Search results for: improving and creating advanced knowledge of concepts
548 Plotting of an Ideal Logic versus Resource Outflow Graph through Response Analysis on a Strategic Management Case Study Based Questionnaire
Authors: Vinay A. Sharma, Shiva Prasad H. C.
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The initial stages of any project are often observed to be in a mixed set of conditions. Setting up the project is a tough task, but taking the initial decisions is rather not complex, as some of the critical factors are yet to be introduced into the scenario. These simple initial decisions potentially shape the timeline and subsequent events that might later be plotted on it. Proceeding towards the solution for a problem is the primary objective in the initial stages. The optimization in the solutions can come later, and hence, the resources deployed towards attaining the solution are higher than what they would have been in the optimized versions. A ‘logic’ that counters the problem is essentially the core of the desired solution. Thus, if the problem is solved, the deployment of resources has led to the required logic being attained. As the project proceeds along, the individuals working on the project face fresh challenges as a team and are better accustomed to their surroundings. The developed, optimized solutions are then considered for implementation, as the individuals are now experienced, and know better of the consequences and causes of possible failure, and thus integrate the adequate tolerances wherever required. Furthermore, as the team graduates in terms of strength, acquires prodigious knowledge, and begins its efficient transfer, the individuals in charge of the project along with the managers focus more on the optimized solutions rather than the traditional ones to minimize the required resources. Hence, as time progresses, the authorities prioritize attainment of the required logic, at a lower amount of dedicated resources. For empirical analysis of the stated theory, leaders and key figures in organizations are surveyed for their ideas on appropriate logic required for tackling a problem. Key-pointers spotted in successfully implemented solutions are noted from the analysis of the responses and a metric for measuring logic is developed. A graph is plotted with the quantifiable logic on the Y-axis, and the dedicated resources for the solutions to various problems on the X-axis. The dedicated resources are plotted over time, and hence the X-axis is also a measure of time. In the initial stages of the project, the graph is rather linear, as the required logic will be attained, but the consumed resources are also high. With time, the authorities begin focusing on optimized solutions, since the logic attained through them is higher, but the resources deployed are comparatively lower. Hence, the difference between consecutive plotted ‘resources’ reduces and as a result, the slope of the graph gradually increases. On an overview, the graph takes a parabolic shape (beginning on the origin), as with each resource investment, ideally, the difference keeps on decreasing, and the logic attained through the solution keeps increasing. Even if the resource investment is higher, the managers and authorities, ideally make sure that the investment is being made on a proportionally high logic for a larger problem, that is, ideally the slope of the graph increases with the plotting of each point.Keywords: decision-making, leadership, logic, strategic management
Procedia PDF Downloads 108547 Targeting Tumour Survival and Angiogenic Migration after Radiosensitization with an Estrone Analogue in an in vitro Bone Metastasis Model
Authors: Jolene M. Helena, Annie M. Joubert, Peace Mabeta, Magdalena Coetzee, Roy Lakier, Anne E. Mercier
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Targeting the distant tumour and its microenvironment whilst preserving bone density is important in improving the outcomes of patients with bone metastases. 2-Ethyl-3-O-sulphamoyl-estra1,3,5(10)16-tetraene (ESE-16) is an in-silico-designed 2- methoxyestradiol analogue which aimed at enhancing the parent compound’s cytotoxicity and providing a more favourable pharmacokinetic profile. In this study, the potential radiosensitization effects of ESE-16 were investigated in an in vitro bone metastasis model consisting of murine pre-osteoblastic (MC3T3-E1) and pre-osteoclastic (RAW 264.7) bone cells, metastatic prostate (DU 145) and breast (MDA-MB-231) cancer cells, as well as human umbilical vein endothelial cells (HUVECs). Cytotoxicity studies were conducted on all cell lines via spectrophotometric quantification of 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide. The experimental set-up consisted of flow cytometric analysis of cell cycle progression and apoptosis detection (Annexin V-fluorescein isothiocyanate) to determine the lowest ESE-16 and radiation doses to induce apoptosis and significantly reduce cell viability. Subsequent experiments entailed a 24-hour low-dose ESE-16-exposure followed by a single dose of radiation. Termination proceeded 2, 24 or 48 hours thereafter. The effect of the combination treatment was investigated on osteoclasts via tartrate-resistant acid phosphatase (TRAP) activity- and actin ring formation assays. Tumour cell experiments included investigation of mitotic indices via haematoxylin and eosin staining; pro-apoptotic signalling via spectrophotometric quantification of caspase 3; deoxyribonucleic acid (DNA) damage via micronuclei analysis and histone H2A.X phosphorylation (γ-H2A.X); and Western blot analyses of bone morphogenetic protein-7 and matrix metalloproteinase-9. HUVEC experiments included flow cytometric quantification of cell cycle progression and free radical production; fluorescent examination of cytoskeletal morphology; invasion and migration studies on an xCELLigence platform; and Western blot analyses of hypoxia-inducible factor 1-alpha and vascular endothelial growth factor receptor 1 and 2. Tumour cells yielded half-maximal growth inhibitory concentration (GI50) values in the nanomolar range. ESE-16 concentrations of 235 nM (DU 145) and 176 nM (MDA-MB-231) and a radiation dose of 4 Gy were found to be significant in cell cycle and apoptosis experiments. Bone and endothelial cells were exposed to the same doses as DU 145 cells. Cytotoxicity studies on bone cells reported that RAW 264.7 cells were more sensitive to the combination treatment than MC3T3-E1 cells. Mature osteoclasts were more sensitive than pre-osteoclasts with respect to TRAP activity. However, actin ring morphology was retained. The mitotic arrest was evident in tumour and endothelial cells in the mitotic index and cell cycle experiments. Increased caspase 3 activity and superoxide production indicated pro-apoptotic signalling in tumour and endothelial cells. Increased micronuclei numbers and γ-H2A.X foci indicated increased DNA damage in tumour cells. Compromised actin and tubulin morphologies and decreased invasion and migration were observed in endothelial cells. Western blot analyses revealed reduced metastatic and angiogenic signalling. ESE-16-induced radiosensitization inhibits metastatic signalling and tumour cell survival whilst preferentially preserving bone cells. This low-dose combination treatment strategy may promote the quality of life of patients with metastatic bone disease. Future studies will include 3-dimensional in-vitro and murine in-vivo models.Keywords: angiogenesis, apoptosis, bone metastasis, cancer, cell migration, cytoskeleton, DNA damage, ESE-16, radiosensitization.
Procedia PDF Downloads 160546 A Multi-Perspective, Qualitative Study into Quality of Life for Elderly People Living at Home and the Challenges for Professional Services in the Netherlands
Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar
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In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning
Procedia PDF Downloads 128545 A Therapeutic Approach for Bromhidrosis with Glycopyrrolate 2% Cream: Clinical Study of 20 Patients
Authors: Vasiliki Markantoni, Eftychia Platsidaki, Georgios Chaidemenos, Georgios Kontochristopoulos
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Introduction: Bromhidrosis, also known as osmidrosis, is a common distressing condition with a significant negative effect on patient’s quality of life. Its etiology is multifactorial. It usually affects axilla, genital skin, breasts and soles, areas where apocrine glands are mostly distributed. Therapeutic treatments include topical antibacterial agents, antiperspirants and neuromuscular blocker agents-toxins. In this study, we aimed to evaluate the efficacy and possible complications of topical glycopyrrolate, an anticholinergic agent, for treatment of bromhidrosis. Glycopyrrolate, applied topically as a cream, solution or spray at concentrations between 0,5% and 4%, has been successfully used to treat different forms of focal hyperhidrosis. Materials and Methods: Twenty patients, six males and fourteen females, meeting the criteria for bromhidrosis were treated with topical glycopyrrolate for two months. The average age was 36. Eleven patients had bromhidrosis located to the axillae, four to the soles, four to both axillae and soles and one to the genital folds. Glycopyrrolate was applied topically as a cream at concentration 2%, formulated in Fitalite. During the first month, patients were using the cream every night and thereafter twice daily. The degree of malodor was assessed subjectively by patients and scaled averagely as ‘none’, ‘mild’, ‘moderate’, and ‘severe’ with corresponding scores of 0, 1, 2, and 3, respectively. The modified Dermatology Life Quality Index (DLQI) was used to assess the quality of life. The clinical efficacy was graded by the patient scale of excellent, good, fair and poor. In the end, patients were given the power to evaluate whether they were totally satisfied with, partially satisfied or unsatisfied and possible side effects during the treatment were recorded. Results: All patients were satisfied at the end of the treatment. No patient defined the response as no improvement. The subjectively assessed score level of bromhidrosis was remarkably improved after the first month of treatment and improved slightly more after the second month. DLQI score was also improved to all patients. Adverse effects were reported in 2 patients. In the first case, topical irritation was reported. This was classed as mild (erythema and desquamation), appeared during the second month of treatment and was treated with low-potency topical corticosteroids. In the second case, mydriasis was reported, that recovered without specific treatment, as soon as we insisted to the importance of careful hygiene after cream application so as not to contaminate the periocular skin or ocular surface. Conclusions: Dermatologists often encounter patients with bromhidrosis, therefore should be aware of treatment options. To the best of our knowledge, this is the first study to evaluate the use of topical glycopyrrolate as a therapeutic approach for bromhidrosis. Our findings suggest that topical glycopyrrolate has an excellent safety profile and demonstrate encouraging results for the management of this distressful condition.Keywords: Bromhidrosis, glycopyrrolate, topical treatment, osmidrosis
Procedia PDF Downloads 165544 Effects of the Age, Education, and Mental Illness Experience on Depressive Disorder Stigmatization
Authors: Soowon Park, Min-Ji Kim, Jun-Young Lee
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Motivation: The stigma of mental illness has been studied in many disciplines, including social psychology, counseling psychology, sociology, psychiatry, public health care, and related areas, because individuals labeled as ‘mentally ill’ are often deprived of their rights and their life opportunities. To understand the factors that deepen the stigma of mental illness, it is important to understand the influencing factors of the stigma. Problem statement: Depression is a common disorder in adults, but the incidence of help-seeking is low. Researchers have believed that this poor help-seeking behavior is related to the stigma of mental illness, which results from low mental health literacy. However, it is uncertain that increasing mental health literacy decreases mental health stigmatization. Furthermore, even though decreasing stigmatization is important, the stigma of mental illness is still a stable and long-lasting phenomenon. Thus, factors other than knowledge about mental disorders have the power to maintain the stigma. Investigating the influencing factors that facilitate the stigma of psychiatric disease could help lower the social stigmatization. Approach: Face-to-face interviews were conducted with a multi-clustering sample. A total of 700 Korean participants (38% male), ranging in age from 18 to 78 (M(SD)age= 48.5(15.7)) answered demographical questions, Korean version of Link’s Perceived Devaluation and Discrimination (PDD) scale for the assessment of social stigmatization against depression, and the Korean version of the WHO-Composite International Diagnostic Interview for the assessment of mental disorders. Multiple-regression was conducted to find the predicting factors of social stigmatization against depression. Ages, sex, years of education, income, living location, and experience of mental illness were used as the predictors. Results: Predictors accounted for 14% of the variance in the stigma of depressive disorders (F(6, 693) = 20.27, p < .001). Among those, only age, years of education, and experience of mental illness significantly predicted social stigmatization against depression. The standardized regression coefficient of age had a negative association with stigmatization (β = -.20, p < .001), but years of education (β = .20, p < .001) and experience of mental illness (β = .08, p < .05) positively predicted depression stigmatization. Conclusions: The present study clearly demonstrates the association between personal factors and depressive disorder stigmatization. Younger age, more education, and self-stigma appeared to increase the stigmatization. Young, highly educated, and mentally ill people tend to reject patients with depressive disorder as friends, teachers, or babysitters; they also tend to think that those patients have lower intelligence and abilities. These results suggest the possibility that people from a high social class, or highly educated people, who have the power to make decisions, help maintain the social stigma against mental illness patients. To increase the awareness that people from high social classes have more stigmatization against depressive disorders will help decrease the biased attitudes against mentally ill patients.Keywords: depressive disorder stigmatization, age, education, self-stigma
Procedia PDF Downloads 403543 Development of International Entry-Level Nursing Competencies to Address the Continuum of Substance Use
Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell
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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use
Procedia PDF Downloads 175542 Erasmus+ Program in Vocational Education: Effects of European International Mobility in Portuguese Vocational Schools
Authors: José Carlos Bronze, Carlinda Leite, Angélica Monteiro
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The creation of the Erasmus Program in 1987 represented a milestone in promoting and funding international mobility in higher education in Europe. Its effects were so significant that they influenced the creation of the European Higher Education Area through the Bologna Process and ensured the program’s continuation and maintenance. Over the last decades, the escalating figures of participants and funds instigated significant scientific studies on the program's effects on higher education. More recently, in 2014, the program was renamed “Erasmus+” when it expanded into other fields of education, namely Vocational Education and Training (VET). Despite being now running in this field of education for a decade (2014-2024), its effects on VET remain less studied and less known, while the higher education field keeps attracting researchers’ attention. Given this gap, it becomes relevant to study the effects of E+ on VET, particularly in the priority domains of the Program: “Inclusion and Diversity,” “Participation in Democratic Life, Common Values and Civic Engagement,” “Environment and Fight Against Climate Change,” and “Digital Transformation.” This latter has been recently emphasized due to the COVID-19 pandemic that forced the so-called emergency remote teaching, leading schools to quickly transform and adapt to a new reality regardless of the preparedness levels of teachers and students. Together with the remaining E+ priorities, they directly relate to an emancipatory perspective of education sustained in soft skills such as critical thinking, intercultural awareness, autonomy, active citizenship, teamwork, and problem-solving, among others. Based on this situation, it is relevant to know the effects of E+ on the VET field, namely questioning how international mobility instigates digitalization processes and supports emancipatory queries therein. As an education field that more directly connects to hard skills and an instrumental approach oriented to the labor market’s needs, a study was conducted to determine the effects of international mobility on developing digital literacy and soft skills in the VET field. In methodological terms, the study used semi-structured interviews with teaching and non-teaching staff from three VET schools who are strongly active in the E+ Program. The interviewees were three headmasters, four mobility project managers, and eight teachers experienced in international mobility. The data was subjected to qualitative content analysis using the NVivo 14 application. The results show that E+ international mobility promotes and facilitates the use of digital technologies as a pedagogical resource at VET schools and enhances and generates students’ soft skills. In conclusion, E+ mobility in the VET field supports adopting the program’s priorities by increasing the teachers’ knowledge and use of digital resources and amplifying and generating participants’ soft skills.Keywords: Erasmus international mobility, digital literacy, soft skills, vocational education and training
Procedia PDF Downloads 31541 Deep Convolutional Neural Network for Detection of Microaneurysms in Retinal Fundus Images at Early Stage
Authors: Goutam Kumar Ghorai, Sandip Sadhukhan, Arpita Sarkar, Debprasad Sinha, G. Sarkar, Ashis K. Dhara
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Diabetes mellitus is one of the most common chronic diseases in all countries and continues to increase in numbers significantly. Diabetic retinopathy (DR) is damage to the retina that occurs with long-term diabetes. DR is a major cause of blindness in the Indian population. Therefore, its early diagnosis is of utmost importance towards preventing progression towards imminent irreversible loss of vision, particularly in the huge population across rural India. The barriers to eye examination of all diabetic patients are socioeconomic factors, lack of referrals, poor access to the healthcare system, lack of knowledge, insufficient number of ophthalmologists, and lack of networking between physicians, diabetologists and ophthalmologists. A few diabetic patients often visit a healthcare facility for their general checkup, but their eye condition remains largely undetected until the patient is symptomatic. This work aims to focus on the design and development of a fully automated intelligent decision system for screening retinal fundus images towards detection of the pathophysiology caused by microaneurysm in the early stage of the diseases. Automated detection of microaneurysm is a challenging problem due to the variation in color and the variation introduced by the field of view, inhomogeneous illumination, and pathological abnormalities. We have developed aconvolutional neural network for efficient detection of microaneurysm. A loss function is also developed to handle severe class imbalance due to very small size of microaneurysms compared to background. The network is able to locate the salient region containing microaneurysms in case of noisy images captured by non-mydriatic cameras. The ground truth of microaneurysms is created by expert ophthalmologists for MESSIDOR database as well as private database, collected from Indian patients. The network is trained from scratch using the fundus images of MESSIDOR database. The proposed method is evaluated on DIARETDB1 and the private database. The method is successful in detection of microaneurysms for dilated and non-dilated types of fundus images acquired from different medical centres. The proposed algorithm could be used for development of AI based affordable and accessible system, to provide service at grass root-level primary healthcare units spread across the country to cater to the need of the rural people unaware of the severe impact of DR.Keywords: retinal fundus image, deep convolutional neural network, early detection of microaneurysms, screening of diabetic retinopathy
Procedia PDF Downloads 140540 Attachment Theory and Quality of Life: Grief Education and Training
Authors: Jane E. Hill
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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.Keywords: counselor education and training, grief education and training, grief and loss, quality of life
Procedia PDF Downloads 191539 Genetics of Pharmacokinetic Drug-Drug Interactions of Most Commonly Used Drug Combinations in the UK: Uncovering Unrecognised Associations
Authors: Mustafa Malki, Ewan R. Pearson
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Tools utilized by health care practitioners to flag potential adverse drug reactions secondary to drug-drug interactions ignore individual genetic variation, which has the potential to markedly alter the severity of these interactions. To our best knowledge, there have been limited published studies on the impact of genetic variation on drug-drug interactions. Therefore, our aim in this project is the discovery of previously unrecognized, clinically important drug-drug-gene interactions (DDGIs) within the list of most commonly used drug combinations in the UK. The UKBB database was utilized to identify the top most frequently prescribed drug combinations in the UK with at least one route of interaction (over than 200 combinations were identified). We have recognised 37 common and unique interacting genes considering all of our drug combinations. Out of around 600 potential genetic variants found in these 37 genes, 100 variants have met the selection criteria (common variant with minor allele frequency ≥ 5%, independence, and has passed HWE test). The association between these variants and the use of each of our top drug combinations has been tested with a case-control analysis under the log-additive model. As the data is cross-sectional, drug intolerance has been identified from the genotype distribution as presented by the lower percentage of patients carrying the risky allele and on the drug combination compared to those free of these risk factors and vice versa with drug tolerance. In GoDARTs database, the same list of common drug combinations identified by the UKBB was utilized here with the same list of candidate genetic variants but with the addition of 14 new SNPs so that we have a total of 114 variants which have met the selection criteria in GoDARTs. From the list of the top 200 drug combinations, we have selected 28 combinations where the two drugs in each combination are known to be used chronically. For each of our 28 combinations, three drug response phenotypes have been identified (drug stop/switch, dose decrease, or dose increase of any of the two drugs during their interaction). The association between each of the three phenotypes belonging to each of our 28 drug combinations has been tested against our 114 candidate genetic variants. The results show replication of four findings between both databases : (1) Omeprazole +Amitriptyline +rs2246709 (A > G) variant in CYP3A4 gene (p-values and ORs with the UKBB and GoDARTs respectively = 0.048,0.037,0.92,and 0.52 (dose increase phenotype)) (2) Simvastatin + Ranitidine + rs9332197 (T > C) variant in CYP2C9 gene (0.024,0.032,0.81, and 5.75 (drug stop/switch phenotype)) (3) Atorvastatin + Doxazosin + rs9282564 (T > C) variant in ABCB1 gene (0.0015,0.0095,1.58,and 3.14 (drug stop/switch phenotype)) (4) Simvastatin + Nifedipine + rs2257401 (C > G) variant in CYP3A7 gene (0.025,0.019,0.77,and 0.30 (drug stop/switch phenotype)). In addition, some other non-replicated, but interesting, significant findings were detected. Our work also provides a great source of information for researchers interested in DD, DG, or DDG interactions studies as it has highlighted the top common drug combinations in the UK with recognizing 114 significant genetic variants related to drugs' pharmacokinetic.Keywords: adverse drug reactions, common drug combinations, drug-drug-gene interactions, pharmacogenomics
Procedia PDF Downloads 162538 Biocultural Biographies and Molecular Memories: A Study of Neuroepigenetics and How Trauma Gets under the Skull
Authors: Elsher Lawson-Boyd
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In the wake of the Human Genome Project, the life sciences have undergone some fascinating changes. In particular, conventional beliefs relating to gene expression are being challenged by advances in postgenomic sciences, especially by the field of epigenetics. Epigenetics is the modification of gene expression without changes in the DNA sequence. In other words, epigenetics dictates that gene expression, the process by which the instructions in DNA are converted into products like proteins, is not solely controlled by DNA itself. Unlike gene-centric theories of heredity that characterized much of the 20th Century (where the genes were considered as having almost god-like power to create life), gene expression in epigenetics insists on environmental ‘signals’ or ‘exposures’, a point that radically deviates from gene-centric thinking. Science and Technology Studies (STS) scholars have shown that epigenetic research is having vast implications for the ways in which chronic, non-communicable diseases are conceptualized, treated, and governed. However, to the author’s knowledge, there have not yet been any in-depth sociological engagements with neuroepigenetics that examine how the field is affecting mental health and trauma discourse. In this paper, the author discusses preliminary findings from a doctoral ethnographic study on neuroepigenetics, trauma, and embodiment. Specifically, this study investigates the kinds of causal relations neuroepigenetic researchers are making between experiences of trauma and the development of mental illnesses like complex post-traumatic stress disorder (PTSD), both throughout a human’s lifetime and across generations. Using qualitative interviews and nonparticipant observation, the author focuses on two public-facing research centers based in Melbourne: Florey Institute of Neuroscience and Mental Health (FNMH), and Murdoch Children’s Research Institute (MCRI). Preliminary findings indicate that a great deal of ambiguity characterizes this infant field, particularly when animal-model experiments are employed and the results are translated into human frameworks. Nevertheless, researchers at the FNMH and MCRI strongly suggest that adverse and traumatic life events have a significant effect on gene expression, especially when experienced during early development. Furthermore, they predict that neuroepigenetic research will have substantial implications for the ways in which mental illnesses like complex PTSD are diagnosed and treated. These preliminary findings shed light on why medical and health sociologists have good reason to be chiming in, engaging with and de-black-boxing ideations emerging from postgenomic sciences, as they may indeed have significant effects for vulnerable populations not only in Australia but other developing countries in the Global South.Keywords: genetics, mental illness, neuroepigenetics, trauma
Procedia PDF Downloads 124537 Health Counseling in the Republic of Estonia through Magazines (1930 – 1940): Striving for a European Lifestyle
Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ulle Ernits
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Background data. This is a study in the field of health humanities. The 1930s were years of rapid cultural and economic development in Europe and in Estonia. The urban way of life the glamorous lifestyle gained popularity, although the society of Estonia in the 1930s had traditionally been agrarian. People's free time increased, which needed to be filled with activities either at home or outside the home. Therefore, the number of popular magazines aimed at housewives increased. More than 200 magazines and bulletins were published in the Republic of Estonia before the Second World War (in 1934, the population of Estonia was 1,126,000). In the 1930s, the Republic of Estonia faced several challenges in healthcare. Infectious diseases, alcoholism, prostitution and child mortality had to be dealt with. Healers without medical education operated in the villages. For the average person, medical care was quite expensive, and despite efforts, by 1940, only 20% of the population was covered by health insurance. Advice published in popular family magazines provided help in solving, understanding and preventing health problems. Aim. The aim of the study is to analyze the health counseling through magazines during the Republic of Estonia (1930-1940) in historical and cultural context. Method. In total, 420 magazine issues were processed. An extensive textual analysis, as well as an analysis of photographs and illustrations from the aspect of health advice was carried out to achieve the research objective. Results. Health counseling was written by well-known doctors of the time, leaders of the abstinence movement and others. There was advice in various areas: prevention of infectious and non-infectious diseases and their treatment with simple methods, first aid, combating sexually transmitted diseases, women's and children's health, mental health, folk medicine techniques, abstinence, healthy eating, skin care, hygiene, introducing pharmacy products. Advice was offered in both written and visual form. Photos and illustrations helped to empower the health advice. Folk heritage and health knowledge of the time were relied upon, and a scientific point of view was popularized. Aspirations towards a European lifestyle were reflected in articles and illustrations. Contribution. The article has an ethnological attitude, and its impact comes down to understanding the history of health care in its socio-cultural context. The health counseling topics of the 1930s are also applicable in today's health education and research. Health counseling builds on the legacy of the past, and it helps to understand that the past is in the future and the main principles of health counseling arise from our history and background.Keywords: estonian republic, health counseling, lifestyle, magazines, media
Procedia PDF Downloads 63536 Swedish Police Officers' Experiences of Meeting with Women Who Were Raped
Authors: Lisa Rudolfsson
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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.Keywords: focus groups, police, raped women, restoration
Procedia PDF Downloads 120535 Acquisition of Murcian Lexicon and Morphology by L2 Spanish Immigrants: The Role of Social Networks
Authors: Andrea Hernandez Hurtado
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Research on social networks (SNs) -- the interactions individuals share with others has shed important light in helping to explain differential use of variable linguistic forms, both in L1s and L2s. Nevertheless, the acquisition of nonstandard L2 Spanish in the Region of Murcia, Spain, and how learners interact with other speakers while sojourning there have received little attention. Murcian Spanish (MuSp) was widely influenced by Panocho, a divergent evolution of Hispanic Latin, and differs from the more standard Peninsular Spanish (StSp) in phonology, morphology, and lexicon. For instance, speakers from this area will most likely palatalize diminutive endings, producing animalico [̩a.ni.ma.ˈli.ko] instead of animalito [̩a.ni.ma.ˈli.to] ‘little animal’. Because L1 speakers of the area produce and prefer salient regional lexicon and morphology (particularly the palatalized diminutive -ico) in their speech, the current research focuses on how international residents in the Region of Murcia use Spanish: (1) whether or not they acquire (perceptively and/or productively) any of the salient regional features of MuSp, and (2) how their SNs explain such acquisition. This study triangulates across three tasks -recognition, production, and preference- addressing both lexicon and morphology, with each task specifically created for the investigation of MuSp features. Among other variables, the effects of L1, residence, and identity are considered. As an ongoing dissertation research, data are currently being gathered through an online questionnaire. So far, 7 participants from multiple nationalities have completed the survey, although a minimum of 25 are expected to be included in the coming months. Preliminary results revealed that MuSp lexicon and morphology were successfully recognized by participants (p<.001). In terms of regional lexicon production (10.0%) and preference (47.5%), although participants showed higher percentages of StSp, results showed that international residents become aware of stigmatized lexicon and may incorporate it into their language use. Similarly, palatalized diminutives (production 14.2%, preference 19.0%) were present in their responses. The Social Network Analysis provided information about participants’ relationships with their interactants, as well as among them. Results indicated that, generally, when residents were more immersed in the culture (i.e., had more Murcian alters) they produced and preferred more regional features. This project contributes to the knowledge of language variation acquisition in L2 speakers, focusing on a stigmatized Spanish dialect and exploring how stigmatized varieties may affect L2 development. Results will show how L2 Spanish speakers’ language is affected by their stay in Murcia. This, in turn, will shed light on the role of SNs in language acquisition, the acquisition of understudied and marginalized varieties, and the role of immersion on language acquisition. As the first systematic account on the acquisition of L2 Spanish lexicon and morphology in the Region of Murcia, it lays important groundwork for further research on the connection between SNs and the acquisition of regional variants, applicable to Murcia and beyond.Keywords: international residents, L2 Spanish, lexicon, morphology, nonstandard language acquisition, social networks
Procedia PDF Downloads 76534 VISMA: A Method for System Analysis in Early Lifecycle Phases
Authors: Walter Sebron, Hans Tschürtz, Peter Krebs
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The choice of applicable analysis methods in safety or systems engineering depends on the depth of knowledge about a system, and on the respective lifecycle phase. However, the analysis method chain still shows gaps as it should support system analysis during the lifecycle of a system from a rough concept in pre-project phase until end-of-life. This paper’s goal is to discuss an analysis method, the VISSE Shell Model Analysis (VISMA) method, which aims at closing the gap in the early system lifecycle phases, like the conceptual or pre-project phase, or the project start phase. It was originally developed to aid in the definition of the system boundary of electronic system parts, like e.g. a control unit for a pump motor. Furthermore, it can be also applied to non-electronic system parts. The VISMA method is a graphical sketch-like method that stratifies a system and its parts in inner and outer shells, like the layers of an onion. It analyses a system in a two-step approach, from the innermost to the outermost components followed by the reverse direction. To ensure a complete view of a system and its environment, the VISMA should be performed by (multifunctional) development teams. To introduce the method, a set of rules and guidelines has been defined in order to enable a proper shell build-up. In the first step, the innermost system, named system under consideration (SUC), is selected, which is the focus of the subsequent analysis. Then, its directly adjacent components, responsible for providing input to and receiving output from the SUC, are identified. These components are the content of the first shell around the SUC. Next, the input and output components to the components in the first shell are identified and form the second shell around the first one. Continuing this way, shell by shell is added with its respective parts until the border of the complete system (external border) is reached. Last, two external shells are added to complete the system view, the environment and the use case shell. This system view is also stored for future use. In the second step, the shells are examined in the reverse direction (outside to inside) in order to remove superfluous components or subsystems. Input chains to the SUC, as well as output chains from the SUC are described graphically via arrows, to highlight functional chains through the system. As a result, this method offers a clear and graphical description and overview of a system, its main parts and environment; however, the focus still remains on a specific SUC. It helps to identify the interfaces and interfacing components of the SUC, as well as important external interfaces of the overall system. It supports the identification of the first internal and external hazard causes and causal chains. Additionally, the method promotes a holistic picture and cross-functional understanding of a system, its contributing parts, internal relationships and possible dangers within a multidisciplinary development team.Keywords: analysis methods, functional safety, hazard identification, system and safety engineering, system boundary definition, system safety
Procedia PDF Downloads 223533 Seed Associated Microbial Communities of Holoparasitic Cistanche Species from Armenia and Portugal
Authors: K. Petrosyan, R. Piwowarczyk, K. Ruraż, S. Thijs, J. Vangronsveld, W. Kaca
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Holoparasitic plants are flowering heterotrophic angiosperms which with the help of an absorbing organ - haustorium, attach to another plant, the so-called the host. Due to the different hosts, unusual lifestyle, lack of roots, chlorophylls and photosynthesis, these plants are interesting and unique study objects for global biodiversity. The seeds germination of the parasitic plants also is unique: they germinate only in response to germination stimulants, namely strigolactones produced by the root of an appropriate host. Resistance of the seeds on different environmental conditions allow them to stay viable in the soil for more than 20 years. Among the wide range of plant protection mechanisms the endophytic communities have a specific role. In this way, they have the potential to mitigate the impacts of adverse conditions such as soil salinization. The major objective of our study was to compare the bacterial endo-microbiomes from seeds of two holoparasitic plants from Orobanchaceae family, Cistanche – C. armena (Armenia) and C. phelypaea (Portugal) – from saline habitats different in soil water status. The research aimed to perform how environmental conditions influence on the diversity of the bacterial communities of C. armena and C. phelypaea seeds. This was achieved by comparison of the endophytic microbiomes of two species and isolation of culturable bacteria. A combination of culture-dependent and molecular techniques was employed for the identification of the seed endomicrobiome (culturable and unculturable). Using the V3-V4 hypervariable region of the 16S rRNA gene, four main taxa were identified: Proteobacteria, Actinobacteria, Bacteroidetes, Firmicutes, but the relative proportion of the taxa was different in each type of seed. Generally, sixteen phyla, 323 genera and 710 bacterial species were identified, mainly Gram negative, halotolerant bacteria with an environmental origin. However, also some unclassified and unexplored taxonomic groups were found in the seeds of both plants. 16S rRNA gene sequencing analysis from both species identified the gram positive, endospore forming, halotolerant and alkaliphile Bacillus spp. which suggests that the endophytic bacteria of examined seeds possess traits that are correlated with the natural habitat of their hosts. The cultivable seed endophytes from C. armena and C. phelypaea were rather similar, notwithstanding the big distances between their growth habitats - Armenia and Portugal. Although the seed endophytic microbiomes of C. armena and C. phelypaea contain a high number of common bacterial taxa, also remarkable differences exist. We demonstrated that the environmental conditions or abiotic stresses influence on diversity of the bacterial communities of holoparasiotic seeds. To the best of our knowledge the research is the first report of endophytes from seeds of holoparasitic Cistanche armena and C. phelypaea plants.Keywords: microbiome, parasitic plant, salinity, seeds
Procedia PDF Downloads 71532 An Evaluation of the Artificial Neural Network and Adaptive Neuro Fuzzy Inference System Predictive Models for the Remediation of Crude Oil-Contaminated Soil Using Vermicompost
Authors: Precious Ehiomogue, Ifechukwude Israel Ahuchaogu, Isiguzo Edwin Ahaneku
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Vermicompost is the product of the decomposition process using various species of worms, to create a mixture of decomposing vegetable or food waste, bedding materials, and vemicast. This process is called vermicomposting, while the rearing of worms for this purpose is called vermiculture. Several works have verified the adsorption of toxic metals using vermicompost but the application is still scarce for the retention of organic compounds. This research brings to knowledge the effectiveness of earthworm waste (vermicompost) for the remediation of crude oil contaminated soils. The remediation methods adopted in this study were two soil washing methods namely, batch and column process which represent laboratory and in-situ remediation. Characterization of the vermicompost and crude oil contaminated soil were performed before and after the soil washing using Fourier transform infrared (FTIR), scanning electron microscopy (SEM), X-ray fluorescence (XRF), X-ray diffraction (XRD) and Atomic adsorption spectrometry (AAS). The optimization of washing parameters, using response surface methodology (RSM) based on Box-Behnken Design was performed on the response from the laboratory experimental results. This study also investigated the application of machine learning models [Artificial neural network (ANN), Adaptive neuro fuzzy inference system (ANFIS). ANN and ANFIS were evaluated using the coefficient of determination (R²) and mean square error (MSE)]. Removal efficiency obtained from the Box-Behnken design experiment ranged from 29% to 98.9% for batch process remediation. Optimization of the experimental factors carried out using numerical optimization techniques by applying desirability function method of the response surface methodology (RSM) produce the highest removal efficiency of 98.9% at absorbent dosage of 34.53 grams, adsorbate concentration of 69.11 (g/ml), contact time of 25.96 (min), and pH value of 7.71, respectively. Removal efficiency obtained from the multilevel general factorial design experiment ranged from 56% to 92% for column process remediation. The coefficient of determination (R²) for ANN was (0.9974) and (0.9852) for batch and column process, respectively, showing the agreement between experimental and predicted results. For batch and column precess, respectively, the coefficient of determination (R²) for RSM was (0.9712) and (0.9614), which also demonstrates agreement between experimental and projected findings. For the batch and column processes, the ANFIS coefficient of determination was (0.7115) and (0.9978), respectively. It can be concluded that machine learning models can predict the removal of crude oil from polluted soil using vermicompost. Therefore, it is recommended to use machines learning models to predict the removal of crude oil from contaminated soil using vermicompost.Keywords: ANFIS, ANN, crude-oil, contaminated soil, remediation and vermicompost
Procedia PDF Downloads 109531 Adapting Cyber Physical Production Systems to Small and Mid-Size Manufacturing Companies
Authors: Yohannes Haile, Dipo Onipede, Jr., Omar Ashour
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The main thrust of our research is to determine Industry 4.0 readiness of small and mid-size manufacturing companies in our region and assist them to implement Cyber Physical Production System (CPPS) capabilities. Adopting CPPS capabilities will help organizations realize improved quality, order delivery, throughput, new value creation, and reduced idle time of machines and work centers of their manufacturing operations. The key metrics for the assessment include the level of intelligence, internal and external connections, responsiveness to internal and external environmental changes, capabilities for customization of products with reference to cost, level of additive manufacturing, automation, and robotics integration, and capabilities to manufacture hybrid products in the near term, where near term is defined as 0 to 18 months. In our initial evaluation of several manufacturing firms which are profitable and successful in what they do, we found low level of Physical-Digital-Physical (PDP) loop in their manufacturing operations, whereas 100% of the firms included in this research have specialized manufacturing core competencies that have differentiated them from their competitors. The level of automation and robotics integration is low to medium range, where low is defined as less than 30%, and medium is defined as 30 to 70% of manufacturing operation to include automation and robotics. However, there is a significant drive to include these capabilities at the present time. As it pertains to intelligence and connection of manufacturing systems, it is observed to be low with significant variance in tying manufacturing operations management to Enterprise Resource Planning (ERP). Furthermore, it is observed that the integration of additive manufacturing in general, 3D printing, in particular, to be low, but with significant upside of integrating it in their manufacturing operations in the near future. To hasten the readiness of the local and regional manufacturing companies to Industry 4.0 and transitions towards CPPS capabilities, our working group (ADMAR Working Group) in partnership with our university have been engaged with the local and regional manufacturing companies. The goal is to increase awareness, share know-how and capabilities, initiate joint projects, and investigate the possibility of establishing the Center for Cyber Physical Production Systems Innovation (C2P2SI). The center is intended to support the local and regional university-industry research of implementing intelligent factories, enhance new value creation through disruptive innovations, the development of hybrid and data enhanced products, and the creation of digital manufacturing enterprises. All these efforts will enhance local and regional economic development and educate students that have well developed knowledge and applications of cyber physical manufacturing systems and Industry 4.0.Keywords: automation, cyber-physical production system, digital manufacturing enterprises, disruptive innovation, new value creation, physical-digital-physical loop
Procedia PDF Downloads 138530 Getting to Know ICU Nurses and Their Duties
Authors: Masih Nikgou
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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite
Procedia PDF Downloads 74529 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka
Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha
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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.Keywords: C-peptide, insulin, large for gestational age, maternal weight
Procedia PDF Downloads 166528 Factors Mitigating against the Use of Alternative to Antibiotics (Phytobiotics) In Poultry Production among Farming Households in Nigeria
Authors: Akinola Helen Olufunke, Soetan Olatunbosun Jonathan, Adeleye Oludamola
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Introduction: Antibiotic resistance has grown significantly, which is a major cause for concern. There have not been many significant developments in antibiotics over the past few decades, and practically all of the ones that are currently in use are losing effectiveness against pathogenic germs. Researchers are starting to focus more on the physiologically active compounds found in plants, particularly phytobiotics in poultry production. Consumption of chicken products is among the greatest in the country, but numerous nations, including Nigeria, use excessive amounts of necessary antibiotics in poultry farming, endangering the safety of such goods (through antimicrobial residues). Drug resistance has become a widespread issue as a result of the risky use of antibiotics in the chicken production industry. In order to replace antibiotics, biotic or natural products like phytobiotics (also known as botanicals or phytogenics) have drawn a lot of interest. Phytobiotics or their components are thought to be a relatively recent category of natural herbs that have acquired acceptance and favor among chicken farmers. The addition of several phytobiotic additions to poultry feed has demonstrated its capacity to improve both the broiler and layer populations' productivity. Design: Experimental research design and cross-sectional study was carried out at every 300 purposively selected farming household in the six-geopolitical zone in Nigeria. Data Analysis: A semi-structured questionnaire was administered to each farmer, and quantitative data were analyzed using Statistical Package for Social Science (SPSS) while the Chi-square test was used to analyze factors mitigating the use of Phytobiotics. Result: The result shows that the benefits associated with the use of phytobiotics are contributed to growth promotion in chickens and enhancement of productive performance of broiler and layer, which could be attributed to their antioxidant activity. The result further revealed that factors mitigating the use of phytobiotics were lack of knowledge in the use of phytobiotics, overdose or underdose usage, and seasonal availability of the phytobiotics. Others are the educational level of the farmers, intrinsic motivation, income poultry farming experience, price of phytobiotics based additives feeds, and intensity of extension agents in visiting them. Conclusion: The difficulties associated with using phytobiotics in chicken farms limit their willingness to boost productivity. The study found that most farmers were ignorant, which prevented them from handling this notion and turning their poultry into a viable enterprise while also allowing them to be creative. They believed that packing phytobiotics-based additive feed was expensive, and lastly, the seasonal availability of some phytobiotics. Recommendation: Further research in phytobiotics use in Nigeria should be carried out in order to establish its efficiency, safety, and awareness.Keywords: mitigating, antibiotics, phytobiotics, poultry farming
Procedia PDF Downloads 170527 Extraction of Rice Bran Protein Using Enzymes and Polysaccharide Precipitation
Authors: Sudarat Jiamyangyuen, Tipawan Thongsook, Riantong Singanusong, Chanida Saengtubtim
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Rice is a staple food as well as exported commodity of Thailand. Rice bran, a 10.5% constituent of rice grain, is a by-product of rice milling process. Rice bran is normally used as a raw material for rice bran oil production or sold as feed with a low price. Therefore, this study aimed to increase value of defatted rice bran as obtained after extracting of rice bran oil. Conventionally, the protein in defatted rice bran was extracted using alkaline extraction and acid precipitation, which results in reduction of nutritious components in rice bran. Rice bran protein concentrate is suitable for those who are allergenic of protein from other sources eg. milk, wheat. In addition to its hypoallergenic property, rice bran protein also contains good quantity of lysine. Thus it may act as a suitable ingredient for infant food formulations while adding variety to the restricted diets of children with food allergies. The objectives of this study were to compare properties of rice bran protein concentrate (RBPC) extracted from defatted rice bran using enzymes together with precipitation step using polysaccharides (alginate and carrageenan) to those of a control sample extracted using a conventional method. The results showed that extraction of protein from rice bran using enzymes exhibited the higher protein recovery compared to that extraction with alkaline. The extraction conditions using alcalase 2% (v/w) at 50 C, pH 9.5 gave the highest protein (2.44%) and yield (32.09%) in extracted solution compared to other enzymes. Rice bran protein concentrate powder prepared by a precipitation step using alginate (protein in solution: alginate 1:0.006) exhibited the highest protein (27.55%) and yield (6.62%). Precipitation using alginate was better than that of acid. RBPC extracted with alkaline (ALK) or enzyme alcalase (ALC), then precipitated with alginate (AL) (samples RBP-ALK-AL and RBP-ALC-AL) yielded the precipitation rate of 75% and 91.30%, respectively. Therefore, protein precipitation using alginate was then selected. Amino acid profile of control sample, and sample precipitated with alginate, as compared to casein and soy protein isolated, showed that control sample showed the highest content among all sample. Functional property study of RBP showed that the highest nitrogen solubility occurred in pH 8-10. There was no statically significant between emulsion capacity and emulsion stability of control and sample precipitated by alginate. However, control sample showed a higher of foaming and lower foam stability compared to those of sample precipitated with alginate. The finding was successful in terms of minimizing chemicals used in extraction and precipitation steps in preparation of rice bran protein concentrate. This research involves in a production of value-added product in which the double amount of protein (28%) compared to original amount (14%) contained in rice bran could be beneficial in terms of adding to food products eg. healthy drink with high protein and fiber. In addition, the basic knowledge of functional property of rice bran protein concentrate was obtained, which can be used to appropriately select the application of this value-added product from rice bran.Keywords: alginate, carrageenan, rice bran, rice bran protein
Procedia PDF Downloads 293526 Symphony of Healing: Exploring Music and Art Therapy’s Impact on Chemotherapy Patients with Cancer
Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia
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Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life
Procedia PDF Downloads 73525 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy
Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes
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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation
Procedia PDF Downloads 391524 Climate Change and Perceived Socialization: The Role of Parents’ Climate Change Coping Style and Household Communication
Authors: Estefanya Vazquez-Casaubon, Veroline Cauberghe, Dieneke Van de Sompel, Hayley Pearce
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Working together to reduce the anthropogenic impact should be a collective action, including effort within the household. In the matter, children are considered to have an important role in influencing the household to reduce the environmental impact through reversed socialization where children motivate and increase the concern of the parents towards environmental protection. Previous studies reveal that communication between parents and kids is key for effective reversed socialization. However, multiple barriers have been identified in the literature, such as the acceptance of the influence from the kids, the properties of the communication, among other factors. Based on the previous evidence, the present study aims to assess barriers and facilitators of communication at the household level that have an impact on reversed socialization. More precisely, the study examines how parents’ climate change coping strategy (problem-focused, meaning-focused, disregarding) influences the valence and the type of the communication related to climate change, and eventually the extent to which they report their beliefs and behaviours to be influenced by the pro-environmental perspectives of their children; i.e. reversed socialization. Via an online survey, 723 Belgian parents self-reported on communication about environmental protection and risk within their household (such as the frequency of exchange about topics related to climate change sourced from school, the household rules, imparting knowledge to the children, and outer factors like media or peer pressure, the emotional valence of the communication), their perceived socialization, and personal factors (coping mechanisms towards climate change). The results, using structural equation modelling, revealed that parents applying a problem-solving coping strategy related to climate change, appear to communicate more often in a positive than in a negative manner. Parents with a disregarding coping style towards climate change appear to communicate less often in a positive way within the household. Parents that cope via meaning-making of climate change showed to communicate less often in either a positive or negative way. Moreover, the perceived valence of the communication (positive or negative) influenced the frequency and type of household communication. Positive emotions increased the frequency of the communication overall. However, the direct effect of neither of the coping mechanisms on the reversed socialization was significant. High frequency of communication about the media, environmental views of the household members among other external topics had a positive impact on the perceived socialization, followed by discussions school-related; while parental instructing had a negative impact on the perceived socialization. Moreover, the frequency of communication was strongly affected by the perceived valence of the communication (positive or negative). The results go in line with previous evidence that a higher frequency of communication facilitates reversed socialization. Hence the results outstand how the coping mechanisms of the parents can be either a facilitator when they cope via problem-solving, while parents that disregard might avert frequent communication about climate change at the household.Keywords: communication, parents’ coping mechanisms, environmental protection, household, perceived socialization
Procedia PDF Downloads 82523 Characterization of Phenolic Compounds from Carménère Wines during Aging with Oak Wood (Staves, Chips and Barrels)
Authors: E. Obreque-Slier, J. Laqui-Estaña, A. Peña-Neira, M. Medel-Marabolí
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Wine is an important source of polyphenols. Red wines show important concentrations of nonflavonoid (gallic acid, ellagic acid, caffeic acid and coumaric acid) and flavonoid compounds [(+)-catechin, (-)-epicatechin, (+)-gallocatechin and (-)-epigallocatechin]. However, a significant variability in the quantitative and qualitative distribution of chemical constituents in wine has to be expected depending on an array of important factors, such as the varietal differences of Vitis vinifera and cultural practices. It has observed that Carménère grapes present a differential composition and evolution of phenolic compounds when compared to other varieties and specifically with Cabernet Sauvignon grapes. Likewise, among the cultural practices, the aging in contact with oak wood is a high relevance factor. Then, the extraction of different polyphenolic compounds from oak wood into wine during its ageing process produces both qualitative and quantitative changes. Recently, many new techniques have been introduced in winemaking. One of these involves putting new pieces of wood (oak chips or inner staves) into inert containers. It offers some distinct and previously unavailable flavour advantages, as well as new options in wine handling. To our best knowledge, there is not information about the behaviour of Carménère wines (Chilean emblematic cultivar) in contact with oak wood. In addition, the effect of aging time and wood product (barrels, chips or staves) on the phenolic composition in Carménère wines has not been studied. This study aims at characterizing the condensed and hydrolyzable tannins from Carménère wines during the aging with staves, chips and barrels from French oak wood. The experimental design was completely randomized with two independent assays: aging time (0-12 month) and different formats of wood (barrel, chips and staves). The wines were characterized by spectrophotometric (total tannins and fractionation of proanthocyanidins into monomers, oligomers and polymers) and HPLC-DAD (ellagitannins) analysis. The wines in contact with different products of oak wood showed a similar content of total tannins during the study, while the control wine (without oak wood) presented a lower content of these compounds. In addition, it was observed that the polymeric proanthocyanidin fraction was the most abundant, while the monomeric fraction was the less abundant fraction in all treatments in two sample. However, significative differences in each fractions were observed between wines in contact from barrel, chips, and staves in two sample dates. Finally, the wine from barrels presented the highest content of the ellagitannins from the fourth to the last sample date. In conclusion, the use of alternative formats of oak wood affects the chemical composition of wines during aging, and these enological products are an interesting alternative to contribute with tannins to wine.Keywords: enological inputs, oak wood aging, polyphenols, red wine
Procedia PDF Downloads 155522 From Clients to Colleagues: Supporting the Professional Development of Survivor Social Work Students
Authors: Stephanie Jo Marchese
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This oral presentation is a reflective piece regarding current social work teaching methods that value and devalue the lived experiences of survivor students. This presentation grounds the term ‘survivor’ in feminist frameworks. A survivor-defined approach to feminist advocacy assumes an individual’s agency, considers each case and needs independent of generalizations, and provides resources and support to empower victims. Feminist ideologies are ripe arenas to update and influence the rapport-building schools of social work have with these students. Survivor-based frameworks are rooted in nuanced understandings of intersectional realities, staunchly combat both conscious and unconscious deficit lenses wielded against victims, elevate lived experiences to the realm of experiential expertise, and offer alternatives to traditional power structures and knowledge exchanges. Actively importing a survivor framework into the methodology of social work teaching breaks open barriers many survivor students have faced in institutional settings, this author included. The profession of social work is at an important crux of change, both in the United States and globally. The United States is currently undergoing a radical change in its citizenry and outlier communities have taken to the streets again in opposition to their othered-ness. New waves of students are entering this field, emboldened by their survival of personal and systemic oppressions- heavily influenced by third-wave feminism, critical race theory, queer theory, among other post-structuralist ideologies. Traditional models of sociological and psychological studies are actively being challenged. The profession of social work was not founded on the diagnosis of disorders but rather a grassroots-level activism that heralded and demanded resources for oppressed communities. Institutional and classroom acceptance and celebration of survivor narratives can catapult the resurgence of these values needed in the profession’s service-delivery models and put social workers back in the driver's seat of social change (a combined advocacy and policy perspective), moving away from outsider-based intervention models. Survivor students should be viewed as agents of change, not solely former victims and clients. The ideas of this presentation proposal are supported through various qualitative interviews, as well as reviews of ‘best practices’ in the field of education that incorporate feminist methods of inclusion and empowerment. Curriculum and policy recommendations are also offered.Keywords: deficit lens bias, empowerment theory, feminist praxis, inclusive teaching models, strengths-based approaches, social work teaching methods
Procedia PDF Downloads 288521 Autism and Work, From the Perception of People Inserted in the Work
Authors: Nilson Rogério Da Silva, Ingrid Casagrande, Isabela Chicarelli Amaro Santos
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Introduction: People with Autism Spectrum Disorder (ASD) may face difficulties in social inclusion in different segments of society, especially in entering and staying at work. In Brazil, although there is legislation that equates it to the condition of disability, the number of people at work is still low. The United Nations estimates that more than 80 percent of adults with autism are jobless. In Brazil, the scenario is even more nebulous because there is no control and tracking of accurate data on the number of individuals with autism and how many of these are inserted in the labor market. Pereira and Goyos (2019) found that there is practically no scientific production about people with ASD in the labor market. Objective: To describe the experience of people with ASD inserted in the work, facilities and difficulties found in the professional exercise and the strategies used to maintain the job. Methodology: The research was approved by the Research Ethics Committee. As inclusion criteria for participation, the professional should accept to participate voluntarily, be over 18 years of age and have had some experience with the labor market. As exclusion criteria, being under 18 years of age and having never worked in a work activity. Participated in the research of 04 people with a diagnosis of ASD, aged 22 to 32 years. For data collection, an interview script was used that addressed: 1) General characteristics of the participants; 2) Family support; 3) School process; 4) Insertion in the labor market; 5) Exercise of professional activity; (6) Future and Autism; 7) Possible coping strategies. For the analysis of the data obtained, the full transcription of the interviews was performed and the technique of Content Analysis was performed. Results: The participants reported problems in different aspects: In the school environment: difficulty in social relationships, and Bullying. Lack of adaptation to the school curriculum and the structure of the classroom; In the Faculty: difficulty in following the activities, ealizar group work, meeting deadlines and establishing networking; At work: little adaptation in the work environment, difficulty in establishing good professional bonds, difficulty in accepting changes in routine or operational processes, difficulty in understanding veiled social rules. Discussion: The lack of knowledge about what disability is and who the disabled person is leads to misconceptions and negatives regarding their ability to work and in this context, people with disabilities need to constantly prove that they are able to work, study and develop as a human person, which can be classified as ableism. The adaptations and the use of technologies to facilitate the performance of people with ASD, although guaranteed in national legislation, are not always available, highlighting the difficulties and prejudice. Final Considerations: The entry and permanence of people with ASD at work still constitute a challenge to be overcome, involving changes in society in general, in companies, families and government agencies.Keywords: autism spectrum disorder (ASD), work, disability, autism
Procedia PDF Downloads 78520 Spatial Setting in Translation: A Comparative Evaluation of translations from Pre-Islamic Poetry
Authors: Raja Lahiani
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This study is concerned with scrutinising translations into English and French of references to locations in the desert of pre-Islamic Arabia. These references are used in the Source Text (ST) within a poetic image. Reference is made to the names of three different mountains in Arabia, namely Qatan, Sitar, and Yadhbul. As these mountains are referred to in the context of the poet’s description of the density and expansion of the clouds, it is crucial to know that while Sitar and Yadhbul are close to each other, Qatan is far away from them. This distance was functional for the poet to describe the expansion of the clouds. This reflects the spacious place (desert) he handled, and the fact that it was possible for him to physically see what he described. The purpose of this image is for the poet to communicate the vastness of the space he managed to see as he was in a moment of contemplation. Thus, knowledge of this characteristic about the setting is capital for the receiver to understand the communicative function of the verse. A corpus of eighteen translations is gathered. These vary between verse and prose renderings. The methodology adopted in this research work is comparative. Comparison is conducted at both the synchronic and diachronic levels; every translation shall be compared to the ST and then to previous translations. The comparative work will prove at the end that the translators who target historical facts do not necessarily succeed in preserving the image of the ST. It also proves that the more recent the translation is, the deeper the translator’s awareness is the link between imagery, setting, and point of view. Since the late eighteenth century and until nowadays, pre-Islamic poetry has been translated into Western languages. Translators differ as to motives, sources, priorities and intellectual backgrounds. A translator's skopoi undoubtedly affect the way s/he handles aspects of the ST. When it comes to culture-specific aspects and details related to setting, the problem is even more complex. Setting is a very important factor that reveals a great deal of the culture of pre-Islamic Arabia as this is remote in place, historical framework and literary tradition from its translators. History is present in pre-Islamic poetry, which justifies the important literature that has been written to extract information and data from it. These are imbedded not only by signalling given facts, events, and meditations but also by means of references to specific locations and landmarks that used to exist at the time. Spatial setting is an integral part of a literary text as it places it within its historical context. The importance of the translator’s awareness of spatial anthropological data before indulging in the process of translation is tested. This is also crucial in measuring the effect of setting loss and setting gain in translation. The findings of this research would ultimately evaluate the extent to which a comparative methodology is reliable in investigating the role of spatial setting awareness in translation.Keywords: historical context, translation, comparative literature, spatial setting
Procedia PDF Downloads 248519 Choking among Babies, Toddlers and Children with Special Needs: A Review of Mechanisms, Implications, Incidence, and Recommendations of Professional Prevention Guidelines
Authors: Ella Abaev, Shany Segal, Miri Gabay
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Background: Choking is a blockage of airways that prevents efficient breathing and air flow to the lungs. Choking may be partial or full and is an emergency situation. Complete or prolonged choking leads to apnea, lack of oxygen in the tissues of the body and brain, and can cause death. There are three mechanisms of choking: obstruction of internal respiratory tracts by food or object aspiration, any material that blocks or covers external air passages, external pressure on the neck or trapping between objects. Children's airways are narrower than that of adults and therefore the risk of choking is greater, due to the aspiration of food and other foreign bodies into the lungs. In the Child Development Center at Safra Children’s Hospital, Tel Hashomer in Israel are treated infants, toddlers, and children aged 0-18 years with various developmental disabilities. Due to the increase in reports of ‘almost an event’ of choking in the past year and the serious consequences of choking event, it was decided to give an emphasis to the issue. Incidence and methods: The number of reports of ‘almost an event’ or a choking event was examined at the center during the years 2013-2018 and a thorough research work was conducted on the subject in order to build a prevention program. Findings: Between 2013 and 2018 the center reported about ten cases of ‘almost choking events’. In the middle of 2018 alone three cases of ‘almost an event’ were reported. Objective: Providing knowledge leads to awareness raise, change of perception, change in behavior and prevention. The center employs more than 130 staff members from various sectors so that it is the work of multi-professional teams to promote the quality and safety of the treatment. The familiarity of the staff with risk factors, prevention guidelines, identification of choking signs, and treatment are most important and significant in determining the outcome of a choking event. Conclusions and recommendations: After in-depth research work was carried out in cooperation with the Risk Management Unit on the subject of choking, which include a description of the definitions, mechanisms, risk factors, treatment methods and extensive recommendations for prevention (e.g. using treatment and stimulation accessories with standards association stamps and adjustment of the type of food and the way it is served to match to the child's age and the ability to swallow). The expected stages of development and emphasis on the population of children with special needs were taken into account. The research findings will be published by the staff and parents of the patients, professional publications, and lectures and there is an expectation to decrease the number of choking events in the next years.Keywords: children with special needs, choking, educational system, prevention guidelines
Procedia PDF Downloads 178