Search results for: exponential family
2110 Aging Among Older Immigrant Women
Authors: Michele Charpentier
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This article examines the experiences of aging of older immigrant women. The data are based on qualitative research that was conducted in Quebec/Canada with 83 elderly women from different ethno-cultural backgrounds (Arab, African, Haitian, Japanese, Chinese, Portuguese, Romanian, etc.). The results on how such immigrant women deal with material conditions of existence such as deskilling, aging alone, being more economically independent and the combined effects of liberation from social and family norms associated with age and gender in the light of the migration route, will be presented. For the majority, migration opened up possibilities for personal development and self-affirmation. The findings demonstrated the relevance of the intersectional approach in understanding the complexity and social conditionings of women’s experiences of aging.Keywords: older immigrant women, qualitative research, experiences of aging, intersectional approach
Procedia PDF Downloads 492109 A Survey on Linear Time Invariant Multivariable Positive Real Systems
Authors: Mojtaba Hakimi-Moghaddam
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Positive realness as the most important property of driving point impedance of passive electrical networks appears in the control systems stability theory in 1960’s. There are three important subsets of positive real (PR) systems are introduced by researchers, that is, loos-less positive real (LLPR) systems, weakly strictly positive real (WSPR) systems and strictly positive real (SPR) systems. In this paper, definitions, properties, lemmas, and theorems related to family of positive real systems are summarized. Properties in both frequency domain and state space representation of system are explained. Also, several illustrative examples are presented.Keywords: real rational matrix transfer functions, positive realness property, strictly positive realness property, Hermitian form asymptotic property, pole-zero properties
Procedia PDF Downloads 2732108 Multi-Scale Modeling of Ti-6Al-4V Mechanical Behavior: Size, Dispersion and Crystallographic Texture of Grains Effects
Authors: Fatna Benmessaoud, Mohammed Cheikh, Vencent Velay, Vanessa Vidal, Farhad Rezai-Aria, Christine Boher
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Ti-6Al-4V titanium alloy is one of the most widely used materials in aeronautical and aerospace industries. Because of its high specific strength, good fatigue, and corrosion resistance, this alloy is very suitable for moderate temperature applications. At room temperature, Ti-6Al-4V mechanical behavior is generally controlled by the behavior of alpha phase (beta phase percent is less than 8%). The plastic strain of this phase notably based on crystallographic slip can be hindered by various obstacles and mechanisms (crystal lattice friction, sessile dislocations, strengthening by solute atoms and grain boundaries…). The grains aspect of alpha phase (its morphology and texture) and the nature of its crystallographic lattice (which is hexagonal compact) give to plastic strain heterogeneous, discontinuous and anisotropic characteristics at the local scale. The aim of this work is to develop a multi-scale model for Ti-6Al-4V mechanical behavior using crystal plasticity approach; this multi-scale model is used then to investigate grains size, dispersion of grains size, crystallographic texture and slip systems activation effects on Ti-6Al-4V mechanical behavior under monotone quasi-static loading. Nine representative elementary volume (REV) are built for taking into account the physical elements (grains size, dispersion and crystallographic) mentioned above, then boundary conditions of tension test are applied. Finally, simulation of the mechanical behavior of Ti-6Al-4V and study of slip systems activation in alpha phase is reported. The results show that the macroscopic mechanical behavior of Ti-6Al-4V is strongly linked to the active slip systems family (prismatic, basal or pyramidal). The crystallographic texture determines which family of slip systems can be activated; therefore it gives to the plastic strain a heterogeneous character thus an anisotropic macroscopic mechanical behavior of Ti-6Al-4V alloy modeled. The grains size influences also on mechanical proprieties of Ti-6Al-4V, especially on the yield stress; by decreasing of the grain size, the yield strength increases. Finally, the grains' distribution which characterizes the morphology aspect (homogeneous or heterogeneous) gives to the deformation fields distribution enough heterogeneity because the crystallographic slip is easier in large grains compared to small grains, which generates a localization of plastic deformation in certain areas and a concentration of stresses in others.Keywords: multi-scale modeling, Ti-6Al-4V alloy, crystal plasticity, grains size, crystallographic texture
Procedia PDF Downloads 1562107 Survey of Rate and Causes of Literacy Preservation in Adult Newly Learners
Authors: Mohammad Narimani, Zahra Rostamoghli
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The main objective of this study is the survey of rate and causes of literacy preservation in adult newly learners. Statistical sample consists of 384 adults who are newly learners of literacy, at 2002, who were selected by stratified sampling method. This is a correlation cross-sectional survey research, in which authors-constructed measures were used for data collection. Results of survey showed that learners' literacy preservation rate after two years was 70%, 61% and 57%, in reading, dictation and mathematic tests, respectively.Following can be noted as factors correlated with literacy preservation; repetition of subjects and learners' subjective review, access to and using the library and publications, feeling of need to and interest in educated matters, socio cultural class of learners, and literacy level of learners' family.Keywords: literacy preservation, new learner, literacy improvement movement, mathematic test
Procedia PDF Downloads 4752106 Bacteriophage Lysis Of Physiologically Stressed Listeria Monocytogenes In A Simulated Seafood Processing Environment
Authors: Geevika J. Ganegama Arachchi, Steve H. Flint, Lynn McIntyre, Cristina D. Cruz, Beatrice M. Dias-Wanigasekera, Craig Billington, J. Andrew Hudson, Anthony N. Mutukumira
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In seafood processing plants, Listeriamonocytogenes(L. monocytogenes)likely exists in a metabolically stressed state due to the nutrient-deficient environment, processing treatments such as heating, curing, drying, and freezing, and exposure to detergents and disinfectants. Stressed L. monocytogenes cells have been shown to be as pathogenic as unstressed cells. This study investigated lytic efficacy of (LiMN4L, LiMN4p, and LiMN17) which were previouslycharacterized as virulent against physiologically stressed cells of three seafood borne L. monocytogenesstrains (19CO9, 19DO3, and 19EO3).Physiologically compromised cells ofL. monocytogenesstrains were prepared by aging cultures in TrypticaseSoy Broth at 15±1°C for 72 h; heat injuringcultures at 54±1 - 55±1°C for 40 - 60 min;salt-stressing cultures in Milli-Q water were incubated at 25±1°C in darkness for three weeks; and incubating cultures in 9% (w/v) NaCl at 15±1°C for 72 h. Low concentrations of physiologically compromised cells of three L. monocytogenesstrainswere challenged in vitrowith high titre of three phages in separate experiments using Fish Broth medium (aqueous fish extract) at 15 °C in order to mimic the environment of seafood processing plant. Each phage, when present at ≈9 log10 PFU/ml, reduced late exponential phase cells of L. monocytogenes suspended in fish protein broth at ≈2-3 log10 CFU/ml to a non-detectable level (< 10 CFU/ml). Each phage, when present at ≈8.5 log10 PFU/ml, reduced both heat-injured cells present at 2.5-3.6 log10 CFU/ml and starved cells that were showed coccoid shape, present at ≈2-3 log10 CFU/ml to < 10 CFU/ml after 30 min. Phages also reduced salt-stressed cellspresent at ≈3 log10 CFU/ml by > 2 log10. L. monocytogenes (≈8 log10 CFU/ml) were reduced to below the detection limit (1 CFU/ml) by the three successive phage infections over 16 h, indicating that emergence of spontaneous phage resistance was infrequent. The three virulent phages showed high decontamination potential for physiologically stressed L. monocytogenes strains from seafood processing environments.Keywords: physiologically stressed L. monocytogenes, heat injured, seafood processing environment, virulent phage
Procedia PDF Downloads 1332105 The Situation of Transgender Individuals Was Worsened During Covid-19
Authors: Kajal Attri
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Introduction: Transgender people are considered third gender in India, although they still face identification issues and alienated from society. Furthermore, they face several challenges, including discrimination in employment, resources, education, and property as a result, most transgender people make a living through begging at traffic lights, trains, and buses; attending auspicious occasions such as childbirth and weddings; and engaging in sex work, which includes both home-based and street-based sex work. During COVID-19, maintaining social distance exacerbates transgender people's circumstances and prevents them from accessing health care services, sexual reassignment surgery, identity-based resources, government security, and financial stability. Nonetheless, the pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. This study focuses on how we missed transgender people during COVID-19 to provide better facilities to cope with this situation when they are already the most vulnerable segment of the society. Methodology: The research was conducted using secondary data from published publications and grey literature obtained from four databases: Pubmed, Psychinfo, Science direct, and Google scholar. The literature included total 25 articles that met the inclusion criteria for a review. Result and Discussion: Transgender people, who are considered the most vulnerable sector of society, have already faced several obstacles as a result of the outbreak. The analysis underscores the difficulties that transgender persons faced during COVID-19, such as, They had trouble accessing the government's social security programmes during the lockdown, which provide rations and pensions since they lack the necessary identifying cards. The impact of COVID-19 leaves transgender people at heightened risk of poverty and ill health because they exist on the margins of society, those livelihood base on sex work, begging, and participation on auspicious occasions. They had a significant risk of contracting SARS-CoV2 because they lived in congested areas or did not have permanent shelter, and they were predominantly infected with HIV, cancer, and other non-communicable illnesses. The pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. Conclusion: The study comes forward with useful suggestions based on content analysis and information to reduce the existing woes of transgenders during any pandemic like COVID-19.Keywords: COVID-19, transgender, lockdown, transwomen, stigmatization
Procedia PDF Downloads 752104 Coping Strategies of Female English Teachers and Housewives to Face the Challenges Associated to the COVID-19 Pandemic Lockdown
Authors: Lisseth Rojas Barreto, Carlos Muñoz Hernández
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The COVID-19 pandemic led to many abrupt changes, including a prolonged lockdown, which brought about work and personal challenges to the population worldwide. Among the most affected populations are women who are workers and housewives at the same time, and especially those who are also parenting. These women were faced with the challenge to perform their usual varied roles during the lockdown from the same physical space, which inevitably had strong repercussions for each of them. This paper will present some results of a research study whose main objective was to examine the possible effects that the COVID-19 pandemic lockdown may have caused in the work, social, family, and personal environments of female English teachers who are also housewives and, by extension in the teaching and learning processes that they lead. Participants included five female English language teachers of a public foreign language school, they are all married, and two of them have children. Similarly, we examined some of the coping strategies these teachers used to tackle the pandemic-related challenges in their different roles, especially those used for their language teaching role; coping strategies are understood as a repertoire of behaviors in response to incidents that can be stressful for the subject, possible challenging events or situations that involve emotions with behaviors and decision-making of people which are used in order to find a meaning or positive result (Lazarus &Folkman, 1986) Following a qualitative-case study design, we gathered the data through a survey and a focus group interview with the participant teachers who work at a public language school in southern Colombia. Preliminary findings indicate that the circumstances that emerged as a result of the pandemic lockdown affected the participants in different ways, including financial, personal, family, health, and work-related issues. Among the strategies that participants found valuable to deal with the novel circumstances, we can highlight the reorganization of the household and work tasks and the increased awareness of time management for the household, work, and leisure. Additionally, we were able to evidence that the participants faced the circumstances with a positive view. Finally, in order to cope with their teaching duties, some participants acknowledged their lack of computer or technology literacy in order to deliver their classes online, which made them find support from their students or more knowledgeable peers to cope with it. Others indicated that they used strategies such as self-learning in order to get acquainted and be able to use the different technological tools and web-based platforms available.Keywords: coping strategies, language teaching, female teachers, pandemic lockdown
Procedia PDF Downloads 1062103 Recovery of Heavy Metals by Ion Exchange on the Zeolite Materials
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Zeolites are a family of mineral compounds. With special properties that have led to several important industrial applications. Ion exchange has enabled the first industrial application in the field of water treatment. The exchange by aqueous pathway is the method most used in the case of such microporous materials and this technique will be used in this work. The objective of this work is to find performance materials for the recovery of heavy metals such as cadmium. The study is to compare the properties of different ion exchange zeolite Na-X, Na-A, their physical mixture and the composite A (LTA) / X (FAU). After the synthesis of various zeolites X and A, it was designed a model Core-Shell to form a composite zeolite A on zeolite X. Finally, ion exchange studies were performed on these zeolite materials. The cation is exclusively tested for cadmium, a toxic element and is harmful to health and the environment.Keywords: zeolite A, zeolite X, ion exchange, water treatment
Procedia PDF Downloads 4292102 A Cross-Sectional Study of Knowledge and Attitudes among College Students in a South Indian City about Intimate Partner Violence
Authors: Krithika Lakshmi Sathiya Moorthy
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Introduction: Young people’s attitude towards Intimate partner violence (IPV) is likely to influence their indulgence in or abstinence from IPV in future. We aimed to assess the knowledge and attitudes of college students in a south Indian city regarding IPV, its associated factors and redressal mechanisms. Methods: A convenient sample of 247 students, pursuing medicine and engineering, participated in this analytical cross sectional study. They responded to a self-administered questionnaire developed and pretested for this study. The questionnaire comprises statements from a third person’s perspective and vignettes to reduce social desirability bias. Clearance was obtained from the Institute Ethical Committee of Velammal Medical College Hospital and Research Institute, Madurai, India. Data were entered in Epidata Entry v3.1, Odense, Denmark and analysed using SPSS v20.0. Results: Among 247 students, 116 (47%) were males and 59 (24.9%) hailed from rural areas. About 18% (43) of students believed that IPV was a problem only among females. Almost half of the students had witnessed IPV; at home between their parents (9.7%), other family members (13.4%), in their neighbourhood (13%) or public places (15%). Only 118 (47.8%) were aware that a law was in place in India to address IPV. The perceived risk factors for IPV were alcoholic spouse (78.9%), low income families (53.8%), personality traits (52.2%) and dowry system (51%). A sizeable number of students (38.4%) believed that some amount of physical violence was allowable in a marital relationship while 57.6% even considered IPV as an expression of love. Males as compared to females were more in agreement with negative gender stereotypes such as husband can– ‘threaten wife to ensure welfare of family’ (55% vs. 34%, p < 0.001), ‘spy on wife to check fidelity’ (41% vs. 27%, p < 0.001), ‘financially deprive housewife to punish’ (13% vs. 3.8%, p=0.001) and agreed with the statement that it is ‘duty of wife to comply with demands for sex from the husband’ (9.5% vs 4.6%, p=0.3). About 32% males and 25.6% females foresaw themselves as perpetrators of IPV in future. Conclusion: Knowledge about IPV and the associated risk factors among the study population was satisfactory. However, there was widespread acceptance of negative societal gender stereotypes, more so among males and some degrees of IPV were acceptable between married couples. The study advocates the need to halt the propagation of negative gender stereotypes in the impressionable young minds and the necessity to spread the awareness that no degree of IPV is acceptable. This knowledge is also required to plan the content and choose the appropriate media to effectively communicate the awareness about IPV among young persons.Keywords: attitude, India, intimate partner violence, knowledge, students
Procedia PDF Downloads 2272101 Proximate Composition and Mineral Contents of Ocimum gratissimum Leaves (African Basil)
Authors: Adebola Ajayi
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Ocimum gratissimum belongs to the Lamiaceae family and is know generally as African Basil. Ocimum gratissimum leaves are widely used as local condiments in diets. The leaves were destalked sorted, washed with potable water to remove dirts, air dried for 14 days under ambient temperature and milled into powder. The proximate composition and mineral contents of Ocimum gratissimum leaves were investigated. The proximate analysis showed the moisture, crude, protein, total ash, crude fiber, crude lipid and total carbohydrate contents were 10.72±0.01%, 12.98±0.10%, 10.95±0.42, 10.21±0.04%, 4.81±0.04% and 49.01±0.25% respectively. The results of the analysis showed that Ocimum gratissimum could be a good source of important food nutrients.Keywords: African Basil, drying, Ocimum gratissimum, proximate
Procedia PDF Downloads 2002100 Prevalence of Emotional Problems among Adolescent Students of Corporation Schools in Chennai
Authors: Vithya Veeramani, Karunanidhi Subbaiah
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Emotional problems were found to be the predominant cause of suicide and second leading cause of death among adolescents in India. Emotional problems seem to be the underlying cause for various other severe psycho-social problems experienced in adolescence and also in later years of life. The Corporation schools in Chennai city are named as Chennai High School or Chennai Higher Secondary School run by the Corporation of Chennai. These schools fulfill the educational needs of students who hail from lower socio-economic status living in slums of the Chennai city. Adolescent students of Chennai schools tend to lack basic needs like food, clothes, shelter, etc. Some of the other significant problems faced by them are broken family, lack of parental support, frequent quarrel between parents, alcoholic parents, drug abuse and substance abuse among parents and neighbors, extended family, illiterate parents, deprivation of love and care, and lack of sense of belongingness. This prevailing condition may affect them emotionally and could lead to maladaptive behaviour, aggressiveness, poor interpersonal relationship with others, school refusal behaviour, school drop-out, suicide, etc. Therefore, it is very important to investigate the emotional problems faced by the adolescent students studying in Chennai schools, Chennai. A cross-sectional survey design was used to find the prevalence of emotional problems among adolescent students. Cluster sampling technique was used to select the schools for the present study considering the school as a cluster. In total, there are 15 zones, under the control of Chennai Corporation, of which only 7 zones have Corporation Schools in Chennai city, comprising of 32 Chennai Higher Secondary Schools and 38 Chennai High Schools. Out of these 70 schools, 29 schools comprising of 17 high schools and 12 higher secondary schools were selected randomly using lottery method. A sample of 2594 adolescent students from 9th standard and 11th standard was chosen for the study. Percentage analysis was done to find out the prevalence rate of emotional problems among adolescents students studying in Chennai Schools. Results of the study revealed that, out of 2594 students surveyed, 21.04% adolescent students were found to have academic problems (n = 546), 15.99% adolescent students had social problems (n = 415), behaviour problems was found to be prevalent among 12.87% adolescent students (n = 334), depression was prevalent among 15.88% adolescent students (n = 412) and anxiety was prevalent among 14.42% adolescent students (n = 374). Prevalence of emotional problems among male and female revealed that academic problems were more prevalent compared to other problems. Behaviour problems were least prevalent among boys and anxiety was least prevalent among girls than other problems. The overall prevalence rate of emotional problems was found to be on an increasing trend among adolescent students of low socio-economic status in Chennai city. The findings indicated the need for intervention to prevent and rehabilitate these adolescent students.Keywords: adolescents, corporation schools, emotional problems, prevalence
Procedia PDF Downloads 2212099 Ecopsychological Approach to Enhance Space Consciousness Toward Environment
Authors: Tiwi Kamidin
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After years of effort trying to integrate environmental education, studies keep revealing that Malaysian still not reached the certain level of desired commitment toward the environment. Some researchers mentioned that our planet healthy is depending on our mentally health especially our psychological and spiritual is split from the natural. Therefore, this study discussed on ecopcyhological approach in order to enhance space consciousness toward the environment. Space consciousness represents not only freedom from ego but also from dependency on the things of this world, from materialism and materiality. It is the spiritual dimension which alone can give transcendent and true meaning to this world. If pupils can balance this internal awareness will put an individual to respect the environment as part of yourself and your family against only as contributors to the continuance of human’s life. Qualitative findings showed that the informants considered their consciousness toward environment has been changed.Keywords: ecopsychological approach, space consciousness, environmental education, environment
Procedia PDF Downloads 3052098 Evaluation of Antimicrobial Activity of Phenolic Compounds Extracted from Jordanian Juglans regia L.
Authors: Hamoud Alshammari, Adnan Almezani, Hamdan Alshammari, Faris Alharbi
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In this study we have examined of antimicrobial activity for unripe Juglan Regia phenolic extracts against a wide range of pathogenic microorganisms. Walnut (Juglans regia L.) is a member of Juglandaceae family used as a remedy in folk medicine. Leaves, barks, fruits and husk (peel) reported to harbor distinctive medical effect. In our study, we examined the anti-microbial effect against a set of gram positive and negative bacteria and even we have tested them against eukaryotic candida strains in a concentration gradual manner. Ethyl acetate extract of J. regia had the best antibacterial activity when compared with ciprofloxacin. The Minimum inhibition concentration for S. aureus, P. aerogenosa and S. epidermidis MIC was 0.85 mg/mL.Keywords: antimicrobial, J. regia, S. aureus, phytochemistry
Procedia PDF Downloads 1992097 Marketing Implications and the Dynamics of Changing Gender Roles in Families
Authors: Kehinde Emmanuel Atanlusi
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It is impossible to stifle the gust of social change as it makes its way through institutionalised hierarchies on its way to expressing itself. This advancement might also have repercussions for institutions, families, and politics, so modifying the norms and establishing new societal ideals. In the following paragraphs, it will explore how gender roles in the family have changed over time, how this has affected consumption, and how marketing has been influenced by these changes. It was decided to use the empirical research method, which led to several discoveries, one of which was that marketing in the pre-modern era was predicated on metanarratives and gender stereotypes. However, these aspects of marketing have undergone significant transformations in the post-modern era, which led to the formation of an assumption regarding what future marketing trends will be like. In spite of the fact that post-modern marketing methods have a number of drawbacks, it was suggested that these strategies be embraced and updated in the future in order to expand consumer bases and target audiences.Keywords: Marketing, Gender Roles, Advertising, Decentralisation, Fragmentation
Procedia PDF Downloads 1142096 Autism and Mental Health - How Different Individuals Are Impacted
Authors: Kerryn Burgoyne
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Statement of the Problem: Women who suffer mental health issues, because of Autism Spectrum Disorder has a significant impact on their lives, especially if they’ve been bullied or discriminated against for the majority of their lives. Autism can impact one's mental health in many ways (child like behaviour), social anxieties or overload. The impact of mental health can also be experienced when the person does not have a good quality of life for themselves (eg employment, independent living skills), or have support from family/friends/society). Mental health issues were also suffered during COVID 19 Lockdown here in Melbourne Australia. It was stated by the Government at the time that people weren’t allowed to travel more than 5 km outside of their residential areas to prevent the spread of COVID to others. Medical appointments were an exception. Kerryn/KTalk will be doing a paper on this topic for the conference if accepted by the committee.Keywords: Autism, mental health, living & learning, KTalk
Procedia PDF Downloads 352095 Phytochemical and Proximate Composition Analysis of Aspillia kotschyi
Authors: A. U. Adamu, E. D Paul, C. E. Gimba, I. G. Ndukwe
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The phytochemical and proximate composition of Aspillia kotschyi belonging to Compositae family which is commonly used as medicinal plant in Nigeria was determined on both the Methanolic and Petroleum sprit extract of the plant. The Methanolic extract of the plant revealed the presence of carbohydrates, cardiac glyscosides, flavonoids, triterpene, and alkaloids. The Petroleum sprit extract showed the presence of only carbohydrates and alkaloid. Proximate composition analysis shows moisture content of 5.7%, total ash of 4.03%, crude protein 10.94%, fibre 9.06%, fat value 0.83%, and nitrogen free extract of 70.19%. The results of this study suggest some merit in the popular use of Aspillia kotschi in herbal medicine.Keywords: Aspillia kotschyi, herbal medicine, phytochemical, proximate composition
Procedia PDF Downloads 3632094 Clinical Nursing Experience in Managing a Uterine Cancer Patient with Psychogenic Shock During the Extracorporeal Membrane Oxygenation Weaning Process
Authors: Syue-Wen Lin
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Objective: This article discusses the nursing experience of caring for a uterine cancer patient who experienced cardiogenic shock and was weaned off ECMO. The patient was placed on ECMO due to cardiogenic shock and initially struggled with anxiety caused by the physical discomfort from the disease and multiple medical devices, as well as the isolation in the ICU and restrictions on physical activity. Over time, the patient was able to wean off ECMO and perform daily activities and rehabilitation independently. Methods: The nursing period was from January 6 to January 9. Through observation, direct care, interviews, physical assessments, and case reviews, the intensive care team and bypass personnel conducted a comprehensive assessment using Gordon's 11 functional health patterns. The assessment identified three main nursing health problems: pain, anxiety, and decreased cardiac tissue perfusion. Results: The author consulted a psychologist to employ open communication techniques and empathetic care to build a trusting nurse-patient relationship. A patient-centered intensive cancer care plan was developed. Pain was assessed using a pain scale, and pain medications were adjusted in consultation with a pharmacist. Lavender essential oil therapy, light music, and pillows were used to distract and alleviate pain. The patient was encouraged to express feelings and family members were invited to increase visits and provide companionship to reduce the uncertainty caused by cancer and illness. Vital signs were closely monitored, and nursing interventions were provided to maintain adequate myocardial perfusion. Post-ECMO, the patient was encouraged to engage in rehabilitation and cardiopulmonary training. Conclusion: A key takeaway from the care process is the importance of observing not only the patient's vital signs but also their psychological state, especially when dealing with cancer patients on ECMO. The patient's greatest source of comfort was the presence of family, which helped alleviate anxiety. Healthcare providers play multiple critical roles as advocates, coordinators, educators, and counselors, listening to and accepting the patient’s emotional responses. The report aims to provide clinical cancer nurses with a reference to improve the quality of care and alleviate cancer-related discomfort.Keywords: ECMO, uterine cancer, palliative care, Gordon's 11 functional health patterns
Procedia PDF Downloads 292093 Photovoltaic Solar Energy in Public Buildings: A Showcase for Society
Authors: Eliane Ferreira da Silva
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This paper aims to mobilize and sensitize public administration leaders to good practices and encourage investment in the PV system in Brazil. It presents a case study methodology for dimensioning the PV system in the roofs of the public buildings of the Esplanade of the Ministries, Brasilia, capital of the country, with predefined resources, starting with the Sustainable Esplanade Project (SEP), of the exponential growth of photovoltaic solar energy in the world and making a comparison with the solar power plant of the Ministry of Mines and Energy (MME), active since: 6/10/2016. In order to do so, it was necessary to evaluate the energy efficiency of the buildings in the period from January 2016 to April 2017, (16 months) identifying the opportunities to reduce electric energy expenses, through the adjustment of contracted demand, the tariff framework and correction of existing active energy. The instrument used to collect data on electric bills was the e-SIC citizen information system. The study considered in addition to the technical and operational aspects, the historical, cultural, architectural and climatic aspects, involved by several actors. Identifying the reductions of expenses, the study directed to the following aspects: Case 1) economic feasibility for exchanges of common lamps, for LED lamps, and, Case 2) economic feasibility for the implementation of photovoltaic solar system connected to the grid. For the case 2, PV*SOL Premium Software was used to simulate several possibilities of photovoltaic panels, analyzing the best performance, according to local characteristics, such as solar orientation, latitude, annual average solar radiation. A simulation of an ideal photovoltaic solar system was made, with due calculations of its yield, to provide a compensation of the energy expenditure of the building - or part of it - through the use of the alternative source in question. The study develops a methodology for public administration, as a major consumer of electricity, to act in a responsible, fiscalizing and incentive way in reducing energy waste, and consequently reducing greenhouse gases.Keywords: energy efficiency, esplanade of ministries, photovoltaic solar energy, public buildings, sustainable building
Procedia PDF Downloads 1312092 A Case Report on the Course and Outcome of a Patient Diagnosed with Trichotillomania and Major Depressive Disorder
Authors: Ziara Carmelli G. Tan, Irene Carmelle S. Tan
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Background: Trichotillomania (TTM) and Major Depressive Disorder (MDD) are two psychiatric conditions that frequently co-occur, presenting a significant challenge for treatment due to their complex interplay. TTM involves repetitive hair-pulling, leading to noticeable hair loss and distress, while MDD is characterized by persistent low mood and loss of interest or pleasure, leading to dysfunctionality. This case report examines the intricate relationship between TTM and MDD in a young adult female, emphasizing the need for a comprehensive, multifaceted therapeutic approach to address both disorders effectively. Case Presentation: The patient is a 21-year-old female college student and youth church leader who presented with chronic hair-pulling and depressive symptoms. Her premorbid personality was marked by low self-esteem and a strong need for external validation. Despite her academic and social responsibilities and achievements, she struggled with managing her emotional distress, which was exacerbated by her family dynamics and her role within her church community. Her hair-pulling and mood symptoms were particularly triggered by self-esteem threats and feelings of inadequacy. She was diagnosed with Trichotillomania, Scalp and Major Depressive Disorder. Intervention/Management: The patient’s treatment plan was comprehensive, incorporating both pharmacological and non-pharmacological interventions. Initial pharmacologic management was Fluoxetine 20mg/day up, titrated to 40mg/day with no improvement; hence, shifted to Escitalopram 20mg/day and started with N-acetylcysteine 600mg/day with noted significant improvement in symptoms. Psychotherapeutic strategies played a crucial role in her treatment. These included supportive-expressive psychodynamic psychotherapy, which helped her explore and understand underlying emotional conflicts. Cognitive-behavioral techniques were employed to modify her maladaptive thoughts and behaviors. Grief processing was integrated to help her cope with significant losses. Family therapy was done to address conflicts and collaborate with the treatment process. Psychoeducation was provided to enhance her understanding of her condition and to empower her in her treatment journey. A suicide safety plan was developed to ensure her safety during critical periods. An interprofessional approach, which involved coordination with the Dermatology service for co-management, was also a key component of her treatment. Outcome: Over the course of 15 therapy sessions, the patient demonstrated significant improvement in both her depressive symptoms and hair-pulling behavior. Her active engagement in therapy, combined with pharmacological support, facilitated better emotional regulation and a more cohesive sense of self. Her adherence to the treatment plan, along with the collaborative efforts of the interprofessional team, contributed to her positive outcomes. Discussion: This case underscores the significance of addressing both TTM and its comorbid conditions to achieve effective treatment outcomes. The intricate interplay between TTM and MDD in the patient’s case highlights the importance of a comprehensive treatment plan that includes both pharmacological and psychotherapeutic approaches. Supportive-expressive psychodynamic psychotherapy, Cognitive-behavioral techniques, and Family therapy were particularly beneficial in addressing the complex emotional and behavioral aspects of her condition. The involvement of an interprofessional team, including dermatology co-management, was crucial in providing holistic care. Future practice should consider the benefits of such a multidisciplinary approach to managing complex cases like this, ensuring that both the psychological and physiological aspects of the disorders are adequately addressed.Keywords: cognitive-behavioral therapy, interprofessional approach, major depressive disorder, psychodynamic psychotherapy, trichotillomania
Procedia PDF Downloads 302091 Designing a Combined Outpatient and Day Treatment Eating Disorder Program for Adolescents and Transitional Aged Youth: A Naturalistic Case Study
Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson
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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth
Procedia PDF Downloads 1072090 The Factors Affecting Pupil Psychological Well-Being in Mainstream Schools: A Systematic Review
Authors: Chantelle Francis, Karen McKenzie, Charlotte Emmerson
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In the context of the rise in mental health difficulties amongst pupils, this review explores the factors that have been indicated as affecting psychological well-being in mainstream school contexts. Search terms relating to school-based psychological well-being were entered into five databases, and twenty-two studies were included in the review. The results suggested that pupil psychological well-being is affected by both direct and indirect factors. The former included a sense of belonging and inclusion, relationships with teachers, and academic attainment. The latter included family socioeconomic status, whole-school approaches, and individual differences factors, such as gender and Special Educational Needs. The implications for policymakers and practitioners are discussed.Keywords: psychological wellbeing, mainstream schools, special educational needs, school-based wellbeing
Procedia PDF Downloads 1152089 Coprophagus Beetles (Scarabaeidae: Coleoptera) of Buxa Tiger Reserve, West Bengal, India
Authors: Subhankar Kumar Sarkar
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Scarab beetles composing the family Scarabaeidae is one of the largest families in the order Coleoptera. The family is comprised of 11 subfamilies. Of these, the subfamily Scarabaeinae includes 13 tribes globally. Indian species are however considered within 2 tribes Scarabaeini and Coprini. Scarab beetles under this subfamily also known as Coprophagus beetles play an indispensable role in forestry and agriculture. Both adults and larvae of these beetles do a remarkable job of carrying excrement into the soil thus enriching the soil to a great extent. Eastern and North Eastern states of India are heavily rich in diversity of organisms as this region exhibits the tropical rain forests of the eastern Himalayas, which exhibits one of the 18 biodiversity hotspots of the world and one of the three of India. Buxa Tiger Reserve located in Dooars between latitudes 26°30” to 26°55” North & longitudes 89°20” to 89°35” East is one such fine example of rain forests of the eastern Himalayas. Despite this, the subfamily is poorly known, particularly from this part of the globe and demands serious revisionary studies. It is with this background; the attempt is being made to assess the Scarabaeinae fauna of the forest. Both extensive and intensive surveys were conducted in different beats under different ranges of Buxa Tiger Reserve. For collection sweep nets, bush beating and collection in inverted umbrella, hand picking techniques were used. Several pit fall traps were laid in the collection localities of the Reserve to trap ground dwelling scarabs. Dung of various animals was also examined to make collections. In the evening hours UV light, trap was used to collect nocturnal beetles. The collected samples were studied under Stereozoom Binocular Microscopes Zeiss SV6, SV11 and Olympus SZ 30. The faunistic investigation of the forest revealed in the recognition of 19 species under 6 genera distributed over 2 tribes. Of these Heliocopris tyrannus Thomson, 1859 was recorded new from the Country, while Catharsius javanus Lansberge, 1886, Copris corpulentus Gillet, 1910, C. doriae Harold, 1877 and C. sarpedon Harold, 1868 from the state. 4 species are recorded as endemic to India. The forest is dominated by the members of the Genus Onthophagus, of which Onthophagus (Colobonthophagus) dama (Fabricius, 1798) is represented by highest number of individuals. Their seasonal distribution is most during Premonsoon followed by Monsoon and Postmonsoon. Zoogeographically all the recorded species are of oriental distribution.Keywords: buxa tiger reserve, diversity, India, new records, scarabaeinae, scarabaeidae
Procedia PDF Downloads 2402088 Children Learning Chinese as a Home Language in an English-Dominant Society
Authors: Sinming Law
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Many Chinese families face many difficulties in maintaining their heritage language for their children in English-dominant societies. This article first looks at the losses from monolingualism and benefits of bilingualism. Then, it explores the common methods used today in teaching Chinese. We conclude that families and community play an indispensable role in their children’s acquisition. For children to acquire adequate proficiency in the language, educators should inform families about this topic and partner with them. Families can indeed be active in the process. Hence, the article further describes a guide designed and written by the author to accommodate the needs of parents. It can be used as a model for future guides. Further, the article recommends effective media routes by which families can have access to similar guides.Keywords: children learning Chinese, biliteracy and bilingual acquisition, family and community support, heritage language maintenance
Procedia PDF Downloads 3662087 Parameter Estimation of Gumbel Distribution with Maximum-Likelihood Based on Broyden Fletcher Goldfarb Shanno Quasi-Newton
Authors: Dewi Retno Sari Saputro, Purnami Widyaningsih, Hendrika Handayani
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Extreme data on an observation can occur due to unusual circumstances in the observation. The data can provide important information that can’t be provided by other data so that its existence needs to be further investigated. The method for obtaining extreme data is one of them using maxima block method. The distribution of extreme data sets taken with the maxima block method is called the distribution of extreme values. Distribution of extreme values is Gumbel distribution with two parameters. The parameter estimation of Gumbel distribution with maximum likelihood method (ML) is difficult to determine its exact value so that it is necessary to solve the approach. The purpose of this study was to determine the parameter estimation of Gumbel distribution with quasi-Newton BFGS method. The quasi-Newton BFGS method is a numerical method used for nonlinear function optimization without constraint so that the method can be used for parameter estimation from Gumbel distribution whose distribution function is in the form of exponential doubel function. The quasi-New BFGS method is a development of the Newton method. The Newton method uses the second derivative to calculate the parameter value changes on each iteration. Newton's method is then modified with the addition of a step length to provide a guarantee of convergence when the second derivative requires complex calculations. In the quasi-Newton BFGS method, Newton's method is modified by updating both derivatives on each iteration. The parameter estimation of the Gumbel distribution by a numerical approach using the quasi-Newton BFGS method is done by calculating the parameter values that make the distribution function maximum. In this method, we need gradient vector and hessian matrix. This research is a theory research and application by studying several journals and textbooks. The results of this study obtained the quasi-Newton BFGS algorithm and estimation of Gumbel distribution parameters. The estimation method is then applied to daily rainfall data in Purworejo District to estimate the distribution parameters. This indicates that the high rainfall that occurred in Purworejo District decreased its intensity and the range of rainfall that occurred decreased.Keywords: parameter estimation, Gumbel distribution, maximum likelihood, broyden fletcher goldfarb shanno (BFGS)quasi newton
Procedia PDF Downloads 3232086 Ideas for Musical Activities and Games in the Early Year (IMAGINE-Autism): A Case Study Approach
Authors: Tania Lisboa, Angela Voyajolu, Adam Ockelford
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The positive impact of music on the development of children with autism is widely acknowledged: music offers a unique channel for communication, wellbeing and self-regulation, as well as access to culture and a means of creative engagement. Yet, no coherent program exists for parents, carers and teachers to follow with their children in the early years, when the need for interventions is often most acute. Hence, research and the development of resources is urgently required. Autism is a project with children on the autism spectrum. The project aims at promoting the participants’ engagement with music through involvement in specially-designed musical activities with parents and carers. The main goal of the research is to verify the effectiveness of newly designed resources and strategies, which are based on the Sounds of Intent in the Early Years (SoI-EY) framework of musical development. This is a pilot study, comprising case studies of five children with autism in the early years. The data comprises semi-structured interviews, observations of videos, and feedback from parents on resources. Interpretative Phenomenological Analysis was chosen to analyze the interviews. The video data was coded in relation to the SoI-EY framework. The feedback from parents was used to evaluate the resources (i.e. musical activity cards). The participants’ wider development was also assessed through selected elements of the Early Years Foundation Stage (EYFS), a national assessment framework used in England: specifically, communication, language and social-emotional development. Five families of children on the autism spectrum (aged between 4-8 years) participated in the pilot. The research team visited each family 4 times over a 3-month period, during which the children were observed, and musical activities were suggested based on the child’s assessed level of musical development. Parents then trialed the activities, providing feedback and gathering further video observations of their child’s musical engagement between visits. The results of one case study will be featured in this paper, in which the evidence suggests that specifically tailored musical activity may promote communication and social engagement for a child with language difficulties on the autism spectrum. The resources were appropriate for the children’s involvement in musical activities. Findings suggest that non-specialist musical engagement with family and carers can be a powerful means to foster communication. The case study featured in this paper illustrates this with a child of limited verbal ability. There is a need for further research and development of resources that can be made available to all those working with children on the autism spectrum.Keywords: autism, development, music education, resources
Procedia PDF Downloads 1002085 Principles and Guidance for the Last Days of Life: Te Ara Whakapiri
Authors: Tania Chalton
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In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.Keywords: end of life, guidelines, New Zealand, palliative care
Procedia PDF Downloads 4332084 Physical Activity in Pacific Adolescent Girls with a Physical Disability
Authors: Caroline Dickson
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While adolescence can be a challenging time, it may also be a time of opportunity. Whereas adolescents with a physical disability negotiate the adolescent developmental stage with similar issues to able-bodied adolescents, they additionally may encounter developmental problems which may impede their adulthood. In part due to the restricted opportunities disabled adolescents experience, they may experience difficulty with mastering this developmental stage. As is well documented, health and wellbeing are positively associated with participating in physical activity. However, the little research available suggested that Pacific adolescents generally are participating in less physical activity than adolescents of other ethnic groups. Objective/Study: The main aim of the study (from a larger mixed method study), was to explore physical activity participation in Pacific adolescent girls with a physical disability in relation to their physiological and psychological wellbeing. The qualitative descriptive study comprised of seven interviews with Pacific adolescent girls and their mothers in a family setting and also included the providers of services to Pacific girls with a physical disability. Including the providers of disability services allowed the researchers to identity a further understanding into challenges of participation for the Pacific adolescent girls and their families while the girls were attempting to participate in physical activity. The purpose of the talanoa (face-to-face interviews that were deemed informal) was to identify partaking and factors influencing participation in physical activity, whilst listening to the voices of the participants. The stories revealed the multitude of factors that influenced physical activity for the Pacific girls with a physical disability. Results: Findings from the qualitative descriptive study found that through physical activity, the Pacific adolescent girls with a physical disability experienced benefits from participation. The findings suggested that these girls wanted to participate in physical activity and clearly indicated the physical activities they preferred. Amongst the physiological and psychological benefits of the Pacific adolescents engaging in physical activity, the adolescents were able to develop positive social relationships, experience autonomy, and generally, their self-worth improved while building confidence. Nevertheless, the adolescents experienced a multitude of factors impeding their engagement in physical activity including cultural stigmas. Their participation was influenced by the interplay of a range of gender, cultural, age-related (adolescence) and socio-economic factors alongside policy and structurally related constraints. Conclusion: Physical activity has the potential to improve the general physiological and psychological health of all adolescents. It should be prioritised particularly in vulnerable populations where they may have limited access. As the Pacific adolescents with a physical activity are dependent on their families for physical activity participation, it is imperative the family be included and consulted. To increase participation, and reduce sedentary behaviours, factors influencing both participation and non-participation need to be considered.Keywords: Pacific adolescent girls, physical activity, physical disability, qualitative descriptive study
Procedia PDF Downloads 1582083 Festivals and Weddings in India during Corona Pandemic
Authors: Arul Aram, Vishnu Priya, Monicka Karunanithi
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In India, in particular, festivals are the occasions of celebrations. They create beautiful moments to cherish. Mostly, people pay a visit to their native places to celebrate with their loved ones. So are wedding celebrations. The Covid-19 pandemic came upon us unexpectedly, and to fight it, the festivals and weddings are celebrated unusually. Crowded places are deserted. Mass gatherings are avoided, changes and alterations are made in our rituals and celebrations. The warmth usually people have at their heart during any festival and wedding has disappeared. Some aspects of the celebrations become virtual/digital rather than real -- for instance, digital greetings/invitations, digital conduct of ceremonies by priests, YouTube worship, online/digital cash gifts, and digital audience for weddings. Each festival has different rituals which are followed with the divine nature in every family, but the pandemic warranted some compromises on the traditions. Likewise, a marriage is a beautiful bond between two families where a lot of traditional customs are followed. The wedding ceremonies are colorful and celebrations may extend for several days. People in India spend financial resources to prepare and celebrate weddings. The bride's and the groom's homes are fully decorated with colors, balloons and other decorations. The wedding rituals and celebrations vary by religion, region, preference and the resources of the groom, bride and their families. They can range from one day to multiple-days events. But the Covid-19 pandemic situation changes the mindset of people over ceremonies. This lockdown has affected those weddings and industries that support them and make the people postpone or at times advance without fanfare their 'big day.' People now adopt the protocols, guidelines and safety measures to reduce the risk and minimize the fear during celebrations. The study shall look into: how the pandemic shattered the expectations of people celebrating; problems faced economically by people/service providers who are benefited by the celebrations; and identify the alterations made in the rituals or the practices of our culture for the safety of families. The study shall employ questionnaires, interviews and visual ethnography to collect data. The study found that during a complete lockdown, people have not bought new clothes, sweets, or snacks, as they generally do before a pandemic. Almost all of them kept their celebrations low-key, and some did not celebrate at all. Digital media played a role in keeping the celebration alive, as people used it to wish their friends and families virtually. During partial unlock, the situation was under control, and people began to go out and see a few family and friends. They went shopping and bought new clothes and needs, but they did it while following safety precautions. There is also an equal percentage of people who shopped online. Although people continue to remain disappointed, they were less stressed up as life was returning to normal.Keywords: covid-19, digital, festivals, India, wedding
Procedia PDF Downloads 1852082 Medicinal Plants: An Antiviral Depository with Complex Mode of Action
Authors: Daniel Todorov, Anton Hinkov, Petya Angelova, Kalina Shishkova, Venelin Tsvetkov, Stoyan Shishkov
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Human herpes viruses (HHV) are ubiquitous pathogens with a pandemic spread across the globe. HHV type 1 is the main causative agent of cold sores and fever blisters around the mouth and on the face, whereas HHV type 2 is generally responsible for genital herpes outbreaks. The treatment of both viruses is more or less successful with antivirals from the nucleoside analogues group. Their wide application increasingly leads to the emergence of resistant mutants In the past, medicinal plants have been used to treat a number of infectious and non-infectious diseases. Their diversity and ability to produce the vast variety of secondary metabolites according to the characteristics of the environment give them the potential to help us in our warfare with viral infections. The variable chemical characteristics and complex composition is an advantage in the treatment of herpes since the emergence of resistant mutants is significantly complicated. The screening process is difficult due to the lack of standardization. That is why it is especially important to follow the mechanism of antiviral action of plants. On the one hand, it may be expected to interact with its compounds, resulting in enhanced antiviral effects, and the most appropriate environmental conditions can be chosen to maximize the amount of active secondary metabolites. During our study, we followed the activity of various plant extracts on the viral replication cycle as well as their effect on the extracellular virion. We obtained our results following the logical sequence of the experimental settings - determining the cytotoxicity of the extracts, evaluating the overall effect on viral replication and extracellular virion.During our research, we have screened a variety of plant extracts for their antiviral activity against both virus replication and the virion itself. We investigated the effect of the extracts on the individual stages of the viral replication cycle - viral adsorption, penetration and the effect on replication depending on the time of addition. If there are positive results in the later experiments, we had studied the activity over viral adsorption, penetration and the effect of replication according to the time of addition. Our results indicate that some of the extracts from the Lamium album have several targets. The first stages of the viral life cycle are most affected. Several of our active antiviral agents have shown an effect on extracellular virion and adsorption and penetration processes. Our research over the last decade has shown several curative antiviral plants - some of which are from the Lamiacea family. The rich set of active ingredients of the plants in this family makes them a good source of antiviral preparation.Keywords: human herpes virus, antiviral activity, Lamium album, Nepeta nuda
Procedia PDF Downloads 1532081 Management of Acute Appendicitis with Preference on Delayed Primary Suturing of Surgical Incision
Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena
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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure
Procedia PDF Downloads 164