Search results for: median duration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2022

Search results for: median duration

672 Comparative Study of Outcomes of Nonfixation of Mesh versus Fixation in Laparoscopic Total Extra Peritoneal (TEP) Repair of Inguinal Hernia: A Prospective Randomized Controlled Trial

Authors: Raman Sharma, S. K. Jain

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Aims and Objectives: Fixation of the mesh during laparoscopic total extraperitoneal (TEP) repair of inguinal hernia is thought to be necessary to prevent recurrence. However, mesh fixation may increase surgical complications and postoperative pain. Our objective was to compare the outcomes of nonfixation with fixation of polypropylene mesh by metal tacks during TEP repair of inguinal hernia. Methods: Forty patients aged 18 to72 years with inguinal hernia were included who underwent laparoscopic TEP repair of inguinal hernia with (n=20) or without (n=20) fixation of the mesh. The outcomes were operative duration, postoperative pain score, cost, in-hospital stay, time to return to normal activity, and complications. Results: Patients in whom the mesh was not fixed had shorter mean operating time (p < 0.05). We found no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications (P > 0.05). Moreover, a net cost savings was realized for each hernia repair performed without stapled mesh. Conclusions: TEP repair without mesh fixation resulted in the shorter operating time and lower operative cost with no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications. All this contribute to make TEP repair without mesh fixation a better choice for repair of uncomplicated inguinal hernia, especially in developing nations with scarce resources.

Keywords: postoperative pain score, inguinal hernia, nonfixation of mesh, total extra peritoneal (TEP)

Procedia PDF Downloads 339
671 Comprehensive Analysis of Electrohysterography Signal Features in Term and Preterm Labor

Authors: Zhihui Liu, Dongmei Hao, Qian Qiu, Yang An, Lin Yang, Song Zhang, Yimin Yang, Xuwen Li, Dingchang Zheng

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Premature birth, defined as birth before 37 completed weeks of gestation is a leading cause of neonatal morbidity and mortality and has long-term adverse consequences for health. It has recently been reported that the worldwide preterm birth rate is around 10%. The existing measurement techniques for diagnosing preterm delivery include tocodynamometer, ultrasound and fetal fibronectin. However, they are subjective, or suffer from high measurement variability and inaccurate diagnosis and prediction of preterm labor. Electrohysterography (EHG) method based on recording of uterine electrical activity by electrodes attached to maternal abdomen, is a promising method to assess uterine activity and diagnose preterm labor. The purpose of this study is to analyze the difference of EHG signal features between term labor and preterm labor. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Among them, EHG signals from 38 term labor and 38 preterm labor were preprocessed with band-pass Butterworth filters of 0.08–4Hz. Then, EHG signal features were extracted, which comprised classical time domain description including root mean square and zero-crossing number, spectral parameters including peak frequency, mean frequency and median frequency, wavelet packet coefficients, autoregression (AR) model coefficients, and nonlinear measures including maximal Lyapunov exponent, sample entropy and correlation dimension. Their statistical significance for recognition of two groups of recordings was provided. The results showed that mean frequency of preterm labor was significantly smaller than term labor (p < 0.05). 5 coefficients of AR model showed significant difference between term labor and preterm labor. The maximal Lyapunov exponent of early preterm (time of recording < the 26th week of gestation) was significantly smaller than early term. The sample entropy of late preterm (time of recording > the 26th week of gestation) was significantly smaller than late term. There was no significant difference for other features between the term labor and preterm labor groups. Any future work regarding classification should therefore focus on using multiple techniques, with the mean frequency, AR coefficients, maximal Lyapunov exponent and the sample entropy being among the prime candidates. Even if these methods are not yet useful for clinical practice, they do bring the most promising indicators for the preterm labor.

Keywords: electrohysterogram, feature, preterm labor, term labor

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670 Therapeutic Effect of Diisopropyldithiocarbamate Sodium Salt Against Diclofenac Induced Testicular Damage in Male Wistar Rats

Authors: Tella Toluwani, Adegbegi Ademuyiwa, Musei Chiedu, Adekunle Odola, Ayangbenro Ayansina, Adaramoye Oluwatosin

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Dithiocarbamates are very useful biological agents with antioxidant properties. Diclofenac (DIC) is a non-steroidal analgesic, anti-inflammatory, and antipyretic agent. The use of diclofenac has been linked with reproductive toxicity/damage. The purpose of this study is (i) To investigate the therapeutic potential of diisopropyldithiocarbamate sodium salt (Na(i-Pr₂dtc)) and vitamin E (VIT E) against diclofenac induced toxicity in the testes of male Wistar rats. (ii) To investigate the effect of (Na(i-Pr₂dtc)) and vitamin E on ameliorating damage done to the testes through histological analysis of the testes. Thirty-six (36) male Wistar rats were used for the experiment, they were divided into six (6) groups, the animals in group 1 served as control, animals in groups 2, 3, 4, 5 and 6 received DIC only, DIC and (Na(i-Pr₂dtc)), DIC and VIT E, (Na(i-Pr₂dtc) only and VIT E only respectively. A single dose of 100 mg/kg body weight of DIC was administered to male Wistar rats, while 30 mg/kg body weight of (Na(i-Pr₂dtc)) was used to treat both normal and DIC treated animals, control animals were treated with the vehicle, after 24 hrs of treatment the animals were euthanized and the testes were removed for analysis. The treatment of rats with Na(i-Pr₂dtc) significantly restored catalase (CAT) activity depressed by diclofenac. (Na(i-Pr₂dtc)) also restored glutathione levels reduced by DIC treatment and this was also accompanied by reduced lipid peroxidation (LPO) level. VIT E significantly restored superoxide dismutase (SOD) activity when compared with DIC only treated animals. Photomicrographs of testes from (Na(i-Pr₂dtc)) treated rats showed seminiferous epithelium with no lesions. We conclude that (Na(i-Pr₂dtc)) has an antioxidant effect, which might be related to the dose and duration of administration.

Keywords: diisopropyldithiocarbamate sodium salt, diclofenac, vitamin E, testes

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669 State and Determinant of Caregiver’s Mental Health in Thailand: A Household Level Analysis

Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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668 DTI Connectome Changes in the Acute Phase of Aneurysmal Subarachnoid Hemorrhage Improve Outcome Classification

Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

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Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

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667 Postgraduate Supervision Relationship: Practices, Challenges, and Strategies of Stakeholders in the Côte d’Ivoire University System

Authors: Akuélé Radha Kondo, Kathrin Heitz-Tokpa, Bassirou Bonfoh, Francis Akindes

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Postgraduate supervision contributes significantly to a student’s academic career, a supervisor’s promotion, and a university’s reputation. Despite this, the length of graduation in the Côte d’Ivoire University system is beyond the normal duration, two years for a master's and three years for a PhD. The paper analyses supervision practices regarding the challenges and strategies mobilised by students, supervisors, and administration staff to manage various relationships. Using a qualitative research design, this study was conducted at three public universities in Côte d’Ivoire. Data were generated from thirty-two postgraduate students, seventeen supervisors, and four administration staff through semi-structured interviews. Data were analysed using content analysis and presented thematically. Findings revealed delegated supervision and co-supervision, two types of supervision relationship practices. Students pointed out that feedback is often delayed from their supervisors in delegation supervision. However, they acknowledged receiving input and scientific guidance. All students believed that their role is to be proactive, not to wait to receive everything from the supervisor, and need to be more autonomous and hardworking. They developed strategies related to these qualities. Supervisors were considered to guide, give advice, control, motivate, provide critical feedback, and validate the work. The administration was rather absent in monitoring supervision delays. Major challenges were related to the supervision relationships and access to the research funds. The study showed that more engagement of the main supervisor, administration monitoring, and secured funding would reduce the time and increase the completion rate.

Keywords: Côte d’Ivoire, postgraduate supervision, practices, strategies

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666 Manganese and Other Geothermal Minerals Exposure to Residents in Ketenger Village, Banyumas, Indonesia

Authors: Rita Yuniatun, Dewi Fadlilah Firdausi, Anida Hanifah, Putrisuvi Nurjannah Zalqis, Erza Nur Afrilia, Akrima Fajrin Nurimani, Andrew Luis Krishna

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Manganese (Mn) is one of the potential contaminants minerals geothermal water. Preliminary studies conducted in Ketenger village, the nearest village with Baturaden hot spring, showed that the concentration of Mn in water supply has exceeded the reference value. Mineral contamination problem in Ketenger village is not only Mn, but also other potential geothermal minerals, such as chromium (Cr), iron (Fe), sulfide (S2-), nickel (Ni), cobalt (Co), and zinc (Zn). It becomes a concern because generally the residents still use ground water as the water source for their daily needs, including drinking and cooking. Therefore, this study aimed to determine the distribution of mineral contamination in drinking water and food and to estimate the health risks possibility from the exposure. Four minerals (Mn, Fe, S2-, and Cr6+) were analyzed in drinking water, carbohydrate sources, vegetables, fishes, and fruits. The test results indicate that Mn concentration in drinking water is 0.35 mg/L, has exceeded the maximum contaminant level (MCL) according to the US EPA (MCL = 0.005 mg/L), whereas other minerals still comply with the standards. In addition, we found that the average of Mn concentration in the carbohydrate sources is quite high (1.87 mg/Kg). Measurement results in Chronic Daily Intake (CDI) and the Risk Quotient (RQ) found that exposure to manganese and other geothermal minerals in drinking water and food are safe from the non-carcinogenic effects in each age group (RQ<1). So, geothermal mineral concentrations in drinking water and food has no effect on non-carcinogenic risk in Ketenger’s residents because of CDI is also influenced by other parameters such as the duration of exposure and the rate of consumption. However, it was found that intake of essential minerals (Mn and Fe) are deficient in every age group. So that, the addition of Mn and Fe intake is recommended.

Keywords: CDI, contaminant, geothermal minerals, manganese, RQ

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665 Impact of an Exercise Program on Physical Fitness of a Candidate to Naval Academy: A Case Study

Authors: Ricardo Chaves, Carlos Vasconcelos

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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.

Keywords: case study, exercise program, Naval Academy, physical fitness

Procedia PDF Downloads 87
664 Customer’s Choice of a Bank: An Empirical Enquiry from the Banked Ghanaian

Authors: Emmanuel Larbi Offei, Felix Agyei-Sasu, Maura Naa Densua Ashong

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Ghana has 26 universal banks and several banking and non-banking financial institutions operating in the country. The growing number of banks has heightened competition among banks to attract and retain customers more customers to ensure sustainability. Hence the need to identify and understand factors that influences customers’ choice of banks cannot be overemphasised. This study investigates the determinants of bank selection criteria by banking customers in Ghana. Four banks were purposively sampled for this study namely Barclays, Standard Chartered, Sahel Sahara and Unibank. Convenience sampling was then used to select 114 bank customers in Accra and interviewed. Questionnaires were used to collect data that were analysed in tables and charts with the use of STATA software. The findings of the study revealed that quick/prompt services and complaint handling, safety of funds, networked branches, easy access to functional Automated Teller Machines (ATMs) and low/moderate service charges were the major determinants of customers’ choice of banks. The results further show that 89.5 percent of all deposits are held in either current or savings accounts. About 22.1 percent of the respondents indicated that they have plans of changing their banks in the near future because they are not satisfied with their banks. A gender analysis of the choice criteria showed differences between the choice criteria of the male as compared to the female. The study recommends that banks in Ghana should focus on products and policies that will not compromise on the safety of funds of their customers. Again, banks must address customer complaints and dissatisfactions as promptly as possible by taking pragmatic steps to address administrative bureaucracies and infrastructural challenges that prolong the duration of banking transactions.

Keywords: Ghana, banks, determinants, customers’ choice, competition

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663 Dermatological Study on Risk Factors for Pruritic Skin: Skin Properties of Elderly

Authors: Dianis Wulan Sari, Takeo Minematsu, Mikako Yoshida, Hiromi Sanada

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Introduction: Pruritus is diagnosed as itching without macroscopic abnormalities on skin. It is the most skin complaint of elderly people. In the present study, we conducted a dermatological study to examine the risk factors of pruritic skin and predicted how to prevent pruritus especially in the elderly population. Pruritus is caused several types of inflammation, including epidermal innate immunity based on keratinocyte responses and acquired immunity regulated by type 1 or 2 helper T (Th) cells. The triggers of pruritus differ among inflammation types, therefore we did separately assess the pruritus-associated factors of each inflammation type in an effort to contribute to the identification of intervention targets for preventing pruritus. Therefore, this study aimed to investigate the factors related with actual condition of pruritic skin by examine the skin properties. Method: This study was conducted in elderly population of Indonesian nursing home. Basic characteristics and behaviors were obtained by interview. The properties of pruritic skin were collected by examination of skin biomarker using skin blotting as novel method of non-invasive skin assessment method and examination of skin barrier function using stratum corneum hydration and skin pH. Result: The average age of participants was 74 years with independent status was 66.8%. Age (β = -0.130, p = 0.044), cumulative lifetime sun exposure (β = 0.145, p = 0.026), bathing duration (β = 0.151, p = 0.022), clothing change frequency (β = 0.135, p = 0.029), and clothing type (β = -0.139, p = 0.021) were risk factors of pruritic skin in multivariate analysis. Conclusion: Risk factors of pruritic skin in elderly population were caused by internal factors such as skin senescence and external factors such as sun exposure, hygiene care and skin care behavior.

Keywords: aging, hygiene care, pruritus, skin care, sun exposure

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662 The Birth Connection: An Examination of the Relationship between Her Birth Event and Infant Feeding among African American Mothers

Authors: Nicole Banton

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The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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661 A Co-Relational Descriptive Study to Assess the Impact of Cancer Event on Self, Family, Coping Level of Cancer Clients and Quality of Life among Them

Authors: Padma Sree Potru

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Abstract: A co-relational descriptive study was conducted to assess the impact of cancer event on self, on family, coping strategies of cancer clients and quality of life among them in G.G.H., Guntur, Andhra Pradesh, India. Aim: The aim of the study was to investigate the impact of cancer events on self, on family, coping of clients and quality of life among cancer patients. Methods: 50 cancer patients were selected through random sampling technique. The data were obtained by using impact of events scale, impact on family scale, coping health inventory and WHOQOL-BREF scale. Results: The results revealed that majority (32%) of them were in the age group of 36-45 years, 72% were females, 44% were having the income of Rs. 5001-10000/- per month, 40% were working for daily wage, and 15% were newly diagnosed of cancer. Among 50 cancer patients, 65% had extreme impact of events, 61% shows extreme impact on family, 46% possess minimal coping strategies and 68% had poor quality of life. This study focuses on that there is a strong positive correlation between quality of life and coping behavior r=0.603 and also between impact of event and impact on family r=0.610, but a negative correlation existed between quality of life and impact of events r= -0.201. ANOVA test reveals that there is a significant difference between subscales of impact on family and coping behavior with f values = 3.893, 3.957 respectively. Chi-square highlights that there is a significant association between impact of events with age, occupation and impact on family with duration of illness. Conclusion: Even though cancer is a dreadful disease still there are many emerging treatment modalities and innovative procedures which are focusing on improving the standards of life among cancer clients. But all this can happen only when the clients accepts the reality, increase their willpower and confidence, desire to live, focusing on coping mechanisms and good ongoing support from the family members.

Keywords: impact of event, impact on family, coping, quality of event

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660 Plasma-Assisted Nitrogen Fixation for the Elevation of Seed Germination and Plant Growth

Authors: Pradeep Lamichhane

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Plasma-assisted nitrogen fixation is a process by which atomic nitrogen generated by plasma is converted into ammonia (NH₃) or related nitrogenous compounds. Nitrogen fixation is essential to plant because fixed inorganic nitrogen compounds are required to them for the biosynthesis of all nitrogen-containing organic compounds, such as amino acids and proteins, nucleoside triphosphates and nucleic acid. Most of our atmosphere is composed of nitrogen; however, the plant cannot absorb it directly from the air ambient. As a portion of the nitrogen cycle, nitrogen fixation fundamental for agriculture and the manufacture of fertilizer. In this study, plasma-assisted nitrogen fixation was performed by exposing a non-thermal atmospheric pressure nitrogen plasma generated a sinusoidal power supply (with an applied voltage of 10 kV and frequency of 33 kHz) on a water surface. Besides this, UV excitation of water molecules at the water interface was also done in order to disassociate water. Hydrogen and hydroxyl radical obtained from this UV photolysis electrochemically combine with nitrogen atom obtained from plasma. As a result of this, nitrogen fixation on plasma-activated water (PAW) significantly enhanced. The amount of nitrogen-based products like NOₓ and ammonia (NH₃) synthesized by this combined process of UV and plasma are 1.4 and 2.8 times higher than those obtained by plasma alone. In every 48 hours, 20 ml of plasma-activated water (pH≈3.15) for 10 minutes with moderate concentrations of NOₓ, NH₃ and hydrogen peroxide (H₂O₂) was irrigated on each corn plant (Zea Mays). It was found that the PAW has shown a significant impact on seeds germination rate and improved seedling growth. The result obtained from this experiment suggested that crop yield could increase in a short duration. In the future, this experiment could open boundless opportunities in plasma agriculture to mobilize nitrogen because nitrite, nitrate, and ammonia are more suitable for plant uptake.

Keywords: plasma-assisted nitrogen fixation, nitrogen plasma, UV excitation of water, ammonia synthesis

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659 Mobulid Ray Post-Release Mortality to Assess the Feasibility of Live-Release Management Measures

Authors: Sila K. Sari, Betty J.L. Laglbauer, Muhammad G. Salim, Irianies C. Gozali, Iqbal Herwata, Fahmi Fahmi, Selvia Oktaviyani, Isabel Ender, Sarah Lewis, Abraham Sianipar, Mark Erdmann

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Taking strides towards the sustainable use of marine stocks requires science-based management of target fish populations and reduction of bycatch in non-selective fisheries. Among elasmobranchs, mobulid rays are faced with high extinction risk due to intrinsic vulnerability to fishing and their conservation has been recognized as a strong priority both in Indonesia and worldwide. Despite their common vulnerabilities to fishing pressure due to slow growth, late maturation and low fecundity, only manta rays, but not devil rays, are protected in Indonesian waters. However, both manta and devil rays are captured in non-selective fisheries, in particular drift gillnets, since their habitat overlaps with fishing grounds for primary target species (e.g. marlin, swordfish and bullet tuna off the coast of Muncar). For this reason, mobulid populations are being heavily impacted, and while national-level protections are crucial to help conservation, they may not suffice alone to insure populations sustainability. In order to assess the potential of applying live-release management measures to conserve mobulids captured as bycatch in drift gillnets, we deployed pop-up survival archival transmitters to assess post-release mortality in Indonesian mobulid rays. We also assessed which fishing practices, in particular, soak duration, affected post-release mortality in order to draw relevant conclusions for management.

Keywords: Mobulid, Devil ray, Manta ray, Bycatch

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658 Enhancing Neural Connections through Music and tDCS: Insights from an fNIRS Study

Authors: Dileep G., Akash Singh, Dalchand Ahirwar, Arkadeep Ghosh, Ashutosh Purohit, Gaurav Guleria, Kshatriya Om Prashant, Pushkar Patel, Saksham Kumar, Vanshaj Nathani, Vikas Dangi, Shubhajit Roy Chowdhury, Varun Dutt

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Transcranial direct current stimulation (tDCS) has shown promise as a novel approach to enhance cognitive performance and provide therapeutic benefits for various brain disorders. However, the exact underlying brain mechanisms are not fully understood. We conducted a study to examine the brain's functional changes when subjected to simultaneous tDCS and music (Indian classical raga). During the study, participants in the experimental group underwent a 20-minute session of tDCS at two mA while listening to music (raga) for a duration of seven days. In contrast, the control group received a sham stimulation for two minutes at two mA over the same seven-day period. The objective was to examine whether repetitive tDCS could lead to the formation of additional functional connections between the medial prefrontal cortex (the stimulated area) and the auditory cortex in comparison to a sham stimulation group. In this study, 26 participants (5 female) underwent pre- and post-intervention scans, where changes were compared after one week of either tDCS or sham stimulation in conjunction with music. The study revealed significant effects of tDCS on functional connectivity between the stimulated area and the auditory cortex. The combination of tDCS applied over the mPFC and music resulted in newly formed connections. Based on our findings, it can be inferred that applying anodal tDCS over the mPFC enhances functional connectivity between the stimulated area and the auditory cortex when compared to the effects observed with sham stimulation.

Keywords: fNIRS, tDCS, neuroplasticity, music

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657 A Simple Model for Solar Panel Efficiency

Authors: Stefano M. Spagocci

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The efficiency of photovoltaic panels can be calculated with such software packages as RETScreen that allow design engineers to take financial as well as technical considerations into account. RETScreen is interfaced with meteorological databases, so that efficiency calculations can be realistically carried out. The author has recently contributed to the development of solar modules with accumulation capability and an embedded water purifier, aimed at off-grid users such as users in developing countries. The software packages examined do not allow to take ancillary equipment into account, hence the decision to implement a technical and financial model of the system. The author realized that, rather than re-implementing the quite sophisticated model of RETScreen - a mathematical description of which is anyway not publicly available - it was possible to drastically simplify it, including the meteorological factors which, in RETScreen, are presented in a numerical form. The day-by-day efficiency of a photovoltaic solar panel was parametrized by the product of factors expressing, respectively, daytime duration, solar right ascension motion, solar declination motion, cloudiness, temperature. For the sun-motion-dependent factors, positional astronomy formulae, simplified by the author, were employed. Meteorology-dependent factors were fitted by simple trigonometric functions, employing numerical data supplied by RETScreen. The accuracy of our model was tested by comparing it to the predictions of RETScreen; the accuracy obtained was 11%. In conclusion, our study resulted in a model that can be easily implemented in a spreadsheet - thus being easily manageable by non-specialist personnel - or in more sophisticated software packages. The model was used in a number of design exercises, concerning photovoltaic solar panels and ancillary equipment like the above-mentioned water purifier.

Keywords: clean energy, energy engineering, mathematical modelling, photovoltaic panels, solar energy

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656 Study of the Protective Effects of Summer Savory against Multiple Organ Damage Induced by Lead Acetate in Rats

Authors: Bassant M. M. Ibrahim, Doha H. Abou Baker, Ahmed Abd Elghafour

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Excessive exposure to heavy metals contributes to the occurrence of deleterious health problems that affect vital organs like the brain, liver, kidneys, and heart. The use of natural products that have antioxidant capabilities may contribute to the protection of these organs. In the present study, the essential oil of summer savory (Satureja hortensis) was used to evaluate its protective effects against lead acetate induced damaging effect on rats’ vital organs, due to its high contents of carvacrol, y-terpinene, and p-cymene. Forty female Wister Albino rats were classified into five equal groups, the 1st served as normal group, the 2nd served as positive control group was given lead acetate (60 mg/kg) intra-peritoneal (IP), the third to fifth groups were treated with calcium disodium (EDTA) as chelating agent and summer savory essential oil in doses of (50 and 100mg/kg) respectively. All treatments were given IP concomitant with lead acetate for ten successive days. At the end of the experiment duration electrocardiogram (ECG), an open field test for the evaluation of psychological state, rotarod test as for the evaluation of locomotor coordination ability as well as anti-inflammatory and oxidative stress biomarkers in serum and histopathology of vital organs were performed. The investigations in this study show that the protective effect of high dose of summer savory essential oil is more than the low dose and that the essential oil of summer savory is a promising agent that can contribute to the protection of vital organs against the hazardous damaging effects of lead acetate.

Keywords: brain, heart, kidneys, lead acetate, liver, protective, summer savory

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655 Oxygen-Tolerant H₂O₂ Reduction Catalysis by Iron Phosphate Coated Iron Oxides

Authors: Chia-Ting Chang, Chia-Yu Lin

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We report on the decisive role of iron phosphate (FePO₄), formed in-situ during the electrochemical characterization, played in the electrocatalytic activity, especially its oxygen tolerance of iron oxides towards H₂O₂ reduction. Iron oxides studied including, Nanorod arrays (NRs) of β-FeOOH, γ-Fe₂O₃, α-Fe₂O₃, α-Fe₂O₃ nanosheets (α-Fe₂O₃NS), α-Fe₂O₃ nanoparticles (α-Fe₂O₃NP), were synthesized using chemical bath deposition. The nanostructure was controlled simply by adjusting the composition of precursor solution and reaction duration for CBD process, whereas the crystal phase was controlled by adjusting the annealing temperature. It was found that iron phosphate (FePO₄) was deposited in-situ onto the surface of this nanostructured α-Fe₂O₃ during the electrochemical pretreatment in the phosphate electrolyte, and both FePO₄ and α-Fe₂O₃ showed the activity in catalysing the electrochemical reduction of H₂O₂. In addition, the interaction/compatibility between deposited FePO₄ and iron oxides has a decisive effect on the overall electrocatalytic activity of the resultant electrodes; FePO₄ only showed synergetic effect on the overall electrocatalytic activity of α-Fe₂O₃NR and α-Fe2O₃NS. Both α-Fe₂O₃NR and α-Fe₂O₃NS showed two reduction peaks in phosphate electrolyte containing H₂O₂, one being pH-dependent and related to the electrocatalytic properties of FePO₄, and the other one being pH-independent and only related to the intrinsic electrocatalytic properties of α-Fe₂O₃NR and α-Fe₂O₃NS. However, all iron oxides showed only one pH-independent reductive peak in non-phosphate electrolyte containing H₂O₂. The synergesitic catalysis exerted by FePO₄ with α-Fe₂O₃NR or α-Fe₂O₃NS providing additional oxygen-insensitive active site for H₂O₂ reduction, which allows their applications to electrochemical detection of H₂O₂ without the interference of O₂ involving in oxidase-catalyzed chemical processes.

Keywords: H₂O₂ reduction, Iron oxide, iron phosphate, O₂ tolerance

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654 Knowledge State of Medical Students in Morocco Regarding Metabolic Dysfunction Associated with Non-alcoholic Fatty Liver Disease (MASLD)

Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

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Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

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653 Wait-Optimized Scheduler Algorithm for Efficient Process Scheduling in Computer Systems

Authors: Md Habibur Rahman, Jaeho Kim

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Efficient process scheduling is a crucial factor in ensuring optimal system performance and resource utilization in computer systems. While various algorithms have been proposed over the years, there are still limitations to their effectiveness. This paper introduces a new Wait-Optimized Scheduler (WOS) algorithm that aims to minimize process waiting time by dividing them into two layers and considering both process time and waiting time. The WOS algorithm is non-preemptive and prioritizes processes with the shortest WOS. In the first layer, each process runs for a predetermined duration, and any unfinished process is subsequently moved to the second layer, resulting in a decrease in response time. Whenever the first layer is free or the number of processes in the second layer is twice that of the first layer, the algorithm sorts all the processes in the second layer based on their remaining time minus waiting time and sends one process to the first layer to run. This ensures that all processes eventually run, optimizing waiting time. To evaluate the performance of the WOS algorithm, we conducted experiments comparing its performance with traditional scheduling algorithms such as First-Come-First-Serve (FCFS) and Shortest-Job-First (SJF). The results showed that the WOS algorithm outperformed the traditional algorithms in reducing the waiting time of processes, particularly in scenarios with a large number of short tasks with long wait times. Our study highlights the effectiveness of the WOS algorithm in improving process scheduling efficiency in computer systems. By reducing process waiting time, the WOS algorithm can improve system performance and resource utilization. The findings of this study provide valuable insights for researchers and practitioners in developing and implementing efficient process scheduling algorithms.

Keywords: process scheduling, wait-optimized scheduler, response time, non-preemptive, waiting time, traditional scheduling algorithms, first-come-first-serve, shortest-job-first, system performance, resource utilization

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652 Motivation for Work and Organizational Commitment in an Engineering Public Faculty: A Perception of Technical and Administrative Employees

Authors: Fátima Aparecida de Carvalho, Ester Eliane Jeunon

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This study addresses issues in the public service: motivation to work and organizational commitment. The goal of this research was to examine how it configures the motivation to work and organizational commitment of the technical and administrative effective staff of the School of Engineering at UFMG. For this purpose a descriptive research under a quantitative and qualitative approach has been performed. In the quantitative research it has been applied a questionnaire to all 146 technical and administrative institution effective staff, that configures a census research. This questionnaire was divided into three parts, the first one aimed at performing a socio-demographic survey of participants, the second one aimed to measure motivation and the third one aimed at measuring organizational commitment. The Bases Organizational Commitment Scale (EBACO) was used in the analysis of data obtained in the third part of the questionnaire. The qualitative research was conducted through interviews with 08 managers, with open-ended questions structured in an analysis category, thus contemplating the administrative structure of the School of Engineering. The results of the research revealed that there is no relevant difference between the hygiene and motivational indices, related to the staff´s gender and area of work. Nonetheless, it was observed higher motivational indices for staff with shorter duration of employment in the institution. Also, the results shown high organizational commitment of the staff with the institution, with a predominance of the component “Requirement for performance”, followed by commitments “Consistent line of activity”, “Affiliative” and “Affective”, which reached almost tge some average in this study. Finally the results showed that all commitment indices have positive moderated correlation to the motivational indices, except the “shortage of alternative” index.

Keywords: motivation to work, organizational commitment, public service, human resources

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651 Evaluation of Agricultural Drought Impact in the Crop Productivity of East Gojjam Zone

Authors: Walelgn Dilnesa Cherie, Fasikaw Atanaw Zimale, Bekalu W. Asres

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The most catastrophic condition for agricultural production is a drought event, which is also one of the most hydro-metrological-related hazards. According to the combined susceptibility of plants to meteorological and hydrological conditions, agricultural drought is defined as the magnitude, severity, and duration of a drought that affects crop production. The accurate and timely assessment of agricultural drought can lead to the development of risk management strategies, appropriate proactive mechanisms for the protection of farmers, and the improvement of food security. The evaluation of agricultural drought in the East Gojjam zone was the primary subject of this study. To identify the agricultural drought, soil moisture anomalies, soil moisture deficit indices, and Normalized Difference Vegetation Indices (NDVI) are used. The measured welting point, field capacity, and soil moisture were utilized to validate the soil water deficit indices computed from the satellite data. The soil moisture and soil water deficit indices in 2013 in all woredas were minimum; this makes vegetation stress also in all woredas. The soil moisture content decreased in 2013/2014/2019, and 2021 in Dejen, 2014, and 2019 in Awobel Woreda. The max/ min values of NDVI in 2013 are minimum; it dominantly shows vegetation stress and an observed agricultural drought that happened in all woredas. The validation process of satellite and in-situ soil moisture and soil water deficit indices shows a good agreement with a value of R²=0.87 and 0.56, respectively. The study area becomes drought detected region, so government officials, policymakers, and environmentalists pay attention to the protection of drought effects.

Keywords: NDVI, agricultural drought, SWDI, soil moisture

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650 The Effects of Supportive Care Interventions with Psychotherapeutic and Exercise Approaches on Depressive Symptoms Among Patients with Lung Cancer: A Meta-Analysis

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

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Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

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649 Effect of Various Durations of Type 2 Diabetes on Muscle Performance

Authors: Santosh Kumar Yadav, Shobha Keswani, Nishat Quddus, Sohrab Ahmad Khan, Zuheb Ahmad Shiddiqui, Varsha Chorsiya

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Introduction: Early onset diabetes is more aggressive than the late onset diabetes. Diabetic individual has a greater spectrum of life period to suffer from its damage, complications, and long-term disability. This study aimed at assessing knee joint muscle performance under various durations of diabetes. Method and Materials: A total of 30 diabetic subjects (18 male and 12 females) without diabetic neuropathy were included for the study. They were divided into three groups with 5 years, 10 years and 15 years of duration of disease each. Muscle performance was evaluated through strength and flexibility. Peak torque for quadriceps muscle was measured using isokinetic dynamometer. Flexibility for quadriceps and hamstring muscles were measured through Ducan’s Elys test and 90/90 test. Results: The result showed significant difference in muscle strength (p<0.05), flexibility (p≤0.05) between groups. Discussion: Optimal muscle strength and flexibility are vital for musculoskeletal health and functional independence. Conclusion: The reduced muscle performance and functional impairment in nonneuropathic diabetic patients suggest that other mechanism besides neuropathy that contribute to altered biomechanics. These findings of this study project early management of these altered parameters through disease-specific physical therapy and assessment-based intervention. Clinical Relevance: Managing disability is more costly than managing disease. Prompt and timely identification and management strategy can dramatically reduce the cost of care for diabetic patients.

Keywords: muscle flexibility, muscle performance, muscle torque, type 2 diabetes

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648 Bridging the Divide: Mixed-Method Analysis of Student Engagement and Outcomes in Diverse Postgraduate Cohorts

Authors: A.Knox

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Student diversity in postgraduate classes puts major challenges on educators seeking to encourage student engagement and desired to learn outcomes. This paper outlines the impact of a set of teaching initiatives aimed at addressing challenges associated with teaching and learning in an environment characterized by diversity in the student cohort. The study examines postgraduate students completing the core capstone unit within a specialized business degree. Although relatively small, the student cohort is highly diverse in terms of cultural backgrounds represented, prior learning and/or qualifications, as well as duration and type of work experience relevant to the degree, is completed. The wide range of cultures, existing knowledge and experience create enormous challenges with respect to students’ learning needs and outcomes. Subsequently, a suite of teaching innovations has been adopted to enhance curriculum content/delivery and the design of assessments. This paper explores the impact of these specific teaching and learning practices, examining the ways they have supported students’ diverse needs and enhanced students’ learning outcomes. Data from surveys and focus groups are used to assess the effectiveness of these practices. The results highlight the effectiveness of peer-assisted learning, cultural competence-building, and advanced assessment options in addressing diverse student needs and enhancing student engagement and learning outcomes. These findings suggest that such practices would benefit students’ learning in environments marked by diversity in the student cohort. Specific recommendations are offered for other educators working with diverse classes.

Keywords: assessment design, curriculum content, curriculum delivery, student diversity

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647 Marker Assisted Breeding for Grain Quality Improvement in Durum Wheat

Authors: Özlem Ateş Sönmezoğlu, Begüm Terzi, Ahmet Yıldırım, Leyla Gündüz

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Durum wheat quality is defined as its suitability for pasta processing, that is pasta making quality. Another factor that determines the quality of durum wheat is the nutritional value of wheat or its final products. Wheat is a basic source of calories, proteins and minerals for humans in many countries of the world. For this reason, improvement of wheat nutritional value is of great importance. In recent years, deficiencies in protein and micronutrients, particularly in iron and zinc, have seriously increased. Therefore, basic foods such as wheat must be improved for micronutrient content. The effects of some major genes for grain quality established. Gpc-B1 locus is one of the genes increased protein and micronutrients content, and used in improvement studies of durum wheat nutritional value. The aim of this study was to increase the protein content and the micronutrient (Fe, Zn ve Mn) contents of an advanced durum wheat line (TMB 1) that was previously improved for its protein quality. For this purpose, TMB1 advanced durum wheat line were used as the recurrent parent and also, UC1113-Gpc-B1 line containing the Gpc-B1 gene was used as the gene source. In all of the generations, backcrossed plants carrying the targeted gene region were selected by marker assisted selection (MAS). BC4F1 plants MAS method was employed in combination with embryo culture and rapid plant growth in a controlled greenhouse conditions in order to shorten the duration of the transition between generations in backcross breeding. The Gpc-B1 gene was selected specific molecular markers. Since Yr-36 gene associated with Gpc-B1 allele, it was also transferred to the Gpc-B1 transferred lines. Thus, the backcrossed plants selected by MAS are resistance to yellow rust disease. This research has been financially supported by TÜBİTAK (112T910).

Keywords: Durum wheat, Gpc-B1, MAS, Triticum durum, Yr-36

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646 Hydrogen Production from Solid Waste of Sago Processing Industries in Indonesia: Effect of Chemical and Biological Pretreatment

Authors: Pratikno Hidayat, Khamdan Cahyari

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Hydrogen is the ultimate choice of energy carriers in future. It contents high energy density (42 kJ/g), emits only water vapor during combustion and has high energy conversion up to 50% in fuel cell application. One of the promising methods to produce hydrogen is from organic waste through dark fermentation method. It utilizes sugar-rich organic waste as substrate and hydrogen-producing microorganisms to generate the hydrogen. Solid waste of sago processing industries in Indonesia is one of the promising raw materials for both producing biofuel hydrogen and mitigating the environmental impact due to the waste disposal. This research was meant to investigate the effect of chemical and biological pretreatment i.e. acid treatment and mushroom cultivation toward lignocellulosic waste of these sago industries. Chemical pretreatment was conducted through exposing the waste into acid condition using sulfuric acid (H2SO4) (various molar i.e. 0.2, 0.3, and 0.4 M and various duration of exposure i.e. 30, 60 and 90 minutes). Meanwhile, biological treatment was conducted through utilization of the solid waste as growth media of mushroom (Oyster and Ling-zhi) for 3 months. Dark fermentation was conducted at pH 5.0, temperature 27℃ and atmospheric pressure. It was noticed that chemical and biological pretreatment could improve hydrogen yield with the highest yield at 3.8 ml/g VS (31%v H2). The hydrogen production was successfully performed to generate high percentage of hydrogen, although the yield was still low. This result indicated that the explosion of acid chemical and biological method might need to be extended to improve degradability of the solid waste. However, high percentage of hydrogen was resulted from proper pretreatment of residual sludge of biogas plant to generate hydrogen-producing inoculum.

Keywords: hydrogen, sago waste, chemical, biological, dark fermentation, Indonesia

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645 Consultation Time and Its Impact on Length of Stay in the Emergency Department

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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644 Determining the Effect of Tdcs in Pain and Quality of Life in Patients with Fibromyalgia

Authors: Farid Rezaei, Zahra Reza Soltani, Behrouz Tavana, Afsaneh Dadarkhah, Masoume Bahrami Asl, S. Alireza Mirghasemi

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Introduction: Fibromyalgia is a syndrome comprised of a group of symptoms. The primary symptom of fibromyalgia is pain propagation is associated by Secondary symptoms include fatigue, cognitive disorders, sleep disorders and hypersensitivity to painful stimuli. Recent studies have shown that there is a direct relationship between fibromyalgia and certain changes in brain activity. Aim: The aim of this study is determining the effect of tDCS in pain and quality of life in patients with fibromyalgia. Method: 68 patients with fibromyalgia who had inclusion criterias were randomly divided into two groups of case and control. Groups were matched in terms of gender, age, education, duration of pain and PMS. Patient groups treated with tDCS device manufacture by Enraf company made in Netherlands (M1 anodal stimulation, 2 mA constant current, 20 minutes, for 10 sessions (3 days a week)). Also the protocol was done for control group, in sham mode of tDCS device that had no current, for 10 sessions of 20 minutes. Before treatment, immediately after the end of 10 sessions treatment (short-term) and 10 week later (long-term effect), pain intensity questionnaires (VAS) and quality of life in fibromyalgia patients questionnaire was completed by the patient. Results: Pain intensity were significantly lower in the treatment group than the sham group 2 weeks and 10 weeks after treatment than before treatment (P < 0.001). Although the quality of life of patients 2 weeks after treatment showed no significant change, but ten weeks after treatment were more than sham group (P < 0.0001). Conclusion: Our results suggest that tDCS is a safe and effective in treating fibromyalgia patients and an important effect in reducing pain and increasing quality of their life.

Keywords: fibromyalgia, tDCS, quality of life, VAS score

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643 The Role of Health Beliefs in Predicting and Explaining Risky Health Behaviours within Cystic Fibrosis

Authors: Rebecca Keyte, Helen Egan, Michail Mantzios

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It is well acknowledged that ongoing adherence is a major concern within CF. However recently literature has indicated that non-adherence should not be viewed just in terms of medical regimens. There are other damaging behaviours that some chronically ill patients engage in which can be viewed as a form of non-adherence, such as risky behaviours. Risky behaviours are a major concern within CF, as they can have adverse health effects on patients regardless of patients adherence to medical regimens. The risky behaviours this research is predominantly focusing on are smoking, excessive alcohol consumption, illicit drug use and risky sexual behaviour. This research investigates patient’s beliefs about their CF and the impact their CF has upon their life, exploring rationales for why some patients engage in risky behaviours. This research utilises qualitative semi-structured interviews taking an interpretive perspective. Twenty-four adult participants have been recruited (16 male, age range 19–66 yrs) from two UK regional CF centres, with a median FEV1 61.77% predicted. Participants were recruited via clinician guidance, with 13 participants identified by clinicians as partaking in risky behaviours. However, during the interviews 17 participants were identified as partaking in risky behaviours, illustrating that not all patients offer full disclosure of engagement in such behaviours to their clinicians. Preliminary findings illustrate a variety of reasons as to why some CF patients engage in risky behaviours, with many participants stating that one challenge in terms of living with CF is accepting their illness. Disclosure of illness was also an issue, the desire to be seen as ‘normal’ was important to many. It is often possible for CF patients to hide their illness as they do not always appear to be unwell. However, literature indicates a desire for normalcy can be accompanied with the engagement of normalised risky behaviours, enabling patients to retaliate against their illness identity. There was also evidence of a life-orientated perspective amongst participants, with some reporting that their desire for fun and enjoyment was the reason for why they were engaging in risky behaviours. Some participants did not acknowledge the impact their risky behaviours could have upon their CF, and others rationalised their continuation with the behaviours by suggesting that they were in fact beneficial to their health. There was an apparent lack of knowledge around the implications of risky behaviours, with participants indicating that they had not been informed of such potential consequences by their clinicians. Given the adverse health effects of risky behaviours within CF, more effective health promotion measures are needed to both reduce and more importantly prevent these behaviours. Due to the initiation of risky behaviours within the CF population commonly occurring during adolescence, the researcher now proposes to conduct semi-structured interviews with paediatric patients to investigate their awareness and beliefs towards risky behaviours. Overall, this research will highlight reasons why some CF patients engage in risky behaviours, in order to inform interventions aimed to prevent the initiation in risky behaviours by increasing patient awareness.

Keywords: cystic fibrosis, health beliefs, preliminary findings, risky health behaviours

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