Search results for: rehabilitation centre

Authors: M. Haruna, O. O. Onafowokan, G. Holt, K. Anderson, R. G. Middleton

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Background: Requirements for satisfactory outcomes following total hip arthroplasty (THA) include restoration of femoral offset, version, and leg length. Various techniques have been described for restoring these biomechanical parameters, with leg length restoration being the most predominantly described. We describe a “quartered head technique” (QHT) which uses a stepwise series of femoral head osteotomies to identify and preserve the centre of rotation of the femoral head during THA in order to ensure reconstruction of leg length, offset and stem version, such that hip biomechanics are restored as near to normal as possible. This study aims to identify whether using the QHT during hip arthroplasty effectively restores leg length and femoral offset to within acceptable parameters. Methods: A retrospective review of 206 hips was carried out, leaving 124 hips in the final analysis. Power analysis indicated a minimum of 37 patients required. All operations were performed using an anterolateral approach by a single surgeon. All femoral implants were cemented, collarless, polished double taper CPT® stems (Zimmer, Swindon, UK). Both cemented, and uncemented acetabular components were used (Zimmer, Swindon, UK). Leg length, version, and offset were assessed intra-operatively and reproduced using the QHT. Post-operative leg length and femoral offset were determined and compared with the contralateral native hip, and the difference was then calculated. For the determination of leg length discrepancy (LLD), we used the method described by Williamson & Reckling, which has been shown to be reproducible with a measurement error of ±1mm. As a reference, the inferior margin of the acetabular teardrop and the most prominent point of the lesser trochanter were used. A discrepancy of less than 6mm LLD was chosen as acceptable. All peri-operative radiographs were assessed by two independent observers. Results: The mean absolute post-operative difference in leg length from the contralateral leg was +3.58mm. 84% of patients (104/124) had LLD within ±6mm of the contralateral limb. The mean absolute post-operative difference in offset from contralateral leg was +3.88mm (range -15 to +9mm, median 3mm). 90% of patients (112/124) were within ±6mm offset of the contralateral limb. There was no statistical difference noted between observer measurements. Conclusion: The QHT provides a simple, inexpensive yet effective method of maintaining femoral leg length and offset during total hip arthroplasty. Combining this technique with pre-operative templating or other techniques described may enable surgeons to reduce even further the discrepancies between pre-operative state and post-operative outcome.

Keywords: leg length discrepancy, technical tip, total hip arthroplasty, operative technique

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Authors: Zbigniew Czyż, Adam Majczak, Lukasz Grabowski

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The paper presents a description of geometric models, computational algorithms, and results of numerical analyses of charge exchange in a two-stroke opposed-piston engine. The research engine was a newly designed internal Diesel engine. The unit is characterized by three cylinders in which three pairs of opposed-pistons operate. The engine will generate a power output equal to 100 kW at a crankshaft rotation speed of 3800-4000 rpm. The numerical investigations were carried out using ANSYS FLUENT solver. Numerical research, in contrast to experimental research, allows us to validate project assumptions and avoid costly prototype preparation for experimental tests. This makes it possible to optimize the geometrical model in countless variants with no production costs. The geometrical model includes an intake manifold, a cylinder, and an outlet manifold. The study was conducted for a series of modifications of manifolds and intake and exhaust ports to optimize the charge exchange process in the engine. The calculations specified a swirl coefficient obtained under stationary conditions for a full opening of intake and exhaust ports as well as a CA value of 280° for all cylinders. In addition, mass flow rates were identified separately in all of the intake and exhaust ports to achieve the best possible uniformity of flow in the individual cylinders. For the models under consideration, velocity, pressure and streamline contours were generated in important cross sections. The developed models are designed primarily to minimize the flow drag through the intake and exhaust ports while the mass flow rate increases. Firstly, in order to calculate the swirl ratio [-], tangential velocity v [m/s] and then angular velocity ω [rad / s] with respect to the charge as the mean of each element were calculated. The paper contains comparative analyses of all the intake and exhaust manifolds of the designed engine. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: computational fluid dynamics, engine swirl, fluid mechanics, mass flow rates, numerical analysis, opposed-piston engine

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.

Keywords: community-based, disability, health outcomes, quality of life, soldiers

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Authors: Ayse Inel Manav, Nuray Simsek

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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.

Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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Authors: Tuba Tekin, Nurcan Baglam, Emine Dincer

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This study aimed to examine the effects of nutrition education received by university students on sustainable healthy eating behaviors and adherence to the Mediterranean diet. The 2nd, 3rd, and 4th-grade university students studying at the Faculty of Health Sciences, Nutrition and Dietetics, Midwifery, Nursing, Physical Therapy, and Rehabilitation departments of universities in Turkey were included in the study. Students' adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Scale, and their sustainable and healthy eating behaviors were evaluated using the Sustainable and Healthy Eating Behaviors Scale. In addition, the body weight and height of the students were measured by the researchers, and the Body Mass Index (BMI) value was calculated. A total of 181 students, 85 of whom were studying in the Department of Nutrition and Dietetics and 96 of whom were educated in other departments, were included in the study. 75.7% of the students in the sample are female, while 24.3% are male. The average body weight of the students was 61.17±10.87 kg, and the average BMI was 22.04±3.40 kg/m2. While the mean score of the Mediterranean Diet Adherence Scale was 6.72±1.84, in the evaluation of adherence to the Mediterranean diet, it was determined that 25.4% of the students had poor adherence and 66.9% needed improvement. When the adherence scores of students who received and did not receive nutrition education were compared, it was discovered that the students who received nutrition education had a higher score (p<0.05). Students who received nutrition education had a higher total score on the Sustainable and Healthy Eating Behaviors scale (p<0.05). A moderately positive correlation was found between the Sustainable and Healthy Eating Behaviors scale total score and the Mediterranean Diet Adherence scores (p<0.05). As a result of the linear regression analysis, it was revealed that a 1-unit increase in the Mediterranean diet adherence score would result in a 1.3-point increase in the total score of the Sustainable and Healthy Eating Behaviors scale. Sustainable and healthy diets are important for improving and developing health and the prevention of diseases. The Mediterranean diet is defined as a sustainable diet model. The findings revealed the relationship between the Mediterranean diet and sustainable nutrition and showed that nutrition education increased knowledge and awareness about sustainable nutrition and increased adherence to the Mediterranean diet. For this reason, courses or seminars on sustainable nutrition can be organized during educational periods.

Keywords: healthy eating, Mediterranean diet, nutrition education, sustainable nutrition

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Authors: Raphael Udeh, Luis García De Guadiana Romualdo, Xenia Dolje-Gore

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Background: Quite disturbing is the huge public health impact of COVID-19: As at today [25th March 2021, the COVID-19 global burden shows over 123 million cases and over 2.7 million deaths worldwide. Rationale: Recent evidence shows calprotectin’s potential as a therapeutic target, stating that tasquinimod, from the Quinoline-3-Carboxamide family is capable of blocking the interaction between calprotectin and TLR4. Hence preventing the cytokine release syndrome, that heralds the functional exhaustion in COVID-19. Early preclinical studies showed that tasquinimod inhibit tumor growth and prevent angiogenesis/cytokine storm. Phase I – III clinical studies in prostate cancer showed it has a good safety profile with good radiologic progression free survival but no effect on overall survival. Rationale/hypothesis: Strategic endeavors have been amplified globally to assess new therapeutic interventions for COVID-19 management – thus the clinical and antiviral efficacy of tasquinimod in COVID-19 remains to be explored. Hence the primary objective of this trial will be to evaluate the efficacy of tasquinimod in the treatment of adult patients with severe COVID-19 infections. Therefore, I hypothesise that among adults with COVID19 infection, tasquinimod will reduce the severe respiratory distress associated with COVID-19 compared to placebo, over a 28-day study period. Method: The setting is in Europe. Design – a randomized, placebo-controlled, phase II double-blinded trial. Trial lasts for 28 days from randomization, Tasquinimod capsule given as 0.5mg daily 1st fortnight, then 1mg daily 2nd fortnight. I0 outcome - assessed using six-point ordinal scale alongside eight 20 outcomes. 125 participants to be enrolled, data collection at baseline and subsequent data points, and safety reporting monitored via serological profile. Significance: This work could potentially establish tasquinimod as an effective and safe therapeutic agent for COVID-19 by reducing the severe respiratory distress, related time to recovery, time on oxygen/admission. It will also drive future research – as in larger multi-centre RCT.

Keywords: Calprotectin, COVID-19, Phase II Trial, Tasquinimod

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: S. Maleczek, K. Drabczyk, L. Bogdan, A. Iwan

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It is known that for industrial applications using solar panel constructed from silicon solar cells require high-efficiency performance. One of the main problems in solar panels is different mechanical and structural defects, causing the decrease of generated power. To analyse defects in solar cells, various techniques are used. However, the thermal imaging is fast and simple method for locating defects. The main goal of this work was to analyze defects in constructed flexible silicon photovoltaic modules via thermal imaging and electroluminescence method. This work is realized for the GEKON project (No. GEKON2/O4/268473/23/2016) sponsored by The National Centre for Research and Development and The National Fund for Environmental Protection and Water Management. Thermal behavior was observed using thermographic camera (VIGOcam v50, VIGO System S.A, Poland) using a DC conventional source. Electroluminescence was observed by Steinbeis Center Photovoltaics (Stuttgart, Germany) equipped with a camera, in which there is a Si-CCD, 16 Mpix detector Kodak KAF-16803type. The camera has a typical spectral response in the range 350 - 1100 nm with a maximum QE of 60 % at 550 nm. In our work commercial silicon solar cells with the size 156 × 156 mm were cut for nine parts (called single solar cells) and used to create photovoltaic modules with the size of 160 × 70 cm (containing about 80 single solar cells). Flexible silicon photovoltaic modules on polyamides or polyester fabric were constructed and investigated taking into consideration anomalies on the surface of modules. Thermal imaging provided evidence of visible voltage-activated conduction. In electro-luminescence images, two regions are noticeable: darker, where solar cell is inactive and brighter corresponding with correctly working photovoltaic cells. The electroluminescence method is non-destructive and gives greater resolution of images thereby allowing a more precise evaluation of microcracks of solar cell after lamination process. Our study showed good correlations between defects observed by thermal imaging and electroluminescence. Finally, we can conclude that the thermographic examination of large scale photovoltaic modules allows us the fast, simple and inexpensive localization of defects at the single solar cells and modules. Moreover, thermographic camera was also useful to detection electrical interconnection between single solar cells.

Keywords: electro-luminescence, flexible devices, silicon solar cells, thermal imaging

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Authors: Seba Mohanty, Jitendra Mahakud

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Capital ratio is one of the major indicators of the stability of the commercial banks. Pertinent to its pervasive importance, over the years the regulators, policy makers focus on the maintenance of the particular level of capital ratio to minimize the solvency and liquidation risk. In this context, it is very much important to identify the relationship between capital and risk and find out the factors which determine the capital ratios of commercial banks. The study examines the relationship between capital and risk of the commercial banks operating in India. Other bank specific variables like bank size, deposit, profitability, non-performing assets, bank liquidity, net interest margin, loan loss reserves, deposits variability and regulatory pressure are also considered for the analysis. The period of study is 1997-2015 i.e. the period of post liberalization. To identify the impact of financial crisis and implementation of Basel II on capital ratio, we have divided the whole period into two sub-periods i.e. 1997-2008 and 2008-2015. This study considers all the three types of commercial banks, i.e. public sector, the private sector and foreign banks, which have continuous data for the whole period. The main sources of data are Prowess data base maintained by centre for monitoring Indian economy (CMIE) and Reserve Bank of India publications. We use simultaneous equation model and more specifically Two Stage Least Square method to find out the relationship between capital and risk. From the econometric analysis, we find that capital and risk affect each other simultaneously, and this is consistent across the time period and across the type of banks. Moreover, regulation has a positive significant impact on the ratio of capital to risk-weighted assets, but no significant impact on the banks risk taking behaviour. Our empirical findings also suggest that size has a negative impact on capital and risk, indicating that larger banks increase their capital less than the other banks supported by the too-big-to-fail hypothesis. This study contributes to the existing body of literature by predicting a strong relationship between capital and risk in an emerging economy, where banking sector plays a majority role for financial development. Further this study may be considered as a primary study to find out the macro economic factors which affecting risk and capital in India.

Keywords: capital, commercial bank, risk, simultaneous equation model

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Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

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Authors: Taku Numao, Kazu Amimoto, Tomoko Shimada, Kyohei Ichikawa

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Background: Unilateral spatial neglect (USN) is a common syndrome following damage to one hemisphere of the brain (usually the right side), in which a patient fails to report or respond to stimulation from the contralesional side. These symptoms are not due to primary sensory or motor deficits, but instead, reflect an inability to process input from that side of their environment. Prism adaptation (PA) is a therapeutic treatment for USN, wherein a patient’s visual field is artificially shifted laterally, resulting in a sensory-motor adaptation. However, patients with USN also tend to perceive a left-leaning subjective vertical in the frontal plane. The traditional PA cannot be used to correct a tilt in the subjective vertical, because a prism can only polarize, not twist, the surroundings. However, this can be accomplished using a head mounted display (HMD) and a web-camera. Therefore, this study investigated whether an HMD system could be used to correct the spatial perception of USN patients in the frontal as well as the horizontal plane. We recruited healthy subjects in order to collect data for the refinement of USN patient therapy. Methods: Eight healthy subjects sat on a chair wearing a HMD (Oculus rift DK2), with a web-camera (Ovrvision) displaying a 10 degree leftward rotation and a 10 degree counter-clockwise rotation along the frontal plane. Subjects attempted to point a finger at one of four targets, assigned randomly, a total of 48 times. Before and after the intervention, each subject’s body-centre judgment (BCJ) was tested by asking them to point a finger at a touch panel straight in front of their xiphisternum, 10 times sight unseen. Results: Intervention caused the location pointed to during the BCJ to shift 35 ± 17 mm (Ave ± SD) leftward in the horizontal plane, and 46 ± 29 mm downward in the frontal plane. The results in both planes were significant by paired-t-test (p<.01). Conclusions: The results in the horizontal plane are consistent with those observed following PA. Furthermore, the HMD and web-camera were able to elicit 3D effects, including in both the horizontal and frontal planes. Future work will focus on applying this method to patients with and without USN, and investigating whether subject posture is also affected by the HMD system.

Keywords: head mounted display, posture, prism adaptation, unilateral spatial neglect

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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Authors: Ewelina Zdebska

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A social worker is an integral part of an interdisciplinary team working with the child and his family in a terminal state. Social support is an integral part of the medical procedure in the care of hospice. This is the basis and prerequisite of full treatment and good care of the child - patient, whose illness often finds at least the expected period of his life when his personal and legal issues are not regulated, and the family burdened with the problem requires care and support specialists - professionals. Hospice for Children in Krakow: a palliative care team operating in the province of Krakow and Malopolska, conducts specialized care for terminally ill children in place of their residence from the time when parents and doctors decided to end of treatment in hospital, allows parents to carry out medical care at home, provides parents social and legal assistance and provides care, psychological support and friendship to families throughout the life of the child's illness and after his death, as long as it is needed. The social worker in a hospice does not bear the burden of solving social problems, which is the responsibility of other authorities, but provides support possible and necessary at the moment. The most common form of assistance is to provide information on benefits, which for the child and his family may be subject to any treatment and fight for the life and health of a child. Employee assists in the preparation and completion of documents, requests to increase the degree of disability because of progressive disease or Allowance care because of the inability to live independently. It works in settling all the issues with the Department of Social Security, as well as with the Municipal and District Team Affairs of disability. Seeking help and support using multi-faceted childcare. With the Centres for Social Welfare contacts are also often on the organization of additional respite care for the sick at home (care), especially in the work of the other members of the family or if the family can not cope with the care and needs extra help. Hospice for Children in Cracow completing construction of Poland's first Respite Care Centre for chronically and terminally ill children, will be an open house where children suffering from chronic and incurable diseases and their families can get professional help, whenever - when they need it. The social worker has to pick up a very important role in caring for a terminally ill child. His presence gives a little patient and family the opportunity to be at this difficult time together while organizing assistance and support.

Keywords: social worker, care, terminal care, hospice

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Authors: Bilgen Ozluk, Ayfer Karaaslan

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Introduction: Adaptation to university life is a difficult process for students. In peer support, students are expected to help other students or sometimes adults using their helping skills. Therefore, it is expected that peer support will have significant effect on students’ adaptation to university life. Aim: This study was conducted with the aim of determining the effect of peer support on adaptation to university life in the first year students of the faculty of health sciences. Methods: The population consists of 340 first year university students receiving education in the departments of nursing, health management, social services, nutrition and dietetics, physiotherapy and rehabilitation at an university located in the province of Konya. The sample of the study consisted of 274 students who voluntarily participated in the study. The data were collected between the dates 23 May 2016 and 3 June 2016. The data were collected using the socio-demographic information, the peer support scale and the university life adaptation scale. Ethical approvals for the study and permission from the university were taken. Numbers, percentages, averages, one-Way ANOVA, pearson correlation analysis and regression analysis have been used in assessing the data. Findings: When the problems most frequently encountered by students just starting the university were ordered, problems regarding their classes took the first place by 41.6%, socio-cultural problems took the second place by 38.7%, and economic problems took the third place by 37.6%. The mean total score of the Adaptation to University Life Scale was found to be 216.78±32.15. Considering that the lowest and highest scores that can be gained from the scale are 132 and 289 respectively, it was found that the adaptation to university life levels of the students were higher than the average. The mean adaptation to university life score of the nursing students was higher than those of the students of other departments. The mean score of ‘the Peer Support Scale’ was found to be 47.24±10.27. Considering that the lowest and highest scores that can be gained from the scale are 17 and 68 respectively, it was found that the peer support levels of the students were higher than the average. As a result of the regression analysis, it was found that 20% of the total variance regarding adaptation to university life was explained by peer support. Conclution: Receiving the support peer groups becomes highly important in the university adaptation process of first-year students. Peer support will create the means for easier completion of this difficult transition process.

Keywords: adaptation to university life, first years, peer support, university student

Procedia PDF Downloads 187

Authors: Anu Chandran, Reena Esther Rani

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Background of the Study: Dotted with multiple Unique Destination Prepositions (UDPs), Tamil Nadu is an established tourism brand as regards leisure, MICE, culture, and ecological flavors. Albeit, the enchanting destination possesses distinctive attributes and resources yet to be tapped for better competitive advantage. Being a destination that allures an incredible variety of migratory birds, Tamil Nadu is deemed to be an ornithologist’s paradise. This study primarily explores the prospects of developing Kaliveli, recognized as a bird sanctuary in the Tindivanam forest division of the Villupuram district in the State. Kaliveli is an ideal nesting site for migratory birds and is currently apt for a prospective analysis of regenerative tourism. Objectives of the study: This research lays an accent on avian tourism as part and parcel of sustainable tourism ventures. The impacts of projects like the Ornithological Conservation Centre on tourists have been gauged in the present paper. It maps the futuristic proactive propositions linked to regenerative tourism on the site. How far technological innovations can do a world of good in Kaliveli through Artificial Intelligence, Smart Tourism, and similar latest coinages to entice real eco-tourists, have been conceptualized. The experiential dimensions of resource stewardship as regards facilitating tourists’ relish the offerings in a sustainable manner is at the crux of this work. Methodology: Modeled as a case study, this work tries to deliberate on the impact of existing projects attributed to avian fauna in Kalveli. Conducted in the qualitative research design mode, the case study method was adopted for the processing and presentation of study results drawn by applying thematic content analysis based on the data collected from the field. Result and discussion: One of the key findings relates to the kind of nature trails that can be a regenerative dynamic for eco-friendly tourism in Kaliveli. Field visits have been conducted to assess the niche tourism aspects which could be incorporated with the regenerative tourism model to be framed as part of the study.

Keywords: regenerative tourism, Kaliveli bird sanctuary, sustainable development, resource Stewardship, Ornithology, Avian Fauna

Procedia PDF Downloads 55

Authors: Patti Kastanias, Wei Wang, Karyn Mackenzie, Sandra Robinson, Susan Wnuk

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Obesity is a worldwide epidemic and is recognized as a chronic disease. Pain in the obese individual is a multidimensional issue. An increase in BMI is positively correlated with pain incidence and severity, especially in central obesity where individuals are twice as likely to have chronic pain. Both obesity and chronic pain are also associated with mood disorders. Pain is worse among obese individuals with depression and anxiety. Bariatric surgery provides patients with an effective solution for long-term weight loss and associated health problems. However, not much is known about acute and chronic pain after bariatric surgery and its contributing factors, including mood disorders. Nurse practitioners (NPs) at one large multidisciplinary bariatric surgery centre led two studies to examine acute and chronic pain and pain management over time after bariatric surgery. The purpose of the initial study was to examine the incidence and severity of acute and chronic pain after bariatric surgery. The aim of the secondary study was to further examine chronic pain, specifically looking at psychological factors that influence severity or incidence of both neuropathic and somatic pain as well as changes in opioid use. The initial study was a prospective, longitudinal study where patients having bariatric surgery at one surgical center were followed up to 6 months postop. Data was collected at 7 time points using validated instruments for pain severity, pain interference, and patient satisfaction. In the second study, subjects were followed longitudinally starting preoperatively and then at 6 months and 1 year postoperatively to capture changes in chronic pain and influencing variables over time. Valid and reliable instruments were utilized for all major study outcomes. In the first study, there was a trend towards decreased acute post-operative pain over time. The incidence and severity of chronic pain was found to be significantly reduced at 6 months post bariatric surgery. Interestingly, interference of chronic pain in daily life such as normal work, mood, and walking ability was significantly improved at 6 months postop however; this was not the case with sleep. Preliminary results of the secondary study indicate that pain severity, pain interference, anxiety and depression are significantly improved at 6 months postoperatively. In addition, preoperative anxiety, depression and emotional regulation were predictive of pain interference, but not pain severity. The results of our regression analyses provide evidence for the impact of pre-existing psychological factors on pain, particularly anxiety in obese populations.

Keywords: bariatric surgery, mood disorders, obesity, pain

Procedia PDF Downloads 276

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

Procedia PDF Downloads 162

Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier

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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.

Keywords: calf raise test, mobile application, validity, reliability

Procedia PDF Downloads 148

Authors: Tuğçe Kök, Gözen Güner Aktaş, Nur Ayalp

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In a global world, Social and cultural sustainability are subjects which have gained significant importance in recent years. The concept of sustainability was included in the document of the World Conservation Union (IUCN) by World Charter for Nature, adopted in 1982 for the first time. However, merged with urban sustainability a new phenomenon has emerged. Sustainability is an essential fact, This fact is discussed via the socio-cultural field of sustainability. Together with central government and local authorities, conservation activities have been intensified on the protection of values on an area scale. Today, local authorities play an important role in the urban historic site rehabilitation and re-construction of traditional houses projects in Ankara, Turkey. Many conservative acts have occurred after 1980’s. To give a remarkable example about the conservation implementations of traditional Turkish houses is ‘Hamamönü, Ankara Re-Construction Project which is one of the historical parts that has suffered from deterioration and unplanned urban development. In this region, preexisting but unused historic fibre of the site has been revised and according to result of this case-study, the relationship between users and re-construction were discussed. Most of the houses were re-constructed in order to build a new tourist attraction area. This study discusses the socio-cultural relations between the new built environment and the visitors, from the point of cultural sustainability. This study questions the transmission of cultural stimulations. A case study was conducted to discuss the perception of cultural aspects of the visitors in the site. The relationship between the real cultural identities and existent ones after the re-constructed project, Which has been transmitted through the visitors and the users of those spaces will be discussed. The aim of the study is to analyze the relation between the cultural identities, which have been tried to be protected with the re-construction project and the users. The purposes of this study are to evaluate the implementations of Altındağ Municipality in Hamamönü and examine the socio-cultural sustainability with the user responses. After the assessment of implementation under socio-cultural sustainability, some proposals for the future of Hamamönü were introduced.

Keywords: social sustainability, cultural sustainability, Hamamönü, Turkey, re-construction

Procedia PDF Downloads 458

Authors: Sule Pallavi, Shah Priyank, Thavkar Amit, Mehta Suyog, Rohira Poonam

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Minoxidil is used topically to help hair growth in the treatment of male androgenetic alopecia. The objective of this study is to compare irritation potential of three conventional formulation of minoxidil 5% topical solution of in human patch test. The study was a single centre, double blind, non-randomized controlled study in 56 healthy adult Indian subjects. Occlusive patch test for 24 hours was performed with three formulation of minoxidil 5% topical solution. Products tested included aqueous based minoxidil 5% (AnasureTM 5%, Sun Pharma, India – Brand A), alcohol based minoxidil 5% (Brand B) and aqueous based minoxidil 5% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate were included as negative control and positive control respectively. Patches were applied and removed after 24hours. The skin reaction was assessed and clinically scored 24 hours after the removal of the patches under constant artificial daylight source using Draize scale (0-4 points scale for erythema/wrinkles/dryness and for oedema). A combined mean score up to 2.0/8.0 indicates a product is “non-irritant” and score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and score above 4.0/8.0 indicates “irritant”. Follow-up was scheduled after one week to confirm recovery for any reaction. The procedure of the patch test followed the principles outlined by Bureau of Indian standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). Fifty six subjects with mean age 30.9 years (27 males and 29 females) participated in the study. The combined mean score (± standard deviation) were: 0.13 ± 0.33 (Brand A), 0.39 ± 0.49 (Brand B), 0.22 ± 0.41 (Brand C), 2.91 ± 0.79 (Positive control) and 0.02 ± 0.13 (Negative control). The mean score of Brand A (Sun Pharma product) was significantly lower than Brand B (p=0.001) and was comparable with Brand C (p=0.21). The combined mean erythema score (± standard deviation) were: 0.09 ± 0.29 (Brand A), 0.27 ± 0.5 (Brand B), 0.18 ± 0.39 (Brand C), 2.02 ± 0.49 (Positive control) and 0.0 ± 0.0 (Negative control). The mean erythema score of Brand A was significantly lower than Brand B (p=0.01) and was comparable with Brand C (p=0.16). Any reaction observed at 24hours after patch removal subsided in a week. All the three topical formulation of minoxidil 5% were non-irritant. Brand A of 5% minoxidil (Sun Pharma) was found to be least irritant than Brand B and Brand C based on the combined mean score and mean erythema score in the human patch test as per the BIS, IS 4011;2018.

Keywords: erythema, irritation, minoxidil, patch test

Procedia PDF Downloads 83

Authors: Makamas Kumprou, Pipatana Amatachaya, Sugalya Amatachaya, Thiwabhorn Thaweewannakij, Preeda Arayawichanon

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Many individuals with spinal cord injury (SCI) need an ambulatory assistive device (AAD) to promote their independence and experience of task-specific walking practice. Without a periodic follow-up for their walking progression, however, many individuals may use the same AAD even though up to 66% of them had the potential to progress walking ability. This may distort their optimal ability and increase the possibility of having negative impacts due to the long-lasting used of an AAD. However, these findings were cross-sectionally collected without data confirmation for the benefit or negative impacts of those who changed the types of AAD used. Therefore, this study prospectively assessed the proportion of ambulatory individuals with SCI who were able to progress their walking ability as determined using a type of AAD, and the changes of their functional ability as well as the incidence of falls over 6 months. Twenty-four subjects with SCI who daily walked with an AAD were involved in the study for 2 visits over 6 months. At the first visit (baseline assessments), the subjects were assessed for their spatiotemporal variables (i.e., cadence, step length, stride length, and step symmetry) and walking ability using the 10-meter walk test (10MWT). Then, they were assessed for the possibility of their walking progression as determined using the ability of walking with the least support AAD with no more than contact guarding assist. Those who were capable of changing an AAD were trained for the ability to walk with a new AAD. Thereafter, all subjects were monthly monitored for incidence of fall over 6 months. At the second visit (after 6 months followed-up), subjects were reassessed for their spatiotemporal variables and 10MWT. The findings indicated that, of all 24 subjects, 8 subjects (33.3%) were able to walk with less support AAD than their usual one. The walking cadence, step length symmetry, and walking ability of these subjects improved significantly greater than those who walked with the same AAD (p < 0.05). Among these subjects, one subject (12.5%) reported fell (3 times) during the follow-up period, whereas 5 subjects (31.3%) who walked with the same AAD experienced at least one fall (range 1 – 16 times). The findings indicated that a large proportion of ambulatory individuals with SCI who daily walked with an AAD could progress their walking ability, whereby their walking ability and safety also significantly improved after they walked with an optimal AAD. The findings suggest the need for a periodic follow-up for an appropriate AAD used for these individuals.

Keywords: walking device, walker, crutches, cane, rehabilitation

Procedia PDF Downloads 108

Authors: Anargha A. Dhorde, Deshpande Gauri, Amit G. Dhorde

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Mula-Mutha basin is one of the speedily urbanizing watersheds, wherein two major urban centers, Pune and Pimpri-Chinchwad, have developed at a shocking rate in the last two decades. Such changing land use/land cover (LULC) is prone to hydrological problems and flash floods are a frequent, eventuality in the lower reaches of the basin. The present research brings out the impact of varying LULC, impervious surfaces on urban surface hydrology and generates storm-runoff scenarios for the hydrological units. The two multi-temporal satellite images were processed and supervised classification is performed with > 75% accuracy. The built-up has increased from 14.4% to 34.37% in the 28 years span, which is concentrated in and around the Pune-PCMC region. Impervious surfaces that were obtained by population calibrated multiple regression models. Almost 50% area of the watershed is impervious, which attribute to increase surface runoff and flash floods. The SCS-CN method was employed to calculate surface runoff of the watershed. The comparison between calculated and measured values of runoff was performed in a statistically precise way which shows no significant difference. Increasing built-up areas, as well as impervious surface areas due to rapid urbanization and industrialization, may lead to generating high runoff volumes in the basin especially in the urbanized areas of the watershed and along the major transportation arteries. Simulations generated with 50 mm and 100 mm rainstorm depth conspicuously noted that most of the changes in terms of increased runoff are constricted to the highly urbanized areas. Considering whole watershed area, the runoff values 39 m³ generated with 1'' rainfall whereas only urbanized areas of the basin (Pune and Pimpari-Chinchwad) were generated 11154 m³ runoff. Such analysis is crucial in providing information regarding their intensity and location, which proves instrumental in their analysis in order to formulate proper mitigation measures and rehabilitation strategies.

Keywords: land use/land cover, LULC, impervious surfaces, surface hydrology, storm-runoff scenarios

Procedia PDF Downloads 197

Authors: Pradeep Kumar Singh Chauhan, Gayatri Devi, Zamir Ahmad, Komal Chauhan, Abha Mittal

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The application of geophysical methods to study the subsurface profile for site investigation is becoming popular globally. These methods are non-destructive and provide the image of subsurface at shallow depths. Seismic refraction method is one of the most common and efficient method being used for civil engineering site investigations particularly for knowing the seismic velocity of the subsurface layers. Resistivity imaging technique is a geo-electrical method used to image the subsurface, water bearing zone, bedrock and layer thickness. Integrated approach combining seismic refraction and 2-D resistivity imaging will provide a better and reliable picture of the subsurface. These are economical and less time-consuming field survey which provide high resolution image of the subsurface. Geophysical surveys carried out in this study include seismic refraction and 2D resistivity imaging method for delineation of sub-surface strata in different parts of Srinagar, Garhwal Himalaya, India. The aim of this survey was to map the shallow subsurface in terms of geological and geophysical properties mainly P-wave velocity, resistivity, layer thickness, and lithology of the area. Both sides of the river, Alaknanda which flows through the centre of the city, have been covered by taking two profiles on each side using both methods. Seismic and electrical surveys were carried out at the same locations to complement the results of each other. The seismic refraction survey was carried out using ABEM TeraLoc 24 channel Seismograph and 2D resistivity imaging was performed using ABEM Terrameter LS equipment. The results show three distinct layers on both sides of the river up to the depth of 20 m. The subsurface is divided into three distinct layers namely, alluvium extending up to, 3 m depth, conglomerate zone lying between the depth of 3 m to 15 m, and compacted pebbles and cobbles beyond 15 m. P-wave velocity in top layer is found in the range of 400 – 600 m/s, in second layer it varies from 700 – 1100 m/s and in the third layer it is 1500 – 3300 m/s. The resistivity results also show similar pattern and were in good agreement with seismic refraction results. The results obtained in this study were validated with an available exposed river scar at one site. The study established the efficacy of geophysical methods for subsurface investigations.

Keywords: 2D resistivity imaging, P-wave velocity, seismic refraction survey, subsurface

Procedia PDF Downloads 233

Authors: Zahra Kazemi Saleh, Bénédicte Poulin-Charronnat, Annie Vinter

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This study examines the effects of aging on visual statistical learning, using eye-tracking techniques to investigate this cognitive phenomenon. Visual statistical learning is a fundamental brain function that enables the automatic and implicit recognition, processing, and internalization of environmental patterns over time. Some previous research has suggested the robustness of this learning mechanism throughout the aging process, underscoring its importance in the context of education and rehabilitation for the elderly. The study included three distinct groups of participants, including 21 young adults (Mage: 19.73), 20 young-old adults (Mage: 67.22), and 17 old-old adults (Mage: 79.34). Participants were exposed to a series of 12 arbitrary black shapes organized into 6 pairs, each with different spatial configurations and orientations (horizontal, vertical, and oblique). These pairs were not explicitly revealed to the participants, who were instructed to passively observe 144 grids presented sequentially on the screen for a total duration of 7 min. In the subsequent test phase, participants performed a two-alternative forced-choice task in which they had to identify the most familiar pair from 48 trials, each consisting of a base pair and a non-base pair. Behavioral analysis using t-tests revealed notable findings. The mean score for the first group was significantly above chance, indicating the presence of visual statistical learning. Similarly, the second group also performed significantly above chance, confirming the persistence of visual statistical learning in young-old adults. Conversely, the third group, consisting of old-old adults, showed a mean score that was not significantly above chance. This lack of statistical learning in the old-old adult group suggests a decline in this cognitive ability with age. Preliminary eye-tracking results showed a decrease in the number and duration of fixations during the exposure phase for all groups. The main difference was that older participants focused more often on empty cases than younger participants, likely due to a decline in the ability to ignore irrelevant information, resulting in a decrease in statistical learning performance.

Keywords: aging, eye tracking, implicit learning, visual statistical learning

Procedia PDF Downloads 58

Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien

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Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.

Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review

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Authors: K. Hariohm, V. Prakash, J. Saravana Kumar

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Introduction and Rationale: Increased scope of Physiotherapy (PT) practice also has contributed to research in the field of PT. It is essential to determine the production and quality of the clinical trials from India since, it may reflect the scientific growth of the profession. These trends can be taken as a baseline to measure our performance and also can be used as a guideline for the future trials. Objective: To quantify and analyze qualitatively the RCT’s from India from the period 2000-2013’ May, and classify data for the information process. Methods: Studies were searched in the Medline database using the key terms “India”, “Indian”, “Physiotherapy”. Clinical trials only with PT authors were included. Trials out of scope of PT practice and on animals were excluded. Retrieved valid articles were analyzed for published year, type of participants, area of study, PEDro score, outcome measure domains of impairment, activity, participation; ‘a priori’ sample size calculation, region, and explanation of the intervention. Result: 45 valid articles were retrieved from the year 2000-2013’ May. The majority of articles were done on symptomatic participants (81%). The frequencies of conditions repeated more were low back pain (n-7) and diabetes (n-4). PEDro score with mode 5 and upper limit of 8 and lower limit 4 was found. 97.2% of studies measure the outcome at the impairment level, 34% in activity level, and 27.8% in participation level. 29.7% of studies did ‘a priori’ sample size calculation. Correlation of year trend and PEDro score found to be not significant (p>.05). Individual PEDro item analysis showed, randomization (100%), concealment (33%) baseline (76%), blinding-subject, therapist, assessor (9.1%, 0%, 10%), follow-up (89%) ITT (15%), statistics between groups (100%), measures of variance (88 %). Conclusion: The trend shows an upward slope in terms of RCTs published from India which is a good indicator. The qualitative analysis showed some gaps in the clinical trial design, which can be expected to be, fulfilled by the future researchers.

Keywords: RCT, PEDro, physical therapy, rehabilitation

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Authors: Fionnuala Tynan, Margaret Nohilly

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary-school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: primary education, shared understanding, teacher voice, wellbeing

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Authors: James Kralj

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Commercial shellfish aquaculture makes significant contributions to the economy and culture of the Pacific Northwest United States. The industry faces intense pressure to minimize environmental impacts as a result of Federal policies like the Magnuson-Stevens Fisheries Conservation and Management Act and the Endangered Species Act. These policies demand the protection of essential fish habitat and declare several salmon species as endangered. Consequently, numerous projects related to the protection and rehabilitation of eelgrass beds, a crucial ecosystem for countless fish species, have been proposed at both state and federal levels. Both eelgrass beds and commercial shellfish farms occupy the same physical space, and therefore understanding the effects of shellfish aquaculture on eelgrass ecosystems has become a top ecological and economic priority of both government and industry. This study evaluates the organismal communities that eelgrass and oyster aquaculture habitats support. Water samples were collected from Willapa Bay, Washington; Tillamook Bay, Oregon; Humboldt Bay, California; and Sammish Bay, Washington to compare species diversity in eelgrass beds, oyster aquaculture plots, and boundary edges between these two habitats. Diversity was assessed using a novel technique: environmental DNA (eDNA). All organisms constantly shed small pieces of DNA into their surrounding environment through the loss of skin, hair, tissues, and waste. In the marine environment, this DNA becomes suspended in the water column allowing it to be easily collected. Once extracted and sequenced, this eDNA can be used to paint a picture of all the organisms that live in a particular habitat making it a powerful technology for environmental monitoring. Industry professionals and government officials should consider these findings to better inform future policies regulating eelgrass beds and oyster aquaculture. Furthermore, the information collected in this study may be used to improve the environmental sustainability of commercial shellfish aquaculture while simultaneously enhancing its growth and profitability in the face of ever-changing political and ecological landscapes.

Keywords: aquaculture, environmental DNA, shellfish, sustainability

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