban management. Metropolitan cities, class-I towns, and major urban centres undergo a continuous process of evolution due to interaction between socio-cultural and economic attributes. This constant evolution leads to urban expansion in all directions. Understanding the patterns and dynamics of urban built-up growth is crucial for policymakers, urban planners, and researchers, as it aids in resource management, decision-making, and the development of sustainable strategies to address the complexities associated with rapid urbanisation. Identifying spatio-temporal patterns of urban growth has emerged as a crucial challenge in monitoring and assessing present and future trends in urban development. Analysing urban growth patterns and tracking changes in land use is an important aspect of urban studies. This study analyses spatio-temporal urban transformations and land-use and land cover changes using remote sensing and GIS techniques. Built-up growth analysis has been done for the city of Surat as a case example, using the GIS tools of NDBI and GIS models of the Built-up Urban Density Index and Shannon Entropy Index to identify trends and the geographical direction of transformation from 2005 to 2020. Surat is one of the fastest-growing urban centres in both the state and the nation, ranking as the 4th fastest-growing city globally. This study analyses the dynamics of urban built-up area transformations both zone-wise and geographical direction-wise, in which their trend, rate, and magnitude were calculated for the period of 15 years. This study also highlights the need for analysing and monitoring the urban growth pattern of class-I cities in India using spatio-temporal and quantitative techniques like GIS for improved urban management.

Keywords: urban expansion, built-up, geographic information system, remote sensing, Shannon’s entropy

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Authors: G. Fitzpatrick, S. O. Chonghaile, D. Harmon

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Objective: Chronic pain patients represent a unique challenge in the Emergency Department. Very little literature has been published regarding this group of patients. Our aim was to determine the attitude of patients with chronic pain to the Emergency Department in order to improve and streamline their future visits. Methods: A two-year survey was carried out on Chronic Pain Patients regarding their Emergency Department Attendances. Patients attending the Pain Clinic in Croom Hospital, Co. Limerick were asked to complete a 20-part questionnaire regarding their experiences of visiting the Emergency Department in the preceding year. 46 questionnaires were completed. Results: Unbearable breakthrough pain was the main reason for visiting the Emergency Department. More than half (54%) of those surveyed were not satisfied with the treatment received. Problems indicated included under-treatment of pain (59%), a sense of being under undue suspicion of drug-seeking behaviour (33%) and a perception that the patient themselves understood their condition better than the treating doctor (76%). Paracetamol, NSAIDs, or time off work comprised 72% of the treatments offered – all of which could have been provided by their General Practitioner. Only 4% were offered a nerve block. 67% felt that the creation of personalised Patient Plans, consisting of an agreed plan between the patient, their pain specialist, and the Emergency Department, would expedite their trip through the Emergency Department. Conclusions: Chronic pain patients generally have a negative experience in the ED. Possible future solutions include increasing our empathy and levels of knowledge, provision of nerve blocks in the ED, and use of personalised “Patient Plans” to streamline the treatment pathway for this group of patients.

Keywords: chronic pain, survey, patients, emergency department

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Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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Authors: Zahra Khodaee

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Environmental Justice (EJ) concept consists of multifaceted movements, community struggles, and discourses in contemporary societies that seek to reduce environmental risks, increase environmental protections, and generally reduce environmental inequalities suffered by minority and poor communities; a term that incorporates ‘environmental racism’ and ‘environmental classism,’ captures the idea that different racial and socioeconomic groups experience differential access to environmental quality. This article explores environmental justice as an urban phenomenon in urban planning and applies it in peri-urban environment of a metropolis. Tehran peri-urban environments which are the result of meeting the city- village- nature systems or «city-village junction» have gradually faced effects such as accelerated environmental decline, changes without land-use plan, and severe service deficiencies. These problems are instances of environmental injustice which make the planners to adjust the problems and use and apply the appropriate strategies and policies by looking for solutions and resorting to theories, techniques and methods related to environmental justice. In order to access to this goal, try to define environmental justice through justice and determining environmental justice indices to analysis environmental injustice in case study. Then, make an effort to introduce some criteria to select case study in two micro and micro levels. Qiyamdasht town as the peri-urban environment of Tehran metropolis is chosen and examined to show the existence of environmental injustice by questionnaire analysis and SPSS software. Finally, use AIDA technique to design a strategic plan and reduce environmental injustice in case study by introducing the better scenario to be used in policy and decision making areas.

Keywords: environmental justice, metropolis of Tehran, Qiyam, Dasht peri, urban settlement, analysis of interconnected decision area (AIDA)

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Authors: Ahdab H. Mahdaly, Debajyoti Pati, Sharran Parkinson, Lee S. Duemer

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The importance of providing employed mothers with the right physical environment inside the home is not an easy task, especially when the culture is involved. This study examines the typical Saudi home as a personal, emotional, social and cultural setting, especially on the interactions between the physical design and perceived control of working mothers. However, owing to the scarcity of published literature on Saudi homes, American employed mothers were included in the study to provide a baseline. With the ongoing transformations in women’s role in Saudi Arabia, there is a perception that traditional home designs may not afford the appropriate sense of control inside the home. Saudi Arabia has numerous interacting layers of socio-cultural-religious forces that affect residential design, and understanding the moderating role of the Saudi home is vital to the ongoing national policy transition on women. The study investigated one narrow, albeit critical, influence of home design on ones sense of control – direct visual and physical accessibility between sets of rooms. Ten subjects, five Saudis and five American, examined visual and physical access between 171 room sets, and provided qualitative responses on how each access influences their sense of control. Three main themes emerged, with potential effects on control: 1- Openness, 2- Proximity, and 3- Separation. Data suggest that although the Saudi home is a substantially more complex setting than the American ones, a class of spaces that can be termed as ‘Neutral Rooms’ serving as cultural separators may represent the ideal solution for optimizing sense of control, without ignoring cultural-religious traditions, during the transition of the Saudi women.

Keywords: direct physical accessibility, home environment, sense of control, visual accessibility, working mothers

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Authors: Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: Substance use disorder is conceptualized as a chronic relapsing condition where relapse is usually defined as the return to problematic substance use following treatment. An issue of great importance is the identification of the predictors of relapse and the development of treatments that may help prevent relapse. One of the strongest predictors of relapse is craving. The purpose of the present study was to study the effect of anxiety, anxiety sensitivity, and coping motives on craving. Materials and method: Participants (n=74) were male opiate users recruited from a semi-private clinic providing de-toxification and treatment services for substance users. Anxiety, anxiety sensitivity, coping motives and craving were assessed using relevant questionnaires. The addiction severity index was used to assess addiction severity. Results: All patients were methadone maintained and one year after detoxification, 36 patients (48.64%) relapsed. Stress and anxiety, anxiety sensitivity, addiction severity and coping motives predicted craving and relapse. Anxiety sensitivity specifically predicted early relapse. Conclusion: Substance use is a severe mental disorder, with high relapse rates. Substance users high in anxiety sensitivity are particularly prone to relapse during the first six months of treatment. Addiction severity and coping motives need to be taken into account when providing interventional services for substance users. Findings imply the significance of additional psychological attention to methadone maintained patients to prevent craving and relapse.

Keywords: anxiety sensitivity, coping motives, relapse, substance use craving

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Authors: B. Self, V. Fleming, C. Maxwell

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The fourth clause of the UK 1967 Abortion Act allows individuals (including health care practitioners) to conscientiously object to participating in an abortion. Individuals are able to object if they consider that participating is incompatible with their religious, moral, philosophical, ethical, or personal beliefs. Currently, there is no research on service users’ opinions and understandings of conscientious objection or the impact of conscientious objection from the UK service users’ perspective. This perspective is imperative in understanding the real-world consequences and impact of conscientious objection and essential when creating policy and guidelines. This qualitative research took a liberal feminist approach. It provided a platform for service users to share their experiences of abortion and conscientious objection, as well as their opinions and understandings of conscientious objection. The method employed was semi-structured interviews. Findings indicated that conscientious objection could work in practice. However, it is currently failing some individuals, as health care practitioners are not always referring and informing service users. Participants didn’t experience burdens such as long waiting times and were still able to access legal abortion. However, participants did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred. Moreover, participants’ opinions on conscientious objection in the UK varied greatly. The majority supported the most common approach within the literature and in practice, whereby health care practitioners are able to object so long as they refer and inform the service user. However, the opinion that health care practitioners should not be allowed to object or should be able to object without referring and informing was also present. Without this research, the impact that conscientious objection is having on service users in the UK and service users’ opinions on conscientious objection wouldn’t be known. These findings will be used to inform national policy and guidelines, making access to abortion fairer and safer for all.

Keywords: conscientious objection, abortion, medical ethics, reproductive justice

Procedia PDF Downloads 138

Authors: Adesomoju O. A., E. A. Onemolease, G. O. Igene

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The study analyzed the determinants of food insecurity among smallholder farming households in the Southwestern part of Nigeria with Ondo and Osun States in focus. Multi-stage sampling procedures were employed to gather data from 389 farming households (194 from Ondo State and 195 from Osun State) spread across 4 agricultural zones, 8 local governments, and 24 communities. The data was analyzed using descriptive statistics, Ordinal regression, and Friedman test. Results revealed the average age of the respondents was 47 years with majority being male 63.75% and married 82.26% and having an household size of 6. Most household heads were educated (94.09%), engaged in farming for about 19 years, and do not belong to cooperatives (73.26%). Respondents derived income from both farming and non-farm activities with the average farm income being N216,066.8/annum and non-farm income being about N360,000/annum. Multiple technologies were adopted by respondents such as application of herbicides (77.63%), pesticides (73.26%) and fertilizers (66.58%). Using the FANTA Cornel model, food insecurity was prevalent in the study area with the majority (61.44%) of the households being severely food insecure, and 35.73% being moderately food insecure. In comparison, 1.80% and 1.03% were food-secured and mildly food insecure. The most significant constraints to food security among the farming households were the inability to access credit (mean rank = 8.78), poor storage infrastructure (8.57), inadequate capital (8.56), and high cost of farm chemicals (8.35). Significant factors related to food insecurity among the farming households were age (b = -0.059), education (b = -0.376), family size (b = 0.197), adoption of technology (b = -0.198), farm income (b = -0.335), association membership (b = -0.999), engagement in non-farm activities (b = -1.538), and access to credit (b = -0.853). Linking farmers' groups to credit institutions and input suppliers was proposed.

Keywords: food insecurity, FANTA Cornel, Ondo, Osun, Nigeria, Southwest, Livelihood

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Authors: Felicity Aphiwe Mkhongi, Walter Musakwa

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Smallholder crop production is a defining factor in achieving food security, particularly at the household level. However, the number of abandoned arable fields is increasing in communal areas of South Africa. While substantial efforts have been devoted to addressing food insecurity in the country, ownership of arable land has not been supplemented with sustainable food production for households. This paper analyses household food security in the context of deagrarianization in two villages, Ambros (Eastern Cape) and Maramanzhi (Limpopo). Semi-structured questionnaires were administered to acquire both qualitative and quantitative data from 106 heads of households. The IBM SPSS Statistics 28.0 computer program was applied to complete data analysis. From the findings of the study, it was evident that compared to arable fields, a greater proportion of households own home-gardens with an average size of 2100m in Ambros and 3400m in Maramanzhi village. The majority of arable fields were abandoned, particularly in Ambros village. Household food access challenges were measured using the Household Food Insecurity Access Scale (HFIAS). This food security indicator revealed that the majority of households were mildly food insecure owing to food shortages emanating from insufficient monthly income and waning household crop production. Food was rated as a very important reason for engaging in cultivation in both villages of the study, but deagrarianization has eroded opportunities for increasing household crop production. Among other possible solutions, this study recommends that the government invest more in agriculture to allow for sustainable strategies that revive abandoned arable land, such as arable fields in communal areas of South Africa, as this could increase food production for households.

Keywords: cultivation, deagrarianization, food security, rural households, smallholder farmers

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Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem

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The deer velvet antler is well known for its traditional medicinal value and is widely used in the clinic. It has been considered to possess bone-strengthening activity. The goal of this study was to investigate the anti-osteoporotic effect of deer antler velvet on ovariectomized rats (OVX), and their possible mechanism of the action. In the first step, the in vitro effects of DAE on bone loss were determined. The proliferation, collagen content and alkaline phosphatase (ALP) activity of human osteoblastic MG-63 cells and osteoclastogenesis from bone marrow-derived precursor cells were measured. The in vivo experiment confirmed the positive effect of DAE on bone tissue. 3-month old female Sparague-Dawley rats were either sham operated or OVX, and administered DAE (20 and 100 mg/kg) for 4 weeks. DAE increased MG-63 cell proliferation and ALP activity in a dose-dependent manner. Collagen content was also increased by DAE treatment. However, the effect of DAE on bone resorption was not observed. OVX rats supplemented with DAE showed osteoprotective effects as the bone ALP level was increased and c-terminal telopeptide level was decreased by 100 mg/kg DAE treatment compared with OVX controls. Moreover, the tartrate-resistant acid phosphatase-5b level was also decreased by DAE treatment. The present study suggests that DAE is effective in preventing bone loss in OVX rats, and may be potential therapeutic agents for the treatment of postmenopausal osteoporosis.

Keywords: bone ALP, c-terminal telopeptide, deer antler, osteoporosis, ovariectomy, tartrate-resistant acid phosphatase-5b

Procedia PDF Downloads 239

Authors: M. Strémy, P. Závacký, P. Cuninka, M. Juhás

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Main goal of this paper is to introduce our design of private cloud for storing large amount of data, especially pictures, and to provide good technological backend for data analysis based on parallel processing and business intelligence. We have tested hypervisors, cloud management tools, storage for storing all data and Hadoop to provide data analysis on unstructured data. Providing high availability, virtual network management, logical separation of projects and also rapid deployment of physical servers to our environment was also needed.

Keywords: cloud, glusterfs, hadoop, juju, kvm, maas, openstack, virtualization

Procedia PDF Downloads 348

Authors: Eman W. Boghdady, A. R. Shehata, M. A. Azem

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Database (DB) security demands permitting authorized users and prohibiting non-authorized users and intruders actions on the DB and the objects inside it. Organizations that are running successfully demand the confidentiality of their DBs. They do not allow the unauthorized access to their data/information. They also demand the assurance that their data is protected against any malicious or accidental modification. DB protection and confidentiality are the security concerns. There are four types of controls to obtain the DB protection, those include: access control, information flow control, inference control, and cryptographic. The cryptographic control is considered as the backbone for DB security, it secures the DB by encryption during storage and communications. Current cryptographic techniques are classified into two types: traditional classical cryptography using standard algorithms (DES, AES, IDEA, etc.) and chaos cryptography using continuous (Chau, Rossler, Lorenz, etc.) or discreet (Logistics, Henon, etc.) algorithms. The important characteristics of chaos are its extreme sensitivity to initial conditions of the system. In this paper, DB-security systems based on chaotic algorithms are described. The Pseudo Random Numbers Generators (PRNGs) from the different chaotic algorithms are implemented using Matlab and their statistical properties are evaluated using NIST and other statistical test-suits. Then, these algorithms are used to secure conventional DB (plaintext), where the statistical properties of the ciphertext are also tested. To increase the complexity of the PRNGs and to let pass all the NIST statistical tests, we propose two hybrid PRNGs: one based on two chaotic Logistic maps and another based on two chaotic Henon maps, where each chaotic algorithm is running side-by-side and starting from random independent initial conditions and parameters (encryption keys). The resulted hybrid PRNGs passed the NIST statistical test suit.

Keywords: algorithms and data structure, DB security, encryption, chaotic algorithms, Matlab, NIST

Procedia PDF Downloads 263

Authors: Malik Abid Hussain Khokhar, Muhammad Naveed Tahir, Muhammad Amin

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Energy demand has been increased manifold due to increasing population, urban sprawl and rapid socio-economic improvements. Low water capacity in dams for continuation of hydrological power, land cover and land use are the key parameters which are creating problems for more energy production. Overall installed hydropower capacity of Pakistan is more than 35000 MW whereas Pakistan is producing up to 17000 MW and the requirement is more than 22000 that is resulting shortfall of 5000 - 7000 MW. Therefore, there is a dire need to develop small hydropower to fulfill the up-coming requirements. In this regards, excessive rainfall, snow nurtured fast flowing perennial tributaries and streams in northern mountain regions of Pakistan offer a gigantic scope of hydropower potential throughout the year. Rivers flowing in KP (Khyber Pakhtunkhwa) province, GB (Gilgit Baltistan) and AJK (Azad Jammu & Kashmir) possess sufficient water availability for rapid energy growth. In the backdrop of such scenario, small hydropower plants are believed very suitable measures for more green environment and power sustainable option for the development of such regions. Aim of this study is to estimate hydropower potential sites for small hydropower plants and stream distribution as per steam network available in the available basins in the study area. The proposed methodology will focus on features to meet the objectives i.e. site selection of maximum hydropower potential for hydroelectric generation using well emerging GIS tool SWAT as hydrological run-off model on the Neelum, Kunhar and the Dor Rivers’ basins. For validation of the results, NDWI will be computed to show water concentration in the study area while overlaying on geospatial enhanced DEM. This study will represent analysis of basins, watershed, stream links, and flow directions with slope elevation for hydropower potential to produce increasing demand of electricity by installing small hydropower stations. Later on, this study will be benefitted for other adjacent regions for further estimation of site selection for installation of such small power plants as well.

Keywords: energy, stream network, basins, SWAT, evapotranspiration

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Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

Procedia PDF Downloads 356

Authors: Luciana Salomon

Abstract:

The Andes hold one of the highest plant species diversity in the world. How such diversity originated is one of the most intriguing questions in studies addressing the pattern of plant diversity worldwide. Recently, the explosive adaptive radiations found in high Andean groups have been pointed as major triggers of this spectacular diversity. The Andes are one of the most species-rich area for the largest genus from the Asteraceae family, Senecio. There, the genus presents an incredible variation in growth form and ecological niche space. If this diversity of Andean Senecio can be explained by a monophyletic origin and subsequent radiation has not been tested up to now. Previous studies trying to disentangle the evolutionary history of some Andean Senecio struggled with the relatively low resolution and support of the phylogenies, which is indicative of recently radiated groups. Using Hyb-Seq, a powerful approach is available to address phylogenetic questions in groups whose evolutionary histories are recent and rapid. This approach was used for Senecio to build a phylogenetic backbone on which to study the mechanisms shaping its hyper-diversity in the Andes, focusing on Senecio ser. Culcitium, an exclusively Andean and well circumscribed group presenting large morphological variation and which is widely distributed across the Andes. Hyb-Seq data for about 130 accessions of Seneciowas generated. Using standard data analysis work flows and a newly developed tool to utilize paralogs for phylogenetic reconstruction, robustness of the species treewas investigated. Fully resolved and moderately supported species trees were obtained, showing Senecio ser. Culcitium as monophyletic. Within this group, some species formed well-supported clades congruent with morphology, while some species would not have exclusive ancestry, in concordance with previous studies showing a geographic differentiation. Additionally, paralogs were detected for a high number of loci, indicating duplication events and hybridization, known to be common in Senecio ser. Culcitium might have lead to hybrid speciation. The rapid diversification of the group seems to have followed a south-north distribution throughout the Andes, having accelerated in the conquest of new habitats more recently available: i.e., Montane forest, Paramo, and Superparamo.

Keywords: evolutionary radiations, andes, paralogy, hybridization, senecio

Procedia PDF Downloads 125