Search results for: adequate dietary intake
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2487

Search results for: adequate dietary intake

927 Expectations and Perceptions of Students of English Department at the University of Halabja as Future Teachers regarding Viewing and Practicing Program

Authors: Barzan Hadi Hama Karim

Abstract:

In recent years, an increasing number of faculties and colleges of basic education are established by the universities and ministry of Higher Education and Scientific Research of Iraqi Kurdistan to graduate English teachers to teach in the basic and high schools. One central consideration of this study is to what extent graduate teachers receive adequate preparation from these faculties and college of basic education. An important program which is offered in the department of English language in these colleges and faculties is Viewing and Practicing. The purpose of this research is to explore how students of basic education colleges and faculties are using the program of Viewing and Practicing to support the educational process. This study provides a general framework about educational uses of the program as a pedagogical tool to teach English Language in the basic schools and describes the different perceptions of the students at the final stage of their education. A survey is used to collect responses from a group of students to determine their expectations and perceptions about the program. The results display that the program has several aspects of strengths, such as improving English teaching and speaking proficiency, cultivating subject knowledge related to applied linguistics and promoting research engagement. The findings of the study address the following questions: Is Viewing and Practicing Program beneficial for students to experience English language for future career at schools? To what extent do the students prefer teaching English Language in the schools?

Keywords: teaching experience, viewing and practicing, perception, expectation

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926 Polyphytopharmaca Improving Asthma Control Test Value, Biomarker (Eosinophils and Malondialdehyde): Quasi Experimental Test in Patients with Asthma

Authors: Andri Andri, Susanthy Djajalaksana, Iin Noor Chozin

Abstract:

Background: Despite advances in asthma therapies, a proportion of patients with asthma continue to have difficulty in gaining adequate asthma control. Complex immunological mechanisms and oxidative stress affect this condition, including the role of malondialdehyde (MDA) as a marker of inflammation. This research aimed to determine the effect of polyphytopharmaca administration on the value of asthma control test (ACT), blood eosinophils level and markers of MDA serum inflammation in patients with asthma. Method: Quasi experimental approach was conducted toward 15 stable asthma patients who were not fully controlled in outpatient pulmonary clinic, Public Hospital of Dr. Saiful Anwar Malang. Assessments of ACT values, eosinophil levels, and serum MDA levels were carried out before and after administration of polyphytopharmaca which contained a combination of 100 mg Nigella sativa extract, Kleinhovia hospita 100 mg, Curcuma xanthorrhiza 75 mg, and Ophiocephalus striatus 100 mg, three times daily with two capsules for 12 weeks. The ACT value was determined by the researcher by asking the patient directly, blood eosinophil levels were calculated by analyzing blood type counts, and serum MDA levels were detected by the qPCR method. Result: There was a significant enhancement of ACT value (18.07 ± 2.57 to 22.06 ± 1.83, p = 0.001) (from 60% uncontrolled ACT to 93.3% controlled ACT), a significant decrease in blood eosinophils levels (653.15 ± 276.15 pg/mL to 460.66 ± 202.04 pg/mL, p = 0.038), and decreased serum MDA levels (109.64 ± 53.77 ng / ml to 78.68 ± 64.92 ng/ml, p = 0.156). Conclusion: Administration of polyphytopharmaca can increase ACT value, decrease blood eosinophils levels and reduce MDA serum in stable asthma patients who are not fully controlled.

Keywords: asthma control test, eosinophils levels, malondialdehyde, polyphytopharmaca

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925 Chronic Aflatoxin Exposure During Pregnancy Is Associated With Lower Fetal Growth Trajectories: A Prospective Cohort Study in Rural Ethiopia

Authors: K. Tesfamariam, S. Gebreyesus, C. Lachat, P. Kolsteren, S. De Saeger, M. De Boevre, A. Argaw

Abstract:

Aflatoxins are toxic secondary metabolites produced by Aspergillus fungi, which are ubiquitously present in the food supplies of low- and middle-income countries. Studies of maternal aflatoxin exposure and fetal outcomes are mainly focused on size at birth and the effect on intrauterine fetal growth has not been assessed using repeated longitudinal fetal biometry across gestation. Therefore, this study intends to assess the association between chronic aflatoxin exposure during pregnancy and fetal growth trajectories in a rural Ethiopian setting. In a prospective cohort study, we enrolled 492 pregnant women. A phlebotomist collected 5 mL of a venous blood sample from eligible women before 28 completed weeks of gestation and aflatoxin B1-lysine concentration was determined using liquid chromatography-tandem mass spectrometry. The mean (±SD) gestational age was 19.1 (3.71) weeks at enrollment, and 28.5 (3.51) and 34.5 (2.44) weeks of gestation at the second and third rounds of ultrasound measurements, respectively. Estimated fetal weight was expressed in centiles using the INTERGROWTH-21st reference. We fitted a multivariable linear mixed-effects model to estimate the rate of fetal growth between aflatoxin-exposed (i.e., aflatoxin B1-lysine concentration above or equal to the limit of detection) and non-exposed mothers in the study. Mothers had a mean (±SD) age of 26.0 (4.58) years. The median (P25, P75) serum AFB1-lysine concentration was 12.6 (0.93, 96.9) pg/mg albumin, and aflatoxin exposure was observed in 86.6% of maternal blood samples. Eighty-five percent of the women enrolled provided at least two ultrasound measurements for analysis. On average, the aflatoxin-exposed group had a significantly lower change over time in fetal weight-for-gestational age centile than the unexposed group (ß = -1.01 centiles/week, 95% CI: -1.87, -0.15, p = 0.02). Chronic maternal AF exposure is associated with lower fetal weight gain over time. Our findings emphasize the importance of nutrition-sensitive strategies to mitigate dietary aflatoxin exposure as well as adopting food safety measures in low-income settings, particularly during the fetal period of development.

Keywords: aflatoxin, fetal growth, low-income setting, mycotoxins

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924 Internal Audit and the Effectiveness and Efficiency of Operations in Hospitals

Authors: Naziru Suleiman

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The ever increasing cases of financial frauds and corporate accounting scandals in recent years have raised more concern on the operation of internal control mechanisms and performance of the internal audit departments in organizations. In most cases the seeming presence of both the internal control system and internal audit in organizations do not prove useful as frauds errors and irregularities are being perpetuated. The aim of this study, therefore, is to assess the role of internal audit in achieving the objectives of internal control system of federal hospitals in Kano State from the perception of the respondents. The study used survey research design and generated data from primary source by means of questionnaire. A total number of 100 copies of questionnaire were administered out of which 68 were duly completed and returned. Cronbach’s alpha was used to test the internal validity of the various items in the constructs. Descriptive statistics, chi-square test, Mann Whitney U test and Kruskal Wallis ANOVA were employed for the analysis of data. The study finds that from the perception of the respondents, internal audit departments in Federal Hospitals in Kano State are effective and that they contribute positively to the overall attainment of the objectives of internal control system of these hospitals. There is no significant difference found on the views of the respondents from the three hospitals. Hence, the study concludes that strong and functional internal audit department is a basic requirement for effectiveness of operations of the internal control system. In the light of the findings, it is recommended that internal audit should continue to ensure that the objectives of internal control system of these hospitals are achieved through proper and adequate evaluation and review of the system.

Keywords: internal audit, internal control, federal hospitals, financial frauds

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923 Revealing of the Wave-Like Process in Kinetics of the Structural Steel Radiation Degradation

Authors: E. A. Krasikov

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Dependence of the materials properties on neutron irradiation intensity (flux) is a key problem while usage data of the accelerated materials irradiation in test reactors for forecasting of their capacity for work in realistic (practical) circumstances of operation. Investigations of the reactor pressure vessel steel radiation degradation dependence on fast neutron fluence (embrittlement kinetics) at low flux reveal the instability in the form of the scatter of the experimental data and wave-like sections of embrittlement kinetics appearance. Disclosure of the steel degradation oscillating is a sign of the steel structure cyclic self-recovery transformation as it take place in self-organization processes. This assumption has received support through the discovery of the similar ‘anomalous’ data in scientific publications and by means of own additional experiments. Data obtained stimulate looking-for ways to management of the structural steel radiation stability (for example, by means of nano - structure modification for radiation defects annihilation intensification) for creation of the intelligent self-recovering material. Expected results: - radiation degradation theory and mechanisms development, - more adequate models of the radiation embrittlement elaboration, - surveillance specimen programs improvement, - methods and facility development for usage data of the accelerated materials irradiation for forecasting of their capacity for work in realistic (practical) circumstances of operation, - search of the ways for creating of the radiation stable self-recovery intelligent materials.

Keywords: degradation, radiation, steel, wave-like kinetics

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922 Present and Future of Micromobility in the City of Medellin

Authors: Saul Emilio Rivero Mejia, Estefanya Marin Tabares, Carlos Andres Rodriguez Toro, Katherine Bolano Restrepo, Sarita Santa Cortes

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Medellin is the Colombian city with the best public transportation system in the country, which is composed of two subway lines, five metro cables, two Bus Rapid Transit lines, and a streetcar. But despite the above, the Aburra Valley, the area in which the city is located, comparatively speaking, has a lower number of urban roads per inhabitant built, compared to the national average. In addition, since there is approximately one vehicle for every three inhabitants in Medellin, the problems of congestion and environmental pollution have become more acute over the years, and it has even been necessary to implement restrictive measures to the use of private vehicles on a permanent basis. In that sense, due to the limitations of physical space, the low public investment in road infrastructure, it is necessary to opt for mobility alternatives according to the above. Within the options for the city, there is what is known as micromobility. Micromobility is understood as those small and light means of transport used to travel short distances, which use electrical energy, such as skateboards and bicycles. These transport alternatives have a high potential for use by the city's young population, but this requires an adequate infrastructure and also state regulation. Taking into account the above, this paper will analyze the current state and future of micro mobility in the city of Medellin, making a prospective analysis, supported by a PEST (political, economic, social and technological) analysis. Based on the above, it is expected to identify the growth of demand for these alternative means and its impact on the mobility of the city in the medium and short term.

Keywords: electric, micromobility, transport, sustainable

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921 Public Transportation Demand and Policy in Kabul, Afghanistan

Authors: Ahmad Samim Ranjbar, Shoshi Mizokami

Abstract:

Kabul is the heart of political, commercial, cultural, educational and social life in Afghanistan and the Kabul fifth fastest growing city in the world, since 2001 with the establishment of new government Lack of adequate employment opportunities and basic utility services in remote provinces have prompted people to move to Kabul and other urban areas. From 2001 to the present, a rapid increase in population, and also less income of the people most of residence tend to use public transport, especially buses, however there is no proper bus system exist in Kabul city, because of wars, from 1992 to 2001 Kabul suffered damage and destruction of its transportation facilities including pavements, sidewalks, traffic circles, drainage systems, traffic signs and signals, trolleybuses and almost all of the public transit buses (e.g. Millie bus). This research is a primary and very important phase into Kabul city transportation and especially an initial and important step toward using large bus in Kabul city, which the main purpose of this research is to find the demand of Kabul city residence for public transport (Large Bus) and compare it with the actual supply from government. Finding of this research shows that the demand of Kabul city residence for the public transport (Large Bus) exceed the supply from the government, means that current public transportation (Large Bus) is not sufficient to serve people of Kabul city, it is mentionable that according to this research there is no need to build a new road or exclusive way for bus, this research propose to government for investment on the public transportation and exceed the number of large buses to can handle the current demand for public transport.

Keywords: transportation, planning, public transport, large bus, Kabul, Afghanistan

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920 Effective Financial Planning: A Study of Comprehensive Retirement Planning for Financial Independence

Authors: Stanley Yap, Chong Wei Ying, Leow Hon Wei

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Purpose: In Malaysia, an effective financial planning is vital to accumulate wealth and financial independence. However, retirees are required to resume working due to insufficient pension fund. This study examines how the financial decision in retirement planning is being made based on the net worth from the household. Design/methodology/approach: This study uses financial data from a married working couple with children to evaluate their composition of financial position. Numerous financial methods are made pertaining to net worth analysis, insurance needs analysis, investment portfolio rebalancing, estate planning, education planning and retirement planning to enhance the financial decision. Findings: Our results show, firstly, financial planning is essential to achieve financial independence; secondly, insurance needs, education and retirement funding are the most significant for household. Thirdly, current resources are critical to maintain family lifestyle after retirement, emergency funds for critical illness, and the long term children education funding. Practical implications: Refer to the findings, sufficient net worth is priority in financial planning. Different suggestions for household include reduction of unnecessary expenses, re-allocate of cash flow, adequate insurance coverage and re-balancing of investment portfolios to accumulate wealth. It is a challenge to obtain financial independence, hence, there is a need to increase the literature on financial planning. Originality/value: To the best of our knowledge, this is the important paper that uses financial information from household to provide solutions to enhance the efficiency of financial planning industry.

Keywords: net worth, financial planning, wealth and financial independence, retirement planning

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919 Perceived Risks in Business-to-Consumer Online Contracts: An Empirical Study in Saudi Arabia

Authors: Shaya Alshahrani

Abstract:

Perceived risks play a major role in consumer intentions, behaviors, attitudes, and decisions about online shopping in the KSA. This paper investigates the influence of six perceived risk dimensions on Saudi consumers: product risk, information risk, financial risk, privacy and security risk, delivery risk, and terms and conditions risk empirically. To ensure the success of this study, a random survey was distributed to reflect the consumers’ perceived risk and to enable the generalization of the results. Data were collected from 323 respondents in the Kingdom of Saudi Arabia (KSA): 50 who had never shopped online and 273 who had done so. The results indicated that all six risks influenced the respondents’ perceptions of online shopping. The non-online shoppers perceived financial and delivery risks as the most significant barriers to online shopping. This was followed closely by performance, information, and privacy and security risks. Terms and conditions were perceived as less significant. The online consumers considered delivery and performance risks to be the most significant influences on internet shopping. This was followed closely by information and terms and conditions. Financial and privacy and security risks were perceived as less significant. This paper argues that introducing adequate legal solutions to addressing related problems arising from this study is an urgent need. This may enhance consumer trust in the KSA online market, increase consumers’ intentions regarding online shopping, and improve consumer protection.

Keywords: perceived risk, online contracts, Saudi Arabia, consumer protection

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918 Effect of Synthetic L-Lysine and DL-Methionine Amino Acids on Performance of Broiler Chickens

Authors: S. M. Ali, S. I. Mohamed

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Reduction of feed cost for broiler production is at most importance in decreasing the cost of production. The objectives of this study were to evaluate the use of synthetic amino acids (L-lysine – DL-methionine) instead of super concentrate and groundnut cake versus meat powder as protein sources. A total of 180 male broiler chicks (Cobb – strain) at 15 day of age (DOA) were selected according to their average body weight (380 g) from a broiler chicks flock at Elbashair Farm. The chicks were randomly divided into six groups of 30 chicks. Each group was further sub divided into three replicates with 10 birds. Six experimental diets were formulated. The first diet contained groundnut cake and super concentrate as the control (GNC + C); in the second diet, meat powder and super concentrate (MP + C) were used. The third diet contained groundnut cake and amino acids (GNC + AA); the forth diet contained meat powder and amino acids (MP + AA). The fifth diet contained groundnut cake, meat powder and super concentrate (GNC + MP + C) and the sixth diet contained groundnut cake, meat powder and amino acids (GNC + MP + AA). The formulated rations were randomly assigned for the different sub groups in a completely randomized design of six treatments and three replicates. Weekly feed intake, body weight and mortality were recorded and body weight gain and feed conversion ratio were calculated. At the end of the experiment (49 DOA), nine birds from each treatment were slaughtered. Live body weight, carcass weight, head, shank, and some internal organs (gizzard, heart, liver, small intestine, and abdominal fat pad) weights were taken. For the overall experimental period the (GNC + C +MP) consumed significantly (P≤0.01) the highest cumulative feed while the (MP + AA) group consumed the lowest amount of feed. The (GNC + C) and the (GNC + AA) groups had the heaviest live body weight while (MP + AA) had the lowest live body weight. The overall FCR was significantly (P≤0.01) the best for (GNC + AA) group while the (MP + AA) reported the worst FCR. However, the (GNC + AA) had significantly (P≤0.01) the lowest AFP. The (GNC + MP + Con) group had the highest dressing % while the (MP + AA) group had the lowest dressing %. It is concluded that amino acids can be used instead of super concentrate in broiler feeding with perfect performance and less cost and that meat powder is not advisable to be used with amino acids.

Keywords: broiler chickens, DL-lysine, methionine, performance

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917 Approaching In vivo Dosimetry for Kilovoltage X-Ray Radiotherapy

Authors: Rodolfo Alfonso, David Alonso, Albin Garcia, Jose Luis Alonso

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Recently a new kilovoltage radiotherapy unit model Xstrahl 200 - donated to the INOR´s Department of Radiotherapy (DR-INOR) in the framework of a IAEA's technical cooperation project- has been commissioned. This unit is able to treat shallow and low deep laying lesions, as it provides 8 discrete beam qualities, from 40 to 200 kV. As part of the patient-specific quality assurance program established at DR-INOR for external beam radiotherapy, it has been recommended to implement in vivo dose measurements (IVD), as they allow effectively discovering eventual errors or failures in the radiotherapy process. For that purpose a radio-photoluminescence (RPL) dosimetry system, model XXX, -also donated to DR-INOR by the same IAEA project- has been studied and commissioned. Main dosimetric parameters of the RPL system, such as reproducibility, linearity, and filed size influence were assessed. In a similar way, the response of radiochromic EBT3 type film was investigated for purposes of IVD. Both systems were calibrated in terms of entrance surface dose. Results of the dosimetric commissioning of RPL and EBT3 for IVD, and their pre-clinical implementation through end-to-end test cases are presented. The RPL dosimetry seems more recommendable for hyper-fractionated schemes with larger fields and curved patient contours, as those in chest wall irradiations, where the use of more than one dosimeter could be required. The radiochromic system involves smaller corrections with field size, but it sensibility is lower; hence it is more adequate for hypo-fractionated treatments with smaller fields.

Keywords: glass dosimetry, in vivo dosimetry, kilovotage radiotherapy, radiochromic dosimetry

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916 A Comparative Analysis Approach Based on Fuzzy AHP, TOPSIS and PROMETHEE for the Selection Problem of GSCM Solutions

Authors: Omar Boutkhoum, Mohamed Hanine, Abdessadek Bendarag

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Sustainable economic growth is nowadays driving firms to extend toward the adoption of many green supply chain management (GSCM) solutions. However, the evaluation and selection of these solutions is a matter of concern that needs very serious decisions, involving complexity owing to the presence of various associated factors. To resolve this problem, a comparative analysis approach based on multi-criteria decision-making methods is proposed for adequate evaluation of sustainable supply chain management solutions. In the present paper, we propose an integrated decision-making model based on FAHP (Fuzzy Analytic Hierarchy Process), TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) and PROMETHEE (Preference Ranking Organisation METHod for Enrichment Evaluations) to contribute to a better understanding and development of new sustainable strategies for industrial organizations. Due to the varied importance of the selected criteria, FAHP is used to identify the evaluation criteria and assign the importance weights for each criterion, while TOPSIS and PROMETHEE methods employ these weighted criteria as inputs to evaluate and rank the alternatives. The main objective is to provide a comparative analysis based on TOPSIS and PROMETHEE processes to help make sound and reasoned decisions related to the selection problem of GSCM solution.

Keywords: GSCM solutions, multi-criteria analysis, decision support system, TOPSIS, FAHP, PROMETHEE

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915 The Proximate Composition and Phytochemical Screening of Momordica Balsamina (Balsam Apple) Fruit and Leaves

Authors: Viruska Jaichand, John Jason Mellem, Viresh Mohanlall

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Malnutrition is a global issue that affects both children and adults, irrespective of their socio-economic status. It is, therefore, important to find various means to tackle malnutrition. This is especially important as undernutrition and overnutrition can be linked to a variety of non-communicable diseases (NCDs). This study aimed to gather more insight into the nutritional and phytochemical quality of Momordica balsamina leaves and fruit (fruit pericarp, fruit flesh and seeds). Results showed that Momordica balsamina had a nutritional composition that would be advantageous to the human diet. The nutritional quality is verified by the presence of a high protein percentage across all samples (19.72%-29.08%), with the leaves containing the highest protein content (29.08%±0.77). There was also a low-fat content present across all samples, which ranged from 1.03% to 2.40%. The ash content indicated the presence of total minerals to be adequate (2.93%-21.16%), where the pericarp had the highest ash quantity (21.16%±0.09). The moisture levels were low (7.11%-13.40%). Momordica balsamina seeds had the highest carbohydrate content (67.84%±0.30). Rich in the major phytoconstituents, Momordica balsamina extracts were found to contain alkaloids, saponins, cardiac glycosides, steroids and triterpenoids. Based on these findings, it can thus be said that the incorporation of Momordica balsamina into an individual’s diet could prevent diseases associated with malnutrition, as well as it could be used to supplement the human diet in managing certain NCDs. Even though there were a number of bioactive compounds detected, further studies which would correlate the phytochemical constituents detected in Momordica balsamina and its effectiveness in treating various diseases are recommended.

Keywords: momordica balsamina, nutrients, proximate composition, bioactive compounds, phytoconstituents

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914 Study of Unsteady Behaviour of Dynamic Shock Systems in Supersonic Engine Intakes

Authors: Siddharth Ahuja, T. M. Muruganandam

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An analytical investigation is performed to study the unsteady response of a one-dimensional, non-linear dynamic shock system to external downstream pressure perturbations in a supersonic flow in a varying area duct. For a given pressure ratio across a wind tunnel, the normal shock's location can be computed as per one-dimensional steady gas dynamics. Similarly, for some other pressure ratio, the location of the normal shock will change accordingly, again computed using one-dimensional gas dynamics. This investigation focuses on the small-time interval between the first steady shock location and the new steady shock location (corresponding to different pressure ratios). In essence, this study aims to shed light on the motion of the shock from one steady location to another steady location. Further, this study aims to create the foundation of the Unsteady Gas Dynamics field enabling further insight in future research work. According to the new pressure ratio, a pressure pulse, generated at the exit of the tunnel which travels and perturbs the shock from its original position, setting it into motion. During such activity, other numerous physical phenomena also happen at the same time. However, three broad phenomena have been focused on, in this study - Traversal of a Wave, Fluid Element Interactions and Wave Interactions. The above mentioned three phenomena create, alter and kill numerous waves for different conditions. The waves which are created by the above-mentioned phenomena eventually interact with the shock and set it into motion. Numerous such interactions with the shock will slowly make it settle into its final position owing to the new pressure ratio across the duct, as estimated by one-dimensional gas dynamics. This analysis will be extremely helpful in the prediction of inlet 'unstart' of the flow in a supersonic engine intake and its prominence with the incoming flow Mach number, incoming flow pressure and the external perturbation pressure is also studied to help design more efficient supersonic intakes for engines like ramjets and scramjets.

Keywords: analytical investigation, compression and expansion waves, fluid element interactions, shock trajectory, supersonic flow, unsteady gas dynamics, varying area duct, wave interactions

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913 Exploring Error-Minimization Protocols for Upper-Limb Function During Activities of Daily Life in Chronic Stroke Patients

Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp

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Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.

Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task

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912 Analytical and Numerical Results for Free Vibration of Laminated Composites Plates

Authors: Mohamed Amine Ben Henni, Taher Hassaine Daouadji, Boussad Abbes, Yu Ming Li, Fazilay Abbes

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The reinforcement and repair of concrete structures by bonding composite materials have become relatively common operations. Different types of composite materials can be used: carbon fiber reinforced polymer (CFRP), glass fiber reinforced polymer (GFRP) as well as functionally graded material (FGM). The development of analytical and numerical models describing the mechanical behavior of structures in civil engineering reinforced by composite materials is necessary. These models will enable engineers to select, design, and size adequate reinforcements for the various types of damaged structures. This study focuses on the free vibration behavior of orthotropic laminated composite plates using a refined shear deformation theory. In these models, the distribution of transverse shear stresses is considered as parabolic satisfying the zero-shear stress condition on the top and bottom surfaces of the plates without using shear correction factors. In this analysis, the equation of motion for simply supported thick laminated rectangular plates is obtained by using the Hamilton’s principle. The accuracy of the developed model is demonstrated by comparing our results with solutions derived from other higher order models and with data found in the literature. Besides, a finite-element analysis is used to calculate the natural frequencies of laminated composite plates and is compared with those obtained by the analytical approach.

Keywords: composites materials, laminated composite plate, finite-element analysis, free vibration

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911 Navigating Weight Loss Among Breast Cancer Survivors: A Qualitative Study of Overweight and Obese Patients' Experiences

Authors: Yi Fung Lin, Pei Chen Tsai

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Purpose: Many breast cancer survivors actively seek information about diet, exercise, and nutritional supplements to expedite recovery, reduce the risk of recurrence, and enhance their quality of life. While weight loss is not a primary concern for overweight or obese patients during the active treatment phase, they continue to face the additional burden and risks associated with excess weight post-treatment. This group has complex views on weight loss: they are concerned that exercise or dietary control might exacerbate symptoms, yet they also believe that obesity could negatively impact health. These perceptions can have both positive and negative effects on weight management. Therefore, this qualitative study aimed to explore the factors that influence overweight or obese breast cancer survivors' ability to manage their weight. Method: Eight women participated in in-depth interviews in 2022. Data was extracted based on the verbatim transcripts of the audio files, and the analysis was conducted through careful reading of the text. This qualitative research collected data until data saturation was reached. Results: A total of 22 codes were identified and subsequently integrated into three main themes: (1) Facilitators, including support systems, others' successful weight loss experiences, education, responsibility to others, and motivation; (2) Barriers, encompassing physical limitations, the stigma associated with weight loss, the cost of weight loss, antiestrogen medication, and cancer symptoms; (3) Variable Factors, which comprise perspectives on cancer, perspectives on obesity, and past experiences with weight loss. Conclusions: These findings are similar to previous research on barriers and motivators, highlighting variable factors that exist and can lead to either positive or negative effects on weight loss. The results can inform the development of weight management programs tailored to the needs of overweight or obese breast cancer survivors. Additionally, the identified factors represent vital variables for future studies, serving as valuable references for further research in this area.

Keywords: weight management, breast cancer, overweight, obese, cancer survivors

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910 Experiencing Daylight in Architectural Spaces: A Case Study of Public Buildings in the Context of Karachi, Pakistan

Authors: Safia Asif, Saadia Bano

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In a world with rapidly depleting resources, using artificial lighting during daytime is an act of human ignorance. Imitated light is the major source of energy consumption in public buildings. Despite, the fact that substantial working hours of these buildings usually persist in natural daylight time; there is a trend of isolated, un-fenestrated and a-contextual interiors majorly dependent on active energy sources. On the contrary, if direct and un-controlled sunlight is allowed inside the building, it will create visual and thermal discomfort. Controlled daylighting with appropriate design mechanisms is one of the important aspects of achieving thermal and visual comfort. The natural sunlight can be utilized intelligently with the help of architectural thermal controlling mechanisms to achieve a healthy and productive environment. This paper is an attempt to investigate and analyze the importance of daylighting with reference to energy efficiency and thermal comfort. For this purpose, three public buildings including two educational institutions and one general post office are selected, as case-studies in the context of Karachi, Pakistan. Various parameters of visual and thermal comfort are analyzed which includes orientation, ceiling heights, overall building profile along with daylight controlling mechanisms in terms of penetration, distribution, protection, and control. In the later part of the research, a questionnaire survey is also conducted to evaluate the user experience in terms of adequate daylighting and thermal comfort.

Keywords: daylight, public buildings, sustainable architecture, visual and thermal comfort

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909 Testing Nature Based Solutions for Air Quality Improvement: Aveiro Case Study

Authors: A. Ascenso, C. Silveira, B. Augusto, S. Rafael, S. Coelho, J. Ferreira, A. Monteiro, P. Roebeling, A. I. Miranda

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Innovative nature-based solutions (NBSs) can provide answers to the challenges that urban areas are currently facing due to urban densification and extreme weather conditions. The effects of NBSs are recognized and include improved quality of life, mental and physical health and improvement of air quality, among others. Part of the work developed in the scope of the UNaLab project, which aims to guide cities in developing and implementing their own co-creative NBSs, intends to assess the impacts of NBSs on air quality, using Eindhoven city as a case study. The state-of-the-art online air quality modelling system WRF-CHEM was applied to simulate meteorological and concentration fields over the study area with a spatial resolution of 1 km2 for the year 2015. The baseline simulation (without NBSs) was validated by comparing the model results with monitored data retrieved from the Eindhoven air quality database, showing an adequate model performance. In addition, land use changes were applied in a set of simulations to assess the effects of different types of NBSs. Finally, these simulations were compared with the baseline scenario and the impacts of the NBSs were assessed. Reductions on pollutant concentrations, namely for NOx and PM, were found after the application of the NBSs in the Eindhoven study area. The present work is particularly important to support public planners and decision makers in understanding the effects of their actions and planning more sustainable cities for the future.

Keywords: air quality, modelling approach, nature based solutions, urban area

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908 Simulation of the Collimator Plug Design for Prompt-Gamma Activation Analysis in the IEA-R1 Nuclear Reactor

Authors: Carlos G. Santos, Frederico A. Genezini, A. P. Dos Santos, H. Yorivaz, P. T. D. Siqueira

Abstract:

The Prompt-Gamma Activation Analysis (PGAA) is a valuable technique for investigating the elemental composition of various samples. However, the installation of a PGAA system entails specific conditions such as filtering the neutron beam according to the target and providing adequate shielding for both users and detectors. These requirements incur substantial costs, exceeding $100,000, including manpower. Nevertheless, a cost-effective approach involves leveraging an existing neutron beam facility to create a hybrid system integrating PGAA and Neutron Tomography (NT). The IEA-R1 nuclear reactor at IPEN/USP possesses an NT facility with suitable conditions for adapting and implementing a PGAA device. The NT facility offers a thermal flux slightly colder and provides shielding for user protection. The key additional requirement involves designing detector shielding to mitigate high gamma ray background and safeguard the HPGe detector from neutron-induced damage. This study employs Monte Carlo simulations with the MCNP6 code to optimize the collimator plug for PGAA within the IEA-R1 NT facility. Three collimator models are proposed and simulated to assess their effectiveness in shielding gamma and neutron radiation from nucleon fission. The aim is to achieve a focused prompt-gamma signal while shielding ambient gamma radiation. The simulation results indicate that one of the proposed designs is particularly suitable for the PGAA-NT hybrid system.

Keywords: MCNP6.1, neutron, prompt-gamma ray, prompt-gamma activation analysis

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907 Assessment of Sleep Disorders in Moroccan Women with Gynecological Cancer: Cross-Sectional Study

Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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906 Addressing Food Grain Losses in India: Energy Trade-Offs and Nutrition Synergies

Authors: Matthew F. Gibson, Narasimha D. Rao, Raphael B. Slade, Joana Portugal Pereira, Joeri Rogelj

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Globally, India’s population is among the most severely impacted by nutrient deficiency, yet millions of tonnes of food are lost before reaching consumers. Across food groups, grains represent the largest share of daily calories and overall losses by mass in India. If current losses remain unresolved and follow projected population rates, we estimate, by 2030, losses from grains for human consumption could increase by 1.3-1.8 million tonnes (Mt) per year against current levels of ~10 Mt per year. This study quantifies energy input to minimise storage losses across India, responsible for a quarter of grain supply chain losses. In doing so, we identify and explore a Sustainable Development Goal (SDG) triplet between SDG₂, SDG₇, and SDG₁₂ and provide insight for development of joined up agriculture and health policy in the country. Analyzing rice, wheat, maize, bajra, and sorghum, we quantify one route to reduce losses in supply chains, by modelling the energy input to maintain favorable climatic conditions in modern silo storage. We quantify key nutrients (calories, protein, zinc, iron, vitamin A) contained within these losses and calculate roughly how much deficiency in these dietary components could be reduced if grain losses were eliminated. Our modelling indicates, with appropriate uncertainty, maize has the highest energy input intensity for storage, at 110 kWh per tonne of grain (kWh/t), and wheat the lowest (72 kWh/t). This energy trade-off represents 8%-16% of the energy input required in grain production. We estimate if grain losses across the supply chain were saved and targeted to India’s nutritionally deficient population, average protein deficiency could reduce by 46%, calorie by 27%, zinc by 26%, and iron by 11%. This study offers insight for development of Indian agriculture, food, and health policy by first quantifying and then presenting benefits and trade-offs of tackling food grain losses.

Keywords: energy, food loss, grain storage, hunger, India, sustainable development goal, SDG

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905 Co-payment Strategies for Chronic Medications: A Qualitative and Comparative Analysis at European Level

Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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904 Application of Logistics Regression Model to Ascertain the Determinants of Food Security among Households in Maiduguri, Metropolis, Borno State, Nigeria

Authors: Abdullahi Yahaya Musa, Harun Rann Bakari

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The study examined the determinants of food security among households in Maiduguri, Metropolis, Borno State, Nigeria. The objectives of the study are to: examine the determinants of food security among households; identify the coping strategies employed by food-insecure households in Maiduguri, Metropolis, Borno State, Nigeria. The population of the study is 843,964 respondents out of which 400 respondents were sampled. The study used a self-developed questionnaire to collect data from four hundred (400) respondents. Four hundred (400) copies of questionnaires were administered and all were retrieved, making 100% return rate. The study employed descriptive and inferential statistics for data analysis. Descriptive statistics (frequency counts and percentages) was used to analyze the socio-economic characteristics of the respondents and objective four, while inferential statistics (logit regression analysis) was used to analyze one. Four hundred (400) copies of questionnaires were administered and all the four hundred (400) were retrieved, making a 100% return rate. The results were presented in tables and discussed according to the research objectives. The study revealed that HHA, HHE, HHSZ, HHSX, HHAS, HHI, HHFS, HHFE, HHAC and HHCDR were the determinants of food security in Maiduguri Metropolis. Relying on less preferred foods, purchasing food on credit, limiting food intake to ensure children get enough, borrowing money to buy foodstuffs, relying on help from relatives or friends outside the household, adult family members skipping or reducing a meal because of insufficient finances and ration money to household members to buy street food were the coping strategies employed by food-insecure households in Maiduguri metropolis. The study recommended that Nigeria Government should intensify the fight against the Boko haram insurgency. This will put an end to Boko Haram Insurgency and enable farmers to return to farming in Borno state.

Keywords: internally displaced persons, food security, coping strategies, descriptive statistics, logistics regression model, odd ratio

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903 Reinforcement Learning for Robust Missile Autopilot Design: TRPO Enhanced by Schedule Experience Replay

Authors: Bernardo Cortez, Florian Peter, Thomas Lausenhammer, Paulo Oliveira

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Designing missiles’ autopilot controllers have been a complex task, given the extensive flight envelope and the nonlinear flight dynamics. A solution that can excel both in nominal performance and in robustness to uncertainties is still to be found. While Control Theory often debouches into parameters’ scheduling procedures, Reinforcement Learning has presented interesting results in ever more complex tasks, going from videogames to robotic tasks with continuous action domains. However, it still lacks clearer insights on how to find adequate reward functions and exploration strategies. To the best of our knowledge, this work is a pioneer in proposing Reinforcement Learning as a framework for flight control. In fact, it aims at training a model-free agent that can control the longitudinal non-linear flight dynamics of a missile, achieving the target performance and robustness to uncertainties. To that end, under TRPO’s methodology, the collected experience is augmented according to HER, stored in a replay buffer and sampled according to its significance. Not only does this work enhance the concept of prioritized experience replay into BPER, but it also reformulates HER, activating them both only when the training progress converges to suboptimal policies, in what is proposed as the SER methodology. The results show that it is possible both to achieve the target performance and to improve the agent’s robustness to uncertainties (with low damage on nominal performance) by further training it in non-nominal environments, therefore validating the proposed approach and encouraging future research in this field.

Keywords: Reinforcement Learning, flight control, HER, missile autopilot, TRPO

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902 Mediterranean Diet, Duration of Admission and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

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Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

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901 Enhancing Skills of Mothers of Asthmatic Children in Techniques of Drug Administration

Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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900 Effects of Intracerebroventricular Injection of Ghrelin and Aerobic Exercise on Passive Avoidance Memory and Anxiety in Adult Male Wistar Rats

Authors: Mohaya Farzin, Parvin Babaei, Mohammad Rostampour

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Ghrelin plays a considerable role in important neurological effects related to food intake and energy homeostasis. As was found, regular physical activity may make available significant improvements to cognitive functions in various behavioral situations. Anxiety is one of the main concerns of the modern world, affecting millions of individuals’ health. There are contradictory results regarding ghrelin's effects on anxiety-like behavior, and the plasma level of this peptide is increased during physical activity. Here we aimed to evaluate the coincident effects of exogenous ghrelin and aerobic exercise on anxiety-like behavior and passive avoidance memory in Wistar rats. Forty-five male Wistar rats (250 ± 20 g) were divided into 9 groups (n=5) and received intra-hippocampal injections of 3.0 nmol ghrelin and performed aerobic exercise training for 8 weeks. Control groups received the same volume of saline and diazepam as negative and positive control groups, respectively. Learning and memory were estimated using a shuttle box apparatus, and anxiety-like behavior was recorded by an elevated plus-maze test (EPM). Data were analyzed by ANOVA test, and p<0.05 was considered significant. Our findings showed that the combined effect of ghrelin and aerobic exercise improves the acquisition, consolidation, and retrieval of passive avoidance memory in Wistar rats. Furthermore, it is supposed that the ghrelin receiving group spent less time in open arms and fewer open arms entries compared with the control group (p<0.05). However, exercising Wistar rats spent more time in the open arm zone in comparison with the control group (p<0.05). The exercise + Ghrelin administration established reduced anxiety (p<0.05). The results of this study demonstrate that aerobic exercise contributes to an increase in the endogenous production of ghrelin, and physical activity alleviates anxiety-related behaviors induced by intra-hippocampal injection of ghrelin. In general, exercise and ghrelin can reduce anxiety and improve memory.

Keywords: anxiety, ghrelin, aerobic exercise, learning, passive avoidance memory

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899 Neuro-Preservation Potential of Resveratrol Against High Fat High Fructose-Induced Metabolic Syndrome

Authors: Rania F. Ahmed, Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O. Saleh, Omar A. H. Ahmed-Farid

Abstract:

The metabolic syndrome is an important public health concern often related to obesity, improper diet, and sedentary lifestyles and can predispose individuals to the development of many dangerous health conditions, disability and early death. This research aimed to investigate the efficacy of resveratrol (RSV) to reverse the neuro-complications associated with metabolic syndrome experimentally-induced in rats using an eight weeks high fat, high fructose diet (HFHF) model. The corresponding drug treatments were administered orally during the last 10 days of the diet. Behavioural tests namely the open field test (OFT) and the forced swimming test (FST) were conducted. Brain levels of monoamines viz. serotonin, norepinephrine and dopamine as well as their metabolites were assessed. 8-hydroxyguanosine (8-OHDG) as an indicative of DNA-fragmentation, nitric oxide (NOx) and tumor necrosis factor-α (TNF- α) were estimated. Finally, brain antioxidant parameters namely malondialdehyde (MDA), reduced and oxidized glutathione (GSH, GSSG) were evaluated. HFHF-induced metabolic syndrome resulted in decreased activity in the OFT and increased immobility duration in the FST. Furthermore, HFHF-induced metabolic syndrome lead to a significant increase in brain monoamines turn over as well as elevation in 8-OHDG, NOx, TNF- α, MDA and GSSG; and reduction in GSH. Ten days daily treatment with RSV (20 and 40 mg/kg p.o) dose dependently increased activity in the OFT and decreased immobility duration in the FST. Moreover, RSV normalized brain monoamines contents, reduced 8-OHDG, NOx, TNF- α, MDA and GSSG; and elevated GSH. In conclusion, we can say that RSV showed neuro-protective properties against HFHF-induced metabolic syndrome represented by monoamines preservation, prevention of neurodegeneration, anti-inflammatory and antioxidant potentials and could be recommended as a beneficial daily dietary supplement to treat the neuronal side effects associated with HFHF-induced metabolic syndrome.

Keywords: antioxidants, DNA-fragmentation, forced swimming test, HFHF-induced metabolic syndrome, monoamines, nitric oxide (NOx), open field, resveratrol, tumor necrosis factor-α (TNF- α), 8-hydroxyguanosine (8-OHDG)

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898 Smartphone Application for Social Inclusion of Deaf Parents and Children About Sphincter Training

Authors: Júlia Alarcon Pinto, Carlos João Schaffhausser, Gustavo Alarcon Pinto

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Introduction: The deaf people in Brazil communicate through the Brazilian Sign Language (LIBRAS), which is restricted to this minority and people that received training. However, there is a lack of prepared professionals in the health system to deal with these patients. Therefore, effective communication, health education, quality of support and assistance are compromised. It is of utmost importance to develop measures that ensure the inclusion of deaf parents and children since there are frequent doubts about sphincter training and an absence of tools to promote effective communication between doctors and their patients. Objective: Use of an efficient, rapid and cheap communication method to promote social inclusion and patient education of deaf parents and children during pediatrics appointments. Results; The application demonstrates how to express phrases and symptoms within seconds and this allows patients to fully understand the information provided during the appointment and are capable to evaluate the signs of readiness, learn the correct approaches with the child, what are the adequate instruments, possible obstacles and the importance to execute medical orientations in order to achieve success in the process. Consequently, patients feel more satisfied, secured and embraced by professionals in the health system care. Conclusion: It is of utmost importance to use efficient and cheap methods that support patient care and education in order to promote health and social inclusion.

Keywords: application, deaf patients, social inclusion, sphincter training

Procedia PDF Downloads 103