Search results for: health risk of call center agents

Authors: Nida Iftikhar, Jamaluddin Thaheem, Bilal Iftikhar

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In the construction industry, adequate and effective decision-making can mean the difference between success and failure. Bidding is the most important element of the construction business since it is a mean by which contractors obtain work. This is probably the only option for any contractor firm to sustain in the market and achieve its objective of earning the profits by winning tenders. The capability to select most appropriate ventures not only defines the success and wellbeing of contractor firms but also their survival and sustainability in the industry. The construction practitioners are usually on their own when it comes to deciding on bidding for a project or not. Usually, experience-based solutions are offered where a lot of subjectivity is involved. This research has been opted considering the local construction industry of Pakistan in order to examine the critical success factors from contractors’ perspective while making bidding decisions, listing and evaluating critical factors in order of their importance, categorization of these factors into decision support & decision oppose groups and to develop a framework to help contractors in the decision-making process. Literature review, questionnaires, and structured interviews are used for identification and quantification of factors affecting bid/no bid decision-making. Statistical methods of ranking analysis and analytical hierarchy process of multi-criteria decision-making method are used for analysis. It is found that profitability, need for work and financial health of client are the most decisive factors in bid/no bid decision-making while project size, project type, fulfilling the tender conditions imposed by the client and relationship, identity & reputation of the client are least impact factors in bid/no bid decision-making. Further, to verify the developed framework, case studies have been conducted to evaluate the bid/no bid decision-making in building procurement. This is the first of its nature study in the context of the local construction industry and recommends using a holistic decision-making framework for such business-critical deliberations.

Keywords: bidding, bid decision-making, construction procurement, contractor

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Authors: David Xiaoqian Sun, Khairunnisa Binti Haji Sibah, Jr., Lejak Anak Ambol

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The purpose of the study was to examine the relationships between objectively measured physical activity levels (PALs), enjoyment of physical activity (EPA), and body mass index (BMI) among adolescents. A total of 188 12-14-year-old Bruneian secondary school adolescents (88 boys and 100 girls) voluntarily took part in this study. Subjects wore the RT3 accelerometer for seven consecutive days in order to measure their PALs. Times of students’ engagement in total (TPA), light (LPA), moderate (MPV), and vigorous PA (VPA) were obtained from the accelerometer. Their BMIs were calculated from their body height and weight. Physical Activity Enjoyment Scale (PACES) was administrated to obtain their EPA levels. Four key enjoyment factors including fun factors, positive perceptions, unexciting in doing activities, and negative perceptions were identified. Subjects’ social economic status (SES) was provided by school administration. Results show that all the adolescents did not meet the recommended PA guidelines even though boys were engaged in more MVPA than girls. No relationships were found between BMI and all PALs in both boys and girls. BMI was significantly related to the PACES scores (r = -.22, p = 0.01), fun factors (r = -.20, p = 0.05) and positive perceptions (r =-.21, p < 0.05). The PACES scores were significantly related to LPA (r = .18, p = 0.01) but not related to MVPA (r = .04, p > 0.05). After controlling for age and SES, BMI was only significantly related to the PACES scores in girls (r = -.27, p < .01) but boys (r = -.06, p > 0.05). Fun factors were significantly related to LPA and MVPA (p < .01) in girls while negative perceptions were significantly related to LPA and MVPA (p < .01) in boys. This study provides evidence that enjoyment may be a trigger of LPA but MVPA and may be influenced by their BMI status particularly in girls. Based on these findings, physical and health educators are suggested to not only make PA more enjoyable, but also consider gender differences in promoting adolescents' participation in MVPA.

Keywords: accelerometer, body mass index, enjoyment of physical activity, moderate to vigorous physical activity

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Authors: Abdullah Ansari, Sinika Rambaran, Sirpaul Jaikishun

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Vermiwash could be used to enhance plant productivity and resistance to some harmful plant pathogens, as well as provide benefit through the disposal of waste matter. Alternaria rot caused by the fungus Alternaria alternata (Fr.) Keissl., is a common soil-borne pathogen that results in postharvest fruit rot of cucumbers, peppers and other cash crops. The production and distribution of Cucumis sativus L. (cucumber) could be severely affected by Alternaria rot. Fungicides are the traditional treatment however; they are not only expensive but can also cause environmental and health problems. Vermiwash was prepared from various medicinal plants (Ocimum tenuiflorum L. {Tulsi}, Azadirachta indica A. Juss. {neem}, Cymbopogon citratus (DC. ex Nees) Stapf. {lemon grass} and Oryza sativa L. {paddy straw} and applied, in vitro, to A. alternata to investigate their effectiveness as organic alternatives to traditional fungicides. All of the samples of vermiwash inhibited the growth of A. alternata. The inhibitive effects on the fungus appeared most effective when A. indica and O. tenuiflorum were used in the production of the vermiwash. Using the serial dilution method, vermiwash from O. tenuiflorum showed the highest percent of inhibition (93.2%), followed by C. citratus (74.7%), A. indica (68.7%), O. sativa, combination, and combination without worms. Using the sterile disc diffusion method, all of the samples produced zones of inhibition against A. alternata. Vermiwash from A. indica produced a zone of inhibition, averaging 15.3mm, followed by O. tenuiflorum (14.0mm), combination without worms, combination, C. citratus and O. sativa. Nystatin produced a zone of inhibition of 10mm. The results indicate that vermiwash is not simply an organic alternative to more traditional chemical fungicides, but it may in fact be a better and more effective product in treating certain fungal plant infections, particularly A. alternata.

Keywords: vermiwash, earthworms, soil, bacteria, alternaria alternata, antifungal, antibacterial

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Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

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Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

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Authors: Shulamit Sternin

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Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.

Keywords: athlete, injury, musician, psychological response

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Authors: Gonul Kurt, Semra Aciksoz

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All types of interventions that increase the knowledge and awareness of youths about Sexually Transmitted Diseases (STD) are considered to be important for safe sex life and sexual health. The aim of this study was to determine the knowledge levels of nursing students about STD and evaluate the effectiveness of peer education and brochure methods to increase the knowledge and awareness about STD. This interventional study was carried out by participation of nursing students attending the first and second grade in a school of nursing on February–May 2015. The study participants were 200 undergraduate nursing student volunteers. The students were given education by peer trainers and brochure methods. First-grade students were divided into five groups with block randomization method and each group were given education by five peer trainers. Second-grade students were given education with brochure by the researchers. The knowledge level of study groups was evaluated before and after educational intervention. The data were collected using the “Data Collection Form” and “Sexually Transmitted Diseases Information Form”. The questionnaire forms developed by the researchers after the literature review. The SPSS 15.0 package software was used for the evaluation of the data obtained from the study. Data were analyzed by Mann-Whitney-U-Test, Wilcoxon Signed Ranks Test and Mc Nemar Test. A p value of <0.05 was regarded as statistically significant. All of participants in the study were female nursing students. The mean age of students was 18.99±0.32 years old in the peer education group and 20.04±0.37 in the brochure education group. There was no statistically significant difference between knowledge levels of the students in both groups before the education (p>0.05). It was determined that an increase in knowledge levels of the students in both groups after the education. This increase was statistically significant (p<0.05). It was determined that knowledge level of the students about STD in brochure group was higher than the peer education group (p<0.001). The results of this study indicate that brochure education method was more effective than the peer education method in both increasing knowledge and awareness about STD.

Keywords: education method, knowledge, nursing students, sexually transmitted diseases

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Authors: Cristina Hotoleanu

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Introduction: The recent Covid-19 pandemic accelerated the development of e-health, including telemedicine, smartphone applications, and medical wearable devices. Providing remote teleconsultations supposes challenges which may require further face-to-face medical interactions. The aim of this study was to assess the correlation between the types of teleconsultations and the need of onsite medical services (investigations and medical visits) for the diagnosis and treatment. Methods: a retrospective study including all the teleconsultations using the platform offered by a telehealth provider in Romania (Telios Care SA) between May 1, 2021- April 30, 2022, was performed. Binary data were analysed using the chi-square test with a significance level of p < 0.05. Results: out of 7163 consultations, 3961 were phone calls, 1981 were online messages, and 1221 were video calls. Onsite medical services were indicated in 3327 (46.44%) cases; the onsite investigations or the onsite visits were recommended for 2908 patients as follows: 2326 in case of phone calls, 582 in case of online messages, none in case of video calls. Both onsite investigations and visits were indicated for 419 patients. The need for onsite additional medical services was significantly higher in the case of phone calls than in the other 2 types of teleconsultations (Chi square= 1207.06, p= 0.00001). The indication for onsite services was done mainly after teleconsultations covering medical specialties (87.34%), significantly higher than the other specialties (Chi square=914.59, p=0.00001). Teleconsultations in surgical specialties and other fields (pharmacy, dentistry, psychology, wellbeing- nutrition, fitness) resulted in 12.13%, respective less than 1%, indication for onsite investigations or visits, explained by using of video calls in most of the cases. Conclusion: a further onsite medical service was necessary in less than a half of the teleconsultations. This indication was done mainly after phone calls and teleconsultations in medical specialties. Video calls were used mostly in psychology, nutrition, and fitness teleconsultations and did not require a further onsite medical service. Other studies are necessary to assess better the types of teleconsultations and the specialties bringing the biggest benefit for the patients.

Keywords: onsite medical services, phone calls, teleconsultations, telemedicine

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Authors: M. Ardelean, F. Manea, A. Pop, J. Schoonman

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The presence of pharmaceuticals in the environment and especially in water has gained increasing attention. They are included in emerging class of pollutants, and for most of them, legal limits have not been set-up due to their impact on human health and ecosystem was not determined and/or there is not the advanced analytical method for their quantification. In this context, the development of various advanced analytical methods for the quantification of pharmaceuticals in water is required. The electrochemical methods are known to exhibit the great potential for high-performance analytical methods but their performance is in direct relation to the electrode material and the operating techniques. In this study, two types of carbon-based electrodes materials, i.e., boron-doped diamond (BDD) and carbon nanofiber (CNF)-epoxy composite electrodes have been investigated through voltammetric techniques for the detection of naproxen in water. The comparative electrochemical behavior of naproxen (NPX) on both BDD and CNF electrodes was studied by cyclic voltammetry, and the well-defined peak corresponding to NPX oxidation was found for each electrode. NPX oxidation occurred on BDD electrode at the potential value of about +1.4 V/SCE (saturated calomel electrode) and at about +1.2 V/SCE for CNF electrode. The sensitivities for NPX detection were similar for both carbon-based electrode and thus, CNF electrode exhibited superiority in relation to the detection potential. Differential-pulsed voltammetry (DPV) and square-wave voltammetry (SWV) techniques were exploited to improve the electroanalytical performance for the NPX detection, and the best results related to the sensitivity of 9.959 µA·µM^-1 were achieved using DPV. In addition, the simultaneous detection of NPX and fluoxetine -a very common antidepressive drug, also present in water, was studied using CNF electrode and very good results were obtained. The detection potential values that allowed a good separation of the detection signals together with the good sensitivities were appropriate for the simultaneous detection of both tested pharmaceuticals. These results reclaim CNF electrode as a valuable tool for the individual/simultaneous detection of pharmaceuticals in water.

Keywords: boron-doped diamond electrode, carbon nanofiber-epoxy composite electrode, emerging pollutans, pharmaceuticals

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Authors: Laxmi R. Kasaraneni

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The Internet connects all the networks, including the nation’s critical infrastructure that are used extensively by not only a nation’s government and military to protect sensitive information and execute missions, but also the primary infrastructure that provides services that enable modern conveniences such as education, potable water, electricity, natural gas, and financial transactions. It has become the central nervous system for the government, the citizens, and the industries. When it is attacked, the effects can ripple far and wide impacts not only to citizens’ well-being but nation’s economy, civil infrastructure, and national security. As such, these critical services may be targeted by malicious hackers during cyber warfare, it is imperative to not only protect them and mitigate any immediate or potential threats, but to also understand the current or potential impacts beyond the IT networks or the organization. The Nation’s IT infrastructure which is now vital for communication, commerce, and control of our physical infrastructure, is highly vulnerable to attack. While existing technologies can address some vulnerabilities, fundamentally new architectures and technologies are needed to address the larger structural insecurities of an infrastructure developed in a more trusting time when mass cyber attacks were not foreseen. This research is intended to improve the core functions of the Internet and critical-sector information systems by providing a clear path to create a safe, secure, and resilient cyber environment that help stakeholders at all levels of government, and the private sector work together to develop the cybersecurity capabilities that are key to our economy, national security, and public health and safety. This research paper also emphasizes the present and future cyber security threats, the capabilities and goals of cyber attackers, a strategic concept and steps to implement cybersecurity for maximum effectiveness, enabling technologies, some strategic assumptions and critical challenges, and the future of cyberspace.

Keywords: critical challenges, critical infrastructure, cyber security, enabling technologies, national security

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Authors: Chengliang Xie, Jinhyun Ryu, Hyun Joon Kim, Gyeong Jae Cho, Wan Sung Choi, Sang Soo Kang, Kye Man Cho, Dong Hoon Lee

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Obesity has become a global health problem and a source of major metabolic diseases like type-2 diabetes, hypertension, heart disease, nonalcoholic fatty liver and cancer. Synthetic anti-obesity drugs are effective but very costly and with undesirable side effects, so natural products such as soybean are needed as an alternative for obesity treatment. Lactobacillus Plantarum P1201is a probiotic bacterial strain reported to produce conjugated linoleic acid (CLA) and increase the ratio of aglycone-isoflavone of soybean, both of which have anti-obesity effect. In this study, the anti-obesity effect of the fermented soybean extract with P1201 (FSE) will be evaluated compared with that of the soybean extract (SE) by 3T3-L1 cells as an in vitro model of adipogenesis. 3T3-L1 cells were treated with SE and FSE during the nine days of the differentiation, lipid accumulation was evaluated by oil-red staining and triglyceride content and the mRNA expression level of adipogenic or lipogenic genes were analyzed by RT-PCR and qPCR. The results showed that formation of lipid droplets in differentiated 3T3-L1 cells was inhibited and triglyceride content was reduced by 23.1% after treated with 1000 μg/mL of FSE compared with control. For SE-treated groups, no delipidating effect was observed. The effect of FSE on adipogenesis inhibition can be attributed to the down-regulation of mRNA expressionof CCAAT/enhancer binding protein (C/EBP-α), lipoprotein lipase (LPL), adiponectin, adipocyte fatty acid-binding protein (aP2), fatty acid synthesis (FAS) and CoA carboxylase (ACC). Our results demonstrated that the anti-obesity effect of soybean can be improved by fermentation with P1201, and P1201can be used as a potential probiotic bacterial strain to produce natural anti-obesity food.

Keywords: fermentation, Lactobacillus plantarum P1201, obesity, soybean

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Authors: Pedro Cabrales, Scott Caroen, Tony R. Reid, Bryan Oronsky

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Introduction and Purpose RRx-001 is an NLRP3 inhibitor and Nrf2 agonist in Phase 3 trials for the treatment of cancer. The purpose of this study was to examine whether treatment with RRx-001, given itsanti-inflammatory and antioxidant properties, improvedexercise and skeletal muscle oxidative capacity in mice on the generalpremiss that better health outcomes correlatewith more activity. Material and Methods Male and female adult mice (n=6 per group) were subjected to an endurance exercise capacity (EEC)test until exhaustion on a motorized treadmill after 3 once weekly doses of either RRx-001 5 mg/kg, RRx-001 2 mg/kg, or vehicle. The EEC protocol consisted of a treadmill velocity of 30meters per min at an uphill inclination (slope of 10%) until the mice reached fatigue, which was defined as the inability of the mice to maintain the appropriate pace despitecontinuous hand stimulation for 1 min. The concentration of malondialdehyde (MDA), an indicator of lipid peroxidation, and creatine kinase (CK), an indicator of muscle damage, in the blood samples collected immediately after the acute exercise was determined with a commercial ELISA assay kit. ResultsThe exhaustive exercise times of the RRx-001 groups were significantly longer than that of the vehicle group (p<0.05) by weeks 2 and 3. In addition, MDA levels in the gastrocnemius, soleus, and extensor digitorum longus muscles were significantly lower than those of the vehicle group were (p<0.05), as were the serum CK levels(p<0.05). ConclusionsIn conclusion, this study found that RRx-001 has anti-fatigue properties, as evidenced by an increase in exercise capacity with RRx-001 treatment, and protects against strenuous exercise-induced muscle damage and lipid peroxidation. This data potentially supports the use of RRx-001 in the clinic to improve exercise performance and reduce physical fatigue.

Keywords: RRx-001, anti-fatigue, muscle protection, increased exercise tolerance, lipid peroxidation

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Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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Authors: Ziyad S. Haidar

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Background: Saliva plays a major role in maintaining oral and dental health (consequently, general health and well-being). Where it normally bathes the oral cavity and acts as a clearing agent. This becomes more apparent when the amount and quality of salivare significantly reduced due to medications, salivary gland neoplasms, disorders such as Sjögren’s syndrome, and especially ionizing radiation therapy for tumors of the head and neck, the fifth most common malignancy worldwide, during which the salivary glands are included within the radiation field or zone. Clinically, patients affected by salivary gland dysfunction often opt to terminate their radiotherapy course prematurely because they become malnourished and experience a significant decrease in their quality of life. Accordingly, the development of an alternative treatment to restore or regenerate damaged salivary gland tissue is eagerly awaited. Likewise, the formulation of a radioprotection modality and early damage prevention strategy is also highly desirable. Objectives: To assess the pre-clinical radio-protective effect as well as the reparative/regenerative potential of layer-by-layer self-assembled lipid-polymer-based core-shell nanocapsules designed and fine-tuned in this experimental work for the sequential (ordered) release of dual cytokines, following a single local administration (direct injection) into a murine sub-mandibular salivary gland model of irradiation. Methods: The formulated core-shell nanocapsules were characterized by physical-chemical-mechanically pre-/post-loading with the drugs (in solution and powder formats), followed by optimizing the pharmaco-kinetic profile. Then, nanosuspensions were administered directly into the salivary glands, 24hrs pre-irradiation (PBS, un-loaded nanocapsules, and individual and combined vehicle-free cytokines were injected into the control glands for an in-depth comparative analysis). External irradiation at an elevated dose of 18Gy (revised from our previous 15Gy model) was exposed to the head-and-neck region of C57BL/6 mice. Salivary flow rate (un-stimulated) and salivary protein content/excretion were regularly assessed using an enzyme-linked immunosorbent assay (3-month period). Histological and histomorphometric evaluation and apoptosis/proliferation analysis followed by local versus systemic bio-distribution and immuno-histochemical assays were then performed on all harvested major organs (at the distinct experimental end-points). Results: Monodisperse, stable, and cytocompatible nanocapsules capable of maintaining the bioactivity of the encapsulant within the different compartments with the core and shell and with controlled/customizable pharmaco-kinetics, resulted, as is illustrated in the graphical abstract (Figure) below. The experimental animals demonstrated a significant increase in salivary flow rates when compared to the controls. Herein, salivary protein content was comparable to the pre-irradiation (baseline) level. Histomorphometry further confirmed the biocompatibility and localization of the nanocapsules, in vivo, into the site of injection. Acinar cells showed fewer vacuoles and nuclear aberration in the experimental group, while the amount of mucin was higher in controls. Overall, fewer apoptotic activities were detected by a Terminal deoxynucleotidyl Transferase (TdT) dUTP Nick-End Labeling (TUNEL) assay and proliferative rates were similar to the controls, suggesting an interesting reparative and regenerative potential of irradiation-damaged/-dysfunctional salivary glands. The Figure below exemplifies some of these findings. Conclusions: Biocompatible, reproducible, and customizable self-assembling layer-by-layer core-shell delivery system is formulated and presented. Our findings suggest that localized sequential bioactive delivery of dual cytokines (in specific dose and order) can prevent irradiation-induced damage via reducing apoptosis and also has the potential to promote in situ proliferation of salivary gland cells; maxSALIVA is scalable (Good Manufacturing Practice or GMP production for human clinical trials) and patent-pending.

Keywords: saliva, head and neck cancer, nanotechnology, controlled drug delivery, xerostomia, mucositis, biopolymers, innovation

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Authors: Maaike Maria Augustina Hommes

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This paper reviews the emergence of the recently approved lust enhancing pill for women (sold under the brand name of Addyi) and its status as ‘medicine’ from a cultural studies perspective to understand the way in which the usage of the pill can be seen as a medicalization of sexual desire. It asks where this medicalization can be localized to understand the current placement of and notions on female sexuality. Via a close reading of a woman’s narration of her usage of the pill that appeared in Shape Magazine, this paper critically reviews the pill’s relation to the concept of ‘cure’ and assesses the way this Pink Pill functions as a cure to the DSM-IV based disorder called Hypoactive Sexual Desire Disorder. As such it finds that in the diagnosis with HSDD meant a huge relief. Now this woman was not just ‘bad at life and bad at marriage’ but ‘just had this health issue’. In order to get to an understanding of the different structures that conjoin in this expression of relief this paper reviews the emergence of the sexual desire disorder within psychology and the way that the loss of desire becomes localized in the brain. This localization will be related to two ways of looking at the human body; the medical gaze as described by Michel Foucault, and the neuromolecular gaze, as introduced by Nikolas Rose and Joelle M.Abi-Rached. Both these penetrating gazes bring about a certain reductionism in which the human body is either viewed as an objectified ‘sick body’ or as a set of chemical reactions. By referring to these modes of looking as reductionist one assumes that something is lost, or forgotten in the act of reducing. It is both what is gained in the formulation of the disorder, as what is lost in reduction of the disorder in medical knowledge that is at the central inquiry of this paper. As such, this paper brings forward the way in which medicine and cultural narrative are deeply intertwined. It is this way in which different forces of subject formation come together that is addressed via an interdisciplinary and object-centered focus on the pink pill.

Keywords: disorder and cure, female sexual desire, medical gaze, neuromolecular gaze

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Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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Authors: Moshmi Sangavarapu

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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.

Keywords: healthcare access, market access, diversity barriers, patient journey

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Authors: Akram Rasheed

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Background: Simulation in the health care field has been increasingly used over the last years in the training of resuscitation and life support practices. It has shown the advantage of improving the decision-making and technical skills through deliberate practice and return demonstration. Local Problem: This article reports on the integration of simulation-based training (SBT) in the training program about proper team dynamics and leadership skills during cardiopulmonary resuscitation (CPR) in the intensive care unit (ICU). Method and Intervention: Training of 180 critical care nurses was conducted using SBT between 1st January and 30th 2020. We had conducted 15 workshops, with the integration of SBT using high fidelity manikins and using demonstration and return-demonstration approach to train the nursing staff about proper team dynamics and leadership skills during CPR. Results: After completing the SBT session, all 180 nurses completed the evaluation form. The majority of evaluation items were rated over 95% for the effectiveness of the education; four items were less than 95% (88–94%). Lower rated items considered training and practice time, improved competency, and commitment to apply to learn. The team dynamics SBT was evaluated as an effective means to improve team dynamics and leadership skills during CPR in the intensive care unit (ICU). Conclusion: The use of simulation-based training to improve team dynamics and leadership skills is an effective method for better patient management during CPR. Besides skills competency, closed-loop communication, clear messages, clear roles, and assignments, knowing one’s limitations, knowledge sharing, constructive interventions, re-evaluating and summarizing, and mutual respect are all important concepts that should be considered during team dynamics training. However, participants reported the need for a repeated practice opportunity to build competency.

Keywords: cardiopulmonary resuscitation, high fidelity manikins, simulation-based training, team dynamics

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Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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Authors: Sidra Shaw, Sarenna Shaw, Chae Joon Lee, Irimpan Mathews, Eric Koehn

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One of the biggest public health concerns of our time is increasing antimicrobial resistance. As of 2019, the CDC has documented more than 2.8 million serious antibiotic resistant infections in the United States. Currently, antibiotic resistant infections are directly implicated in over 750,000 deaths per year globally. On our current trajectory, British economist Jim O’Neill predicts that by 2050, an additional 10 million people (about half the population of New York) will die annually due to drug resistant infections. As a result, new biochemical pathways must be targeted to generate next generation antibiotic drugs that will be effective against drug resistant bacteria. One enticing target is the biosynthesis of DNA within bacteria, as few drugs interrupt this essential life process. Thymidylate synthase enzymes are essential for life as they catalyze the synthesis of a DNA building block, 2′-deoxythymidine-5′-monophosphate (dTMP). In humans, the thymidylate synthase enzyme (TSase) has been shown to be distinct from the flavin-dependent thymidylate synthase (FDTS) produced by many pathogenic bacteria. TSase and FDTS have distinct structures and mechanisms of catalysis, which should allow selective inhibition of FDTS over human TSase. Currently, C. diff is one of the most antibiotic resistant bacteria, and no drugs that target thymine biosynthesis exist for C. diff. Here we present the initial biochemical characterization of FDTS from C. diff. Specifically, we examine enzyme kinetics and binding features of this enzyme to determine the nature of interaction with ligands/inhibitors and understand the molecular mechanism of catalysis. This research will provide more insight into the targetability of the C. diff FDTS enzyme for novel antibiotic drugs.

Keywords: flavin-dependent thymidylate synthase, FDTS, clostridioides difficile, C. diff, antibiotic resistance, DNA synthesis, enzyme kinetics, binding features

Procedia PDF Downloads 87

Authors: Yu-Ching Liu

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Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.

Keywords: family caregiver, Long-term care, work-life balance, decision-making

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Authors: Isaac Mugume, Charles Basalirwa, Daniel Waiswa, Triphonia Ngailo

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Rainfall is a major climatic parameter affecting many sectors such as health, agriculture and water resources. Its quantitative prediction remains a challenge to weather forecasters although numerical weather prediction models are increasingly being used for rainfall prediction. The performance of six convective parameterization schemes, namely the Kain-Fritsch scheme, the Betts-Miller-Janjic scheme, the Grell-Deveny scheme, the Grell-3D scheme, the Grell-Fretas scheme, the New Tiedke scheme of the weather research and forecast (WRF) model regarding quantitative rainfall prediction over Uganda is investigated using the root mean square error for the March-May (MAM) 2013 season. The MAM 2013 seasonal rainfall amount ranged from 200 mm to 900 mm over Uganda with northern region receiving comparatively lower rainfall amount (200–500 mm); western Uganda (270–550 mm); eastern Uganda (400–900 mm) and the lake Victoria basin (400–650 mm). A spatial variation in simulated rainfall amount by different convective parameterization schemes was noted with the Kain-Fritsch scheme over estimating the rainfall amount over northern Uganda (300–750 mm) but also presented comparable rainfall amounts over the eastern Uganda (400–900 mm). The Betts-Miller-Janjic, the Grell-Deveny, and the Grell-3D underestimated the rainfall amount over most parts of the country especially the eastern region (300–600 mm). The Grell-Fretas captured rainfall amount over the northern region (250–450 mm) but also underestimated rainfall over the lake Victoria Basin (150–300 mm) while the New Tiedke generally underestimated rainfall amount over many areas of Uganda. For deterministic rainfall prediction, the Grell-Fretas is recommended for rainfall prediction over northern Uganda while the Kain-Fritsch scheme is recommended over eastern region.

Keywords: convective parameterization schemes, March-May 2013 rainfall season, spatial variation of parameterization schemes over Uganda, WRF model

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Authors: Alokananda Ghosh, Shraban Sarkar

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The study aims to identify suitable sites for new hospitals with critical obstetric care facilities in Birbhum, one of the vulnerable and underserved districts of Eastern India, considering six main and 14 sub-criteria, using GIS-based Analytic Hierarchy Process (AHP) and Multi-Attribute Utility Theory (MAUT) approach. The criteria were identified through field surveys and previous literature. After collecting expert decisions, a pairwise comparison matrix was prepared using the Saaty scale to calculate the weights through AHP. On the contrary, objective weighting methods, i.e., Entropy and Criteria Importance through Interaction Correlation (CRITIC), were used to perform the MAUT. Finally, suitability maps were prepared by weighted sum analysis. Sensitivity analyses of AHP were performed to explore the effect of dominant criteria. Results from AHP reveal that ‘maternal death in transit’ followed by ‘accessibility and connectivity’, ‘maternal health care service (MHCS) coverage gap’ were three important criteria with comparatively higher weighted values. Whereas ‘accessibility and connectivity’ and ‘maternal death in transit’ were observed to have more imprint in entropy and CRITIC, respectively. While comparing the predictive suitable classes of these three models with the layer of existing hospitals, except Entropy-MAUT, the other two are pointing towards the left-over underserved areas of existing facilities. Only 43%-67% of existing hospitals were in the moderate to lower suitable class. Therefore, the results of the predictive models might bring valuable input in future planning.

Keywords: hospital site suitability, analytic hierarchy process, multi-attribute utility theory, entropy, criteria importance through interaction correlation, multi-criteria decision analysis

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Authors: Arash Yousefi

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Experts suggest that relying exclusively on parameters to convey a situation or establish a condition may not be adequate. Assessing and appraising incidents in a system based on accident parameters, such as accident frequency, lost workdays, or fatalities, may not always be precise and occasionally erroneous. The frequency rate of accidents is a metric that assesses the correlation between the number of accidents causing work-time loss due to injuries and the total working hours of personnel over a year. Traditionally, this has been calculated based on one million working hours, but the American Occupational Safety and Health Organization has updated its standards. The new coefficient of 200/000 working hours is now used to compute the frequency rate of accidents. It's crucial to ensure that the total working hours of employees are equally represented when calculating individual event and incident numbers. The accident severity rate is a metric used to determine the amount of time lost or wasted during a given period, often a year, in relation to the total number of working hours. It measures the percentage of work hours lost or wasted compared to the total number of useful working hours, which provides valuable insight into the number of days lost or wasted due to work-related incidents for each working hour. Calculating the severity of an incident can be difficult if a worker suffers permanent disability or death. To determine lost days, coefficients specified in the "tables of days equivalent to OSHA or ANSI standards" for disabling injuries are used. The accident frequency coefficient denotes the rate at which accidents occur, while the accident severity coefficient specifies the extent of damage and injury caused by these accidents. These coefficients are crucial in accurately assessing the magnitude and impact of accidents.

Keywords: incidents, safety, analysis, frequency, severity, injuries, determine

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Authors: Renata Markiewicz-Żukowska, Patryk Nowakowski, Sylwia K. Naliwajko, Jakub M. Bołtryk, Katarzyna Socha, Anna Puścion-Jakubik, Jolanta Soroczyńska, Maria H. Borawska

Abstract:

Selenium (Se) is an essential element for human health. As an integral part of glutathione peroxidase, it has antioxidant, anti-inflammatory and anticancer activities. Unfortunately, Se dietary intake is often insufficient, especially in regions where the soil is low in Se. Therefore, in search for good sources of Se, the content of this element in food products should be monitored. Food product can be considered as a source of Se when its standard portion covers above 15% of recommended daily allowance. In the case of nuts, 42g is recognized as the standard portion. The aim of this study was to determine the Se content in nuts and to answer the question of whether the studied nuts can be considered as a source of Se in the diet. The material for the study consisted of 10 types of nuts (12 samples of each one): almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios and walnuts. The nuts were mineralized using microwave technique (Berghof, Germany). The content of Se was determined by atomic absorption spectrometry method with electrothermal atomization in a graphite tube with Zeeman background correction (Hitachi, Japan). The accuracy of the method was verified on certified reference material: Simulated Diet D. The statistical analysis was performed using Statistica v. 13.0 software. Statistical significance was determined at p < 0.05 level. The highest content of Se was found in Brazil nuts (4566.21 ± 3393.9 µg/kg) and the lowest in almonds (36.07 ± 18.8 µg/kg). A standard portion (42g) of almonds, brazil nuts, cashews, hazelnuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios and walnuts covers the recommended daily allowance for Se respectively in: 2, 192, 28, 2, 16, 7, 4, 3, 12, 6%. Brazil nuts, cashews and macadamia nuts can be considered as a good source of Se in diet.

Keywords: atomic absorption spectrometry, diet, nuts, selenium

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Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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Authors: Maryam Firouzmandi, Moosa Miri

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Smile is considered to be one of the most effective methods of influencing people. Increasing numbers of patients are requesting cosmetic dental procedures to achieve the perfect smile. Based on the patient’s age, oral and facial characteristics, and the dentist’s expertise, different concepts of treatment would be available. Orthodontics is the most conservative and the ideal treatment alternative for crowded anterior teeth; however, it may be rejected by patients due to occupational limitations of time, physical discomfort including pain and functional limitations, psychological discomfort, and appearance during treatment. In addition, orthodontic treatment will not resolve deficits of contour and color of the anterior teeth. In consequence, patients may demand restorative techniques to resolve their anterior mal-alignment instead, often called "instant orthodontics". Following its introduction, however, adhesive dentistry has suffered at times from overuse. Creating short-term attractive smiles at the expense of long-term dental health and optimal tooth biomechanics by using cosmetic techniques should not be considered an ethical approach. The objective of this narrative review was to investigate the literature for guidelines with regard to decision making and treatment planning for anterior tooth mal-alignment. In this regard, indications of orthodontic, restorative, combination of both treatments, and adjunctive periodontal surgery were discussed in clinical cases to achieve a proportional smile. Restorative modalities would include disking, cosmetic contouring, veneers, and crowns and were compared with limited or comprehensive orthodontic options. A rapid review was also presented on pros and cons of snap on smile to mask malalignments. Diagnostic tools such as mock up, wax up, and digital smile design were also considered to achieve more conservative and functional treatments with respect to biologic factors.

Keywords: crowding, misalignment, veneer, crown, orthodontics

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Authors: Harumi Katayama, Mina Suzuki, Taeko Muramatsu, Yui Shimogawa, Yoshimi Mizushima, Mitsuo Hiramatsu, Kimitsugu Nakamura, Takeshi Suzue

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Purpose: There are very often footbaths in the hot-spring area as culture from old days in Japan. This culture moderately supported mental and physical health among people. In Japanese hospitals, nurses provide footbath for severe patients to mental comfortable. However, there are only a few evidences effect of footbath for mental comfortable. In this presentation, we show the effect of stress relief of the footbath using biomarker among 35 college students in volunteer. Methods: The experiment was designed in two groups of the footbath group and the simple relaxation group randomly. As mental load, Kraepelin test was given to the students beforehand. Ultra-weak chemiluminescence (UCL) in saliva and self-administered liner scale measurable emotional state were measured on four times concurrently; there is before and after the mental load, after the stress relief, and 30 minutes after the stress relief. The scale that measured emotional state was consisted of 7 factors; there is excitement, relaxation, vigorous, fatigue, tension, calm, and sleepiness with 22 items. ANOVA was calculated effect of the footbath for stress relief. Results: The level of UCL (photons/100sec) was significantly increased in response on both groups after mental load. After the two types of stress relief, UCL (photons/100sec) of footbath group was significantly decreased compared to simple relaxation group. Score of sleepiness and relaxation were significantly increased after the stress relief in the footbath group than the simple relaxation group. However, score of excitement, vigorous, tension, and calm were exhibit the same degree of decrease after the stress relief on both group. Conclusion: It was suggested that salivary UCL may be a sensitive biomarker for mild stress relief as nursing care. In the future, we will measure using UCL to evaluate as stress relief for inpatients, outpatients, or general public as the subjects.

Keywords: bio-marker, footbath, Japan, stress relief

Procedia PDF Downloads 320

Authors: Jae-Il Jeong, Hoon-Jae Park, Jung-Woo Cho, Yang-Gon Kim, Jin-Young Park, Joo-Young Oh, Si-Geun Choi, Seock-Sam Kim, Young Tae Cho, Chan Gyu Kim, Jong-Hyoung Kim

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Bearing component has strongly required to decrease vibration and wear to achieve high durability and life time. In the industry field, bearing durability is improved by surface treatment on the bearing surface by centrifugal casting or gravity casting production method. However, this manufacturing method has caused problems such as long processing time, defect rate, and health harmful effect. To solve this problem, there is a laser cladding deposition treatment, which provides fast processing and food adhesion. Therefore, optimum conditions of white metal laser deposition should be studied to minimize bearing contact axis wear using laser cladding techniques. In this study, we deposit a soft white metal layer on SCM440, which is mainly used for shaft and bolt. On laser deposition process, the laser power and powder feed rate and laser head speed factors are controlled to find out the optimal conditions. We also measure hardness using micro Vickers, analyze FE-SEM (Field Emission Scanning Electron Microscope) and EDS (Energy Dispersive Spectroscopy) to study the mechanical properties and surface characteristics with various parameters change. Furthermore, this paper suggests the optimum condition of laser cladding deposition to apply in industrial fields. This work was supported by the Industrial Innovation Project of the Korea Evaluation Institute of Industrial Technology (KEIT) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (Research no. 10051653).

Keywords: laser deposition, bearing, white metal, mechanical properties

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Authors: Anne Klimesch, Alejandra Martinez, Martin HäRter, Isabelle Scholl, Paulina Bravo

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Patient-centered care (PCC) is a key principle of high-quality healthcare. In Latin America, research on and promotion of PCC have taken place in the past. However, thorough implementation of PCC in practice is still missing. In Germany, an integrative model of patient-centeredness has been developed by synthesis of diverse concepts of PCC. The model could serve as a point of reference for further research on the implementation of PCC. However, it is predominantly based on research from Europe and North America. This scoping review, therefore, aims to accumulate research on PCC in Latin America in the past 15 years and analyse how PCC has been conceptualized. The resulting overview of PCC in Latin America will be a foundation for a subsequent study aiming at the adaptation of the integrative model of patient-centeredness to the Latin American health care context. Scientific databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, SCIELO, Redalyc.) will be searched, and reference and citation tracking will be performed. Studies will be included if they were carried out in Latin America, investigated PCC in any clinical and community setting (public and private), and were published in English, Spanish, French, or Portuguese since 2006. Furthermore, any theoretical framework or conceptual model to guide how PCC is conceptualized in Latin America will be included. Two reviewers will be responsible for the identification of articles, screening of records, and full-text assessment. The results of the scoping review will be used in the development of a mixed-methods study with the aim to understand the needs for PCC, as well as barriers and facilitators in Latin America. Based on the outcomes, the integrative model of PCC will be translated to Spanish and adapted to the Latin American context. The integrative model will enable the dissemination of the concept of PCC in Latin America and will provide a common ground for further research on the topic. The project will thereby make an important contribution to an evidence-based implementation of PCC in Latin America.

Keywords: conceptual framework, integrative model of PCC, Latin America, patient-centered care

Procedia PDF Downloads 185