Search results for: comprehensive care

Authors: Lulu Liao, Huijing Chen, Yinan Zhao, Hongting Ning, Hui Feng

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Urinary tract infection rate is an important index of care quality in nursing homes. The aim of the study is to understand the nursing assistant's current knowledge and attitudes of urinary incontinence and to explore related stakeholders' viewpoint about urinary incontinence training. This explanatory sequential study used Knowledge, Practice, and Attitude Model (KAP) and Adult Learning Theories, as the conceptual framework. The researchers collected data from 509 nursing assistants in sixteen nursing homes in Hunan province in China. The questionnaire survey was to assess the knowledge and attitude of urinary incontinence of nursing assistants. On the basis of quantitative research and combined with focus group, training demands were identified, which nurse managers should adopt to improve nursing assistants’ professional practice ability in urinary incontinence. Most nursing assistants held the poor knowledge (14.0 ± 4.18) but had positive attitudes (35.5 ± 3.19) toward urinary incontinence. There was a significant positive correlation between urinary incontinence knowledge and nursing assistants' year of work and educational level, urinary incontinence attitude, and education level (p < 0.001). Despite a general awareness of the importance of prevention of urinary tract infections, not all nurse managers fully valued the training in urinary incontinence compared with daily care training. And the nursing assistants required simple education resources to equip them with skills to address problem about urinary incontinence. The variety of learning methods also highlighted the need for educational materials, and nursing assistants had shown a strong interest in online learning. Related education material should be developed to meet the learning need of nurse assistants and provide suitable training method for planned quality improvement in urinary incontinence.

Keywords: mixed methods, nursing assistants, nursing homes, urinary incontinence

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: Aryati Yashadhana, Ted Fields Jnr., Wendy Fernando, Kelvin Brown, Godfrey Blitner, Francis Hayes, Ruby Stanley, Brian Donnelly, Bridgette Jerrard, Anthea Burnett, Anthony B. Zwi

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Indigenous Australians experience some of the worst health outcomes globally, with life expectancy being significantly poorer than those of non-Indigenous Australians. This is largely attributed to preventable diseases such as diabetes (prevalence 39% in Indigenous Australian adults > 55 years), which is attributed to a raised risk of diabetic visual impairment and cataract among Indigenous adults. Our study aims to explore the interface between structural and sociocultural determinants and human agency, in order to understand how they impact (1) accessibility of eye health and chronic disease services and (2) the potential for Indigenous patients to achieve positive clinical eye health outcomes. We used Participatory Action Research methods, and aimed to privilege the voices of Indigenous people through community collaboration. Semi-structured interviews (n=82) and patient focus groups (n=8) were conducted by Indigenous Community-Based Researchers (CBRs) with diabetic Indigenous adults (> 40 years) in four remote communities in Australia. Interviews (n=25) and focus groups (n=4) with primary health care clinicians in each community were also conducted. Data were audio recorded, transcribed verbatim, and analysed thematically using grounded theory, comparative analysis and Nvivo 10. Preliminary analysis occurred in tandem with data collection to determine theoretical saturation. The principal investigator (AY) led analysis sessions with CBRs, fostering cultural and contextual appropriateness to interpreting responses, knowledge exchange and capacity building. Identified themes were conceptualised into three spheres of influence: structural (health services, government), sociocultural (Indigenous cultural values, distrust of the health system, ongoing effects of colonialism and dispossession) and individual (health beliefs/perceptions, patient phenomenology). Permeating these spheres of influence were three core determinants: economic disadvantage, health literacy/education, and cultural marginalisation. These core determinants affected accessibility of services, and the potential for patients to achieve positive clinical outcomes at every level of care (primary, secondary, tertiary). Our findings highlight the clinical realities of institutionalised and structural inequities, illustrated through the lived experiences of Indigenous patients and primary care clinicians in the four sampled communities. The complex determinants surrounding inequity in health for Indigenous Australians, are entrenched through a longstanding experience of cultural discrimination and ostracism. Secure and long term funding of Aboriginal Community Controlled Health Services will be valuable, but are insufficient to address issues of inequity. Rather, working collaboratively with communities to build trust, and identify needs and solutions at the grassroots level, while leveraging community voices to drive change at the systemic/policy level are recommended.

Keywords: indigenous, Australia, culture, public health, eye health, diabetes, social determinants of health, sociology, anthropology, health equity, aboriginal and Torres strait islander, primary care

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Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

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Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

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Authors: Nicki Mohammadi, Emma Reford, Natalia Romano Spica, Laura Tabacof, Jenna Tosto-Mancuso, David Putrino, Christopher P. Kellner

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Introductory Statement: The onset of the COVID-19 pandemic demanded an unprecedented need for the rapid development, dispersal, and application of infection testing. However, despite the impressive mobilization of resources, individuals were incredibly limited in their access to tests, particularly during the initial months of the pandemic (March-April 2020) in New York City (NYC). Access to COVID-19 testing is crucial in understanding patients’ illness experiences and integral to the development of COVID-19 standard-of-care protocols, especially in the context of overall access to healthcare resources. Succinct Description of basic methodologies: 18 Patients in a COVID-19 Remote Patient Monitoring Program (Precision Recovery within the Mount Sinai Health System) were interviewed regarding their experience with COVID-19 during the first wave (March-May 2020) of the COVID-19 pandemic in New York City. Patients were asked about their experiences navigating COVID-19 diagnoses, the health care system, and their recovery process. Transcribed interviews were analyzed for thematic codes, using grounded theory to guide the identification of emergent themes and codebook development through an iterative process. Data coding was performed using NVivo12. References for the domain “testing” were then extracted and analyzed for themes and statistical patterns. Clear Indication of Major Findings of the study: 100% of participants (18/18) referenced COVID-19 testing in their interviews, with a total of 79 references across the 18 transcripts (average: 4.4 references/interview; 2.7% interview coverage). 89% of participants (16/18) discussed the difficulty of access to testing, including denial of testing without high severity of symptoms, geographical distance to the testing site, and lack of testing resources at healthcare centers. Participants shared varying perspectives on how the lack of certainty regarding their COVID-19 status affected their course of recovery. One participant shared that because she never tested positive she was shielded from her anxiety and fear, given the death toll in NYC. Another group of participants shared that not having a concrete status to share with family, friends and professionals affected how seriously onlookers took their symptoms. Furthermore, the absence of a positive test barred some individuals from access to treatment programs and employment support. Concluding Statement: Lack of access to COVID-19 testing in the first wave of the pandemic in NYC was a prominent element of patients’ illness experience, particularly during their recovery phase. While for some the lack of concrete results was protective, most emphasized the invalidating effect this had on the perception of illness for both self and others. COVID-19 testing is now widely accessible; however, those who are unable to demonstrate a positive test result but who are still presumed to have had COVID-19 in the first wave must continue to adapt to and live with the effects of this gap in knowledge and care on their recovery. Future efforts are required to ensure that patients do not face barriers to care due to the lack of testing and are reassured regarding their access to healthcare. Affiliations- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 2Abilities Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY

Keywords: accessibility, COVID-19, recovery, testing

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Authors: K. Makangali, G. Tokysheva, A. Shoman

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Goat meat and goat meat products have garnered increasing attention within the realm of nutrition and health due to their potential to provide a myriad of benefits. This scientific article presents a comprehensive review of the health advantages associated with goat meat consumption and the products derived from it. The paper explores the nutritional content of goat meat, highlighting its favorable composition in terms of protein, essential minerals, and amino acids. It delves into the intricate balance of macronutrients, with lower fat and cholesterol levels compared to other meats, making goat meat a desirable choice for individuals seeking healthier dietary options.

Keywords: goat meat, amino acid, nutrition, meat products, meat

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Authors: Quan Gu, Daniel Dimitrov

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BingleSeq was developed as a shiny-based, intuitive, and comprehensive application that enables the analysis of single-Cell RNA-Sequencing count data. This was achieved via incorporating three state-of-the-art software packages for each type of RNA sequencing analysis, alongside functional annotation analysis and a way to assess the overlap of differential expression method results. At its current state, the functionality implemented within BingleSeq is comparable to that of other applications, also developed with the purpose of lowering the entry requirements to RNA Sequencing analyses. BingleSeq is available on GitHub and will be submitted to R/Bioconductor.

Keywords: bioinformatics, functional annotation analysis, single-cell RNA-sequencing, transcriptomics

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Authors: Chimuanya Osuji, Kido Uyamasi, Morgan Bradley

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Introduction: Obesity is a major risk factor for many chronic diseases, with higher rates occurring among certain populations. Even though disparities in obesity rates exist for those with disabilities, few studies have assessed the association between disability and obesity status. This study aims to examine the association between type of disability and obesity status among US adults during the Covid-19 pandemic (2019-2021). Methods: Data for this cross-sectional study was obtained from the 2019, 2020 and 2021 NHIS. Multinomial logistic regressions were used to assess the relationship between each type of disability and obesity status (reference= normal/underweight). Each model adjusted for demographic, health status and health-related quality of life variables. Statistical analyses were conducted using SAS version 9.4. Results: Of the 82,632 US adults who completed the NHIS in 2019, 2020, and 2021. 8.9% (n= 7,354) reported at least 1 disability-related condition. Respondents reported having a disability across vision (1.5%), hearing (1.5%), mobility (5.3%), communication (0.8%), cognition (2.4%) and self-care (1.1%) domains. After adjusting for covariates, adults with at least 1 disability-related condition were about 30% more likely to have moderate-severe obesity (AOR=1.3; 95% CI=1.11, 1.53). Mobility was the only disability category positively associated with mild obesity (AOR=1.16; 95% CI=1.01, 1.35) and moderate/severe obesity (AOR=1.6; 95% CI=1.35, 1.89). Individuals with vision disability were about 35% less likely to have mild obesity (AOR=0.66; 95% CI=0.51, 0.86) and moderate-severe obesity (AOR=0.66; 95% CI= 0.48, 0.9). Individuals with hearing disability were 28% less likely to have mild obesity (AOR=0.72; 95% CI= 0.56, 0.94). Individuals with communication disability were about 30% less likely to be overweight (AOR=0.66; 95% CI=0.47, 0.93) and 50% less likely to have mild obesity (AOR=0.45; 95% CI= 0.29, 0.71). Individuals with cognitive disability were about 25% less likely to have mild obesity and about 35% less likely to have moderate-severe obesity. Individuals with self-care disability were about 30% less likely to be overweight. Conclusion: Mobility-related disabilities are significantly associated with obesity status among adults residing in the United States. Researchers and policy makers should implement obesity intervention methods that can address the gap in obesity prevalence rates among those with and without disabilities.

Keywords: cognition, disability, mobility, obesity

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Authors: Sabrina Ladjama, Aicha Rizi, Azzedine Abbaci

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In this work, we use the crossover model to formulate a comprehensive fundamental equation of state for the thermodynamic properties for several n-alkanes in the critical region that extends to the classical region. This equation of state is constructed on the basis of comparison of selected measurements of pressure-density-temperature data, isochoric and isobaric heat capacity. The model can be applied in a wide range of temperatures and densities around the critical point for n-heptane. It is found that the developed model represents most of the reliable experimental data accurately.

Keywords: crossover model, critical region, fundamental equation, n-heptane

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Authors: Meinrad Haule Lembuka

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Ubuntu is an African philosophy and model with the meaning of 'humanity to others' or 'care for other’s needs because of the guiding principle of interdependence’ that embraces collective and holistic efforts in development through the human face. The study uses a literature review method reflecting Julius Nyerere’s contributions in realizing Ubuntu and social work practice. Nyerere strived to restore Africa development in the lens of humanism through the values of solidarity, communal participation, compassion, care, justice etc; He later founded developmental social work through Ujamaa model, educational for self reliance and African dignity. Nyerere was against post-colonial syndromes through African socialism that envisioned values and principles of social work to provide social justice, human dignity, social change and social development. Also, he managed to serve the primary mission of the social work profession to enhance human wellbeing and help meet basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty with African Ubuntu practice of equal distribution of resources. Nyerere further endorsed social work legal framework that embraced universal human rights: service, equality, social justice, and human dignity, Importance of human relationship, integrity and competence. Nyerere proved that Indigenous model can work with formal system like Social work profession. In 2014 the National Heritage Council of South Africa (NHC) honored him an Award of African Ubuntu champion. Nyerere strongly upheld to be an ambassador of social work through his remarkably contributions in developmental social work (Ujamaa model), social change, human dignity, equality, social unity and social justice in Africa and globe at large.

Keywords: ubuntu, Indiginious knowledge, Indiginious social work, ubuntu social work

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Authors: Shu Hwang Ang, Choo Yee Yu, Geik Yong Ang, Yean Yean Chan, Yatimah Binti Alias, And Sook Mei Khor

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With the high prevalence of Type 2 diabetes mellitus across the world, the morbidities and mortalities associated with Type 2 diabetes have significant impact on the production line for a nation. With routine scheduled clinical visits to manage Type 2 diabetes, diabetic patients with hectic lifestyles can have low clinical compliance. Hence, it often decreases the effectiveness of diabetic management personalized for each diabetic patient. Here, we report a useful developed point-of-care (POC) device that detect glycated hemoglobin (HbA1c, biomarker for long-term Type 2 diabetic management). In fact, the established POC devices certified to be used in clinical setting are not only expensive ($ 8 to $10 per test), they also require skillful practitioners to perform sampling and interpretation. As a paper-based biosensor, the developed HbA1c biosensor utilized lateral flow principle to offer an alternative for cost-effective (approximately $2 per test) and end-user friendly device for household testing. Requiring as little as 2 L of finger-picked blood, the test can be performed at the household with just simple dilution and washings. With visual interpretation of numbers of test lines shown on the developed biosensor, it can be interpreted as easy as a urine pregnancy test, aided with scale of intensity provided. In summary, the developed HbA1c immunosensor has been tested to have high selectivity towards HbA1c, and is stable with reasonably good performance in clinical testing. Therefore, our developed HbA1c immunosensor has high potential to be an effective diabetic management tool to increase patient compliance and thus contain the progression of the diabetes.

Keywords: blood, glycated hemoglobin (HbA1c), lateral flow, type 2 diabetes mellitus

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Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

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Authors: Alireza Rahpeyma

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One of the most significant challenges faced by cities is inefficient and deteriorated urban fabric. Deteriorated areas bring about numerous issues, including economic, social, physical, and infrastructural problems, sewage management, environmental concerns, and security issues. One of the crucial necessities of modern urban life is the revitalization and renovation of these urban fabrics. Another important aspect is preserving a cohesive cultural and social identity during the urban renewal process. Urban renovation and upgrading are not a one-time occurrence but rather an ongoing process that ultimately needs to become ingrained in the system. This process is not swift; it involves sensitive and intricate stages that require well-designed plans within short, medium, and long-term timeframes. To revitalize dilapidated areas, a comprehensive understanding of the urban region's sustainability is essential. The goal of this study is to provide a suitable model for the upgrading and renewal of areas 2, 4, 5, 7, 8, and 10 in Tehran, preserving the heritage within these urban fabrics (urban assets), including the valuable morphologies of these areas, to prevent financial wastage. This study was conducted descriptively and analytically using the SWOT technique and GIS software. The research results regarding urban upgrading and renewal bring about the following points: 1) Urban upgrading and renewal ensure satisfactory efficiency, justice, environmental quality, safety and security, hygiene, sewage management, and the comfort and aesthetics of urban spaces. 2) Employing the above processes in old city centers re-establishes the historical and cultural connection between people and their past, a past that is evolving and improving and will not repeat itself. 3) Despite the expansion and growth of Iranian cities, cultural and national identity can be preserved by adhering to healthy urban revitalization principles. 4) Proper urban upgrading and renewal prevent social fragmentation, deviant behavioral patterns, psychological and occupational disorders, and financial losses. In general, preserving the identity and urban life in renovation and upgrading must be comprehensive, encompassing various dimensions, including physical, social, economic, political, and administrative aspects.

Keywords: dilapidated areas, renovation, sustainable reconstruction, Tehran-Iran

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Authors: Vaiyapuri Subbarayn Periasamy, Jegan Athinarayanan, Ali A. Alshatwi

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The widespread use of Titanium oxide nanoparticles (TiO2-NPs), now are found with different physic-chemical properties (size, shape, chemical properties, agglomeration, etc.) in many processed foods, agricultural chemicals, biomedical products, food packaging and food contact materials, personal care products, and other consumer products used in daily life. Growing evidences have been highlighted that there are risks of physico-chemical properties dependent toxicity with special attention to “TiO2-NPs and human immune system”. Unfortunately, agglomeration and aggregation have frequently been ignored in immuno-toxicological studies, even though agglomeration and aggregation would be expected to affect nanotoxicity since it changes the size, shape, surface area, and other properties of the TiO2-NPs. In this present investigation, we assessed the immune toxic effect of TiO2-NPs on human immune cells Total WBC including Lymphocytes (T cells (CD3+), T helper cells (CD3+, CD4+), Suppressor/cytotoxic T cells (CD3+/CD8+) and NK cells (CD3-/CD16+ and CD56+), Monocytes (CD14+, CD3-) and B lymphocytes (CD19+, CD3-) in order to find the immunological response (IL1A, IL1B, IL2 IL-4, IL5 IL-6, IL-10, IL-12, IL-13, IFN-γ, TGF-β, and TNF-a) and redox gene regulation (TNF, p53, BCl-2, CAT, GSTA4, TNF, CYP1A, POR, SOD1, GSTM3, GPX1, and GSR1)-linking physicochemical properties with special reference to agglomeration of TiO2-NPs. Our findings suggest that TiO2-NPs altered cytokine production, enhanced phagocytic indexing, metabolic stress through specific immune regulatory- genes expression in different WBC subsets and may contribute to pro-inflammatory response. Although TiO2-NPs have great advantages in the personal care products, biomedical, food and agricultural products, its chronic and acute immune-toxicity still need to be assessed carefully with special reference to food and environmental safety.

Keywords: TiO2 nanoparticles, oxidative stress, cytokine, human immune cells

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Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

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Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong

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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.

Keywords: esophageal perforation, preterm, newborn, feeding tube

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Authors: Ndarusanze Berchmans

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This research work focused on the analysis of the observations of tuberculous meningitis in HIV-positive patients who were treated by the Prince Regent Charles Hospital in Bujumbura. A number of 246 seropositive patients were examined by the laboratory of Prince Regent Charles in the period between 2010 and 2015. We did a retrospective study; we used data from the registers of the laboratories mentioned above; the objective was to approach the epidemiological, biological, clinical, and therapeutic characteristics of tuberculosis meningitis infection: 124 women (50.40% of AIDS patients) and 122 men (49.59% of AIDS patients) were subject to the diagnosis by identification of cerebrospinal fluid (CSF). The average age of the patients was 30 years for this period. The population at risk has an average age of between 34 and 42 years for the years between 2010-2015. From 2010 to 2012, cases of opportunistic diseases (e.g., tuberculous meningitis and Cryptococcus neoformans meningitis), often found in immunocompromised, were observed at a high rate; in this period, there was a disturbance of the rhythm providing antiretroviral drugs to people with AIDS. The rate of the two meningitis (tuberculous meningitis and Cryptococcus neoformans meningitis) remained above 10% to gradually decrease until 2015, with the gradual return of antiretrovirals. This period records an overall average of 25 cases of tuberculous meningitis, or a percentage of 10.16%. For the year 2015, there were 4 cases of tuberculous meningitis out of a total of 35 seropositive examined (11.42%). This year's percentage shows that the number of tuberculous meningitis cases has fallen from the rate in previous years. This is the result of the care given by associations against HIV/AIDS to HIV-positive people. This decrease in cases of tuberculous meningitis is due to the acquisition of antiretrovirals by all HIV-positive people treated by hospitals. For the moment, these hospitals are taking care of many AIDS patients by providing them permanently with antiretrovirals; Besides that, there are many patients who are supported by associations whose activities are directed against HIV/AIDS.

Keywords: Cryptococcus neoformans meningitis, tuberculosis meningitis, neurological complications, epidemiology of meningitis

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Authors: Hussain Ali, Ahmad Ali, Syed Rashid Ali

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The maternal mortality is one of the basic health issues faced by rural women in Pakistan. There are various structural and socio-cultural determinants which confine women to domestic sphere. Such mobility restriction compels women for home delivery which causes high maternal mortality and morbidity. However, it is hard to find out the research findings and well-organized literature that explain the cultural factors act as determinant to home delivery among Pakhtun women. The overall objective of this research is to study men’s decision making within the household in Pakhtun society as determinant of home delivery among Pakhtun women in Khyber Pakhtunkhwa province of Pakistan. In the present study, researchers used the quantitative research design in which the data are collected through household survey technique from (n=503) ever-married women having reproductive age (15-49 years) by using interview schedule. The data are analyzed through SPSS, and binary logistic regression was applied to draw the association between home as a place of delivery and men’s decision making in the Pakhtun society. The results show that majority (76%) of the husbands are key decision makers about the home delivery due to their superior position within household. Similarly, majority (88%) Pakhtun women prefer to stay in home for their delivery due to their dependency on husband’s decision. The researcher concludes that men are key decision makers in Pakhtun society and their decisions affect women maternal health care. Similarly, the women are in subordinate position, and their limited decision making in the domestic sphere are greatly responsible for home delivery which causing high maternal mortality rate in the study area. In order to achieve Sustainable Development Goal No. 3, the study recommends empowering women in the decision making about accessing and utilizing maternal health care services and given financial autonomy to them.

Keywords: home delivery, men’s decision, Pakhtun women, subordinate position

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Authors: K. A. Adepoju, O. I. Shittu, A. U. Chukwu

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In this paper, a new four-parameter generalized version of the Fisher Snedecor distribution called Beta- F distribution is introduced. The comprehensive account of the statistical properties of the new distributions was considered. Formal expressions for the cumulative density function, moments, moment generating function and maximum likelihood estimation, as well as its Fisher information, were obtained. The flexibility of this distribution as well as its robustness using cancer remission time data was demonstrated. The new distribution can be used in most applications where the assumption underlying the use of other lifetime distributions is violated.

Keywords: fisher-snedecor distribution, beta-f distribution, outlier, maximum likelihood method

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Authors: Keigo Nishitani, Kohei Mizuta Mizuta, Kazuyoshi Kurita, Yukinori Taniguchi

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To establish mass production process of Ti capsule which has Fe powder inside as magnetic hyperthermia implant, we assumed that Ti thin sheet can be drawn into a φ1.0 mm die hole through the medium of Fe Powder and becomes outer shell of capsule. This study discusses mechanism of powder assisted deep drawing process by both of numerical simulation and experiment. Ti thin sheet blank was placed on die, and was covered by Fe powder layer without pressurizing. Then upper punch was indented on the Fe powder layer, and the blank can be drawn into die cavity as pressurized powder particles were extruded into die cavity from behind of the drawn blank. Distinct Element Method (DEM) has been used to demonstrate the process. To identify bonding parameters on Fe particles which are cohesion, tensile bond stress and inter particle friction angle, axial and diametrical compression failure test of Fe powder compact was conducted. Several density ratios of powder compacts in range of 0.70 - 0.85 were investigated and relationship between mean stress and equivalent stress was calculated with consideration of critical state line which rules failure criterion in consolidation of Fe powder. Since variation of bonding parameters with density ratio has been experimentally identified, and good agreement has been recognized between several failure tests and its simulation, demonstration of powder assisted sheet forming by using DEM becomes applicable. Results of simulation indicated that indent/drawing length of Ti thin sheet is promoted by smaller Fe particle size, larger indent punch diameter, lower friction coefficient between die surface and Ti sheet and certain degrees of die inlet taper angle. In the deep drawing test, we have made die-set with φ2.4 mm punch and φ1.0 mm die bore diameter. Pure Ti sheet with 100 μm thickness, annealed at 650 deg. C has been tested. After indentation, indented/drawn capsule has been observed by microscope, and its length was measured to discuss the feasibility of this capsulation process. Longer drawing length exists on progressive loading pass comparing with the case of single stroke loading. It is expected that progressive loading has an advantage of which extrusion of powder particle into die cavity with Ti sheet is promoted since powder particle layer can be rebuilt while the punch is withdrawn from the layer in each loading steps. This capsulation phenomenon is qualitatively demonstrated by DEM simulation. Finally, we have fabricated Ti capsule which has Fe powder inside for magnetic hyperthermia cancer care treatment. It is concluded that suggested method is possible to use the manufacturing of Ti capsule implant for magnetic hyperthermia cancer care.

Keywords: metal powder compaction, metal forming, distinct element method, cancer care, magnetic hyperthermia

Procedia PDF Downloads 279

Authors: Martin Hofmann, Diego Stutzer, Thomas Niederhauser, Juergen Burger

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Dental biofilm is the main etiologic factor for caries, periodontal and peri-implant infections. In addition to the risk of tooth loss, periodontitis is also associated with an increased risk of systemic diseases such as atherosclerotic cardiovascular disease and diabetes. For this reason, dental hygienists use ultrasonic scalers for prophylactic and periodontal care of the teeth. However, the current instruments are limited to their dimensions and operating frequencies. The innovative design of a planar ultrasonic transducer introduces a new type of dental scalers. The flat titanium-based design allows the mass to be significantly reduced compared to a conventional screw-mounted Langevin transducer, resulting in a more efficient and controllable scaler. For the development of the novel device, multi-physics finite element analysis was used to simulate and optimise various design concepts. This process was supported by prototyping and electromechanical characterisation. The feasibility and potential of a planar ultrasonic transducer have already been confirmed by our current prototypes, which achieve higher performance compared to commercial devices. Operating at the desired resonance frequency of 28 kHz with a driving voltage of 40 Vrms results in an in-plane tip oscillation with a displacement amplitude of up to 75 μm by having less than 8 % out-of-plane movement and an energy transformation factor of 1.07 μm/mA. In a further step, we will adapt the design to two additional resonance frequencies (20 and 40 kHz) to obtain information about the most suitable mode of operation. In addition to the already integrated characterization methods, we will evaluate the clinical efficiency of the different devices in an in vitro setup with an artificial biofilm pocket model.

Keywords: ultrasonic instrumentation, ultrasonic scaling, piezoelectric transducer, finite element simulation, dental biofilm, dental calculus

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Authors: J. J. Rickard, A. Belli, P. Goldberg Oppenheimer

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Medical diagnostics, environmental monitoring, homeland security and forensics increasingly demand specific and field-deployable analytical technologies for quick point-of-care diagnostics. Although technological advancements have made optical methods well-suited for miniaturization, a highly-sensitive detection technique for minute sample volumes is required. Raman spectroscopy is a well-known analytical tool, but has very weak signals and hence is unsuitable for trace level analysis. Enhancement via localized optical fields (surface plasmons resonances) on nanoscale metallic materials generates huge signals in surface-enhanced Raman scattering (SERS), enabling single molecule detection. This enhancement can be tuned by manipulation of the surface roughness and architecture at the sub-micron level. Nevertheless, the development and application of SERS has been inhibited by the irreproducibility and complexity of fabrication routes. The ability to generate straightforward, cost-effective, multiplex-able and addressable SERS substrates with high enhancements is of profound interest for SERS-based sensing devices. While most SERS substrates are manufactured by conventional lithographic methods, the development of a cost-effective approach to create nanostructured surfaces is a much sought-after goal in the SERS community. Here, a method is established to create controlled, self-organized, hierarchical nanostructures using electrohydrodynamic (HEHD) instabilities. The created structures are readily fine-tuned, which is an important requirement for optimizing SERS to obtain the highest enhancements. HEHD pattern formation enables the fabrication of multiscale 3D structured arrays as SERS-active platforms. Importantly, each of the HEHD-patterned individual structural units yield a considerable SERS enhancement. This enables each single unit to function as an isolated sensor. Each of the formed structures can be effectively tuned and tailored to provide high SERS enhancement, while arising from different HEHD morphologies. The HEHD fabrication of sub-micrometer architectures is straightforward and robust, providing an elegant route for high-throughput biological and chemical sensing. The superior detection properties and the ability to fabricate SERS substrates on the miniaturized scale, will facilitate the development of advanced and novel opto-fluidic devices, such as portable detection systems, and will offer numerous applications in biomedical diagnostics, forensics, ecological warfare and homeland security.

Keywords: hierarchical electrohydrodynamic patterning, medical diagnostics, point-of care devices, SERS

Procedia PDF Downloads 332

Authors: C. Puangsawat, C. Limotai, P. Srikhachin

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Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

Procedia PDF Downloads 116

Authors: Jibran Abbasy, Rizwan Sultan, Ammar Humayun, Tabish Chawla

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Background: Hydatid disease caused by Echinococcus Granulosus affects liver in 70-90% of cases. Dogs are the definitive host while humans are the accidental host. Modalities used for its treatment are especially important for our population as the disease is endemic in many Asian countries. The aim of the study was to perform an audit of the various modalities used for treatment of hydatid disease of liver and the response to each modality in tertiary care center of Pakistan. Materials and Methods: Retrospective audit of patients diagnosed and treated for Hydatid disease of the liver at Aga Khan University Hospital from 1st January 2007 to 31st December 2014 was completed. All patients aged 16 and above were included. Patients who had extra hepatic disease and missing records were excluded. Outcome measures were morbidity, mortality and recurrence of the disease. Results: During the study period 56 patients were treated for isolated hepatic hydatid disease and were included. Mean age was 39 years with 48% being females and 52% males. Most common presenting complaint was abdominal pain seen in 53% of patients(n=41). Duration of symptoms was less than 6 months in 74% (n=38). Mostly right lobe was involved in 69% (n=38).Most common treatment modality used was surgery in 34 patients followed by PAIR in 14 patients while 8 patients were treated medically. At a median follow up of 34 months recurrence was seen in 2 patients treated with PAIR while no patient treated with surgery had recurrence with the median follow up of 20 months. While no morbidity and mortality were observed in PAIR, but in surgery 5 patients had morbidity while 1 patient had mortality. Conclusion: Our data is comparative to other studies in terms of morbidity, mortality, and recurrence. We had adequate follow up. In our study PAIR and surgery both are effective and have less complications and recurrence rate. Surgery is still the gold standard in terms of recurrence.

Keywords: echinococcous granulosus, puncture aspiration irrigation reaspiration (PAIR), surgery, hydatid disease

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Authors: Patrick Mapulanga, Chisomo Petros Ganya

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Purpose: This study aimed to investigate the integration of Simulation-Based Education (SBE) into nursing and midwifery curricula in resource-constrained countries using Malawi as a case study. The purpose of this study is to assess the extent to which SBE is mentioned in curricula and explore the associated content, assessment criteria, and guidelines. Methodology: The research methodology involved a desk study of nursing and midwifery curricula in Malawi. A comprehensive review was conducted to identify references to SBE by examining documents such as official curriculum guides, syllabi, and educational policies. The focus is on understanding the prevalence of SBE without delving into the specific content or assessment details. Findings: The findings revealed that SBE is indeed mentioned in the nursing and midwifery curricula in Malawi; however, there is a notable absence of detailed content and assessment criteria. While acknowledgement of SBE is a positive step, the lack of specific guidelines poses a challenge to its effective implementation and assessment within the educational framework. Conclusion: The study concludes that although the recognition of SBE in Malawian nursing and midwifery curricula signifies a potential openness to innovative learning strategies, the absence of detailed content and assessment criteria raises concerns about the practical application of SBE. Addressing this gap is crucial for harnessing the full transformative potential of SBE in resource-constrained environments. Areas for Further Research: Future research endeavours should focus on a more in-depth exploration of the content and assessment criteria related to SBE in nursing and midwifery curricula. Investigating faculty perspectives and students’ experiences with SBE could provide valuable insights into the challenges and opportunities associated with its implementation. Study Limitations and Implications: The study's limitations include reliance on desk-based analysis, which limits the depth of understanding regarding SBE implementation. Despite this constraint, the implications of the findings underscore the need for curriculum developers, educators, and policymakers to collaboratively address the gaps in SBE integration and ensure a comprehensive and effective learning experience for nursing and midwifery students in resource-constrained countries.

Keywords: simulation based education, transformative learning, nursing and midwifery, curricula, Malawi

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Authors: Alexandra M. Kriofske Mainella

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This paper will examine the need for more aggressive public policies around bodily, reproductive and sexual health education for young people with disabilities in the United States. This paper will consider the policies around sexuality education for students in the United States and the recommendation for national standards around sexuality education. We will investigate the intersection of these policies and recommendations for students with disabilities and the Individuals with Disabilities Education Act (IDEA): what this means for students with disabilities’ access to comprehensive sexuality education and how it affects their behaviors and outcomes.

Keywords: disability, sexuality, education, policy

Procedia PDF Downloads 422

Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

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Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

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Authors: Jiaqi Yin, Baofeng Liang

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The rapid development in the fields of computer science and information technology presents new challenges and opportunities for foundational programming education. Traditional programming courses often focus heavily on theoretical knowledge while neglecting students’ practical programming and problem-solving abilities. This paper delves into the significance of programming education based on application abilities and provides a detailed explanation of a reform approach that incorporates project-driven teaching to nurture students with more comprehensive computer science skills.

Keywords: fundamentals of programming, application abilities, pedagogical reform, program design

Procedia PDF Downloads 53

Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Chukwuka E. V., Rowling J. K., Rushdie Salman

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The field of electronic engineering encompasses the study and application of electrical systems, circuits, and devices. Engineers in this discipline design, analyze and optimize electronic components to develop innovative solutions for various industries. This abstract provides a brief overview of the diverse areas within electronic engineering, including analog and digital electronics, signal processing, communication systems, and embedded systems. It highlights the importance of staying abreast of advancements in technology and fostering interdisciplinary collaboration to address contemporary challenges in this rapidly evolving field.

Keywords: smart home engineering, energy efficiency, user-centric design, security frameworks

Procedia PDF Downloads 70