Search results for: maturity score
234 Evaluating the Characteristics of Paediatric Accidental Poisonings
Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo
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Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.Keywords: accidental, caregiver, paediatrics, poisoning
Procedia PDF Downloads 204233 Knowledge, Attitude and Practices of Contraception among the Married Women of Reproductive Age Group in Selected Wards of Dharan Sub-Metropolitan City
Authors: Pratima Thapa
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Background: It is very critical to understand that awareness of family planning and proper utilization of contraceptives is an important indicator for reducing maternal and neonatal mortality and morbidity. It also plays an important role in promoting reproductive health of the women in an underdeveloped country like ours. Objective: To assess knowledge, attitude and practices of contraception among married women of reproductive age group in selected wards of Dharan Sub-Metropolitan City. Materials and methods: A cross-sectional descriptive study was conducted among 209 married women of reproductive age. Simple random sampling was used to select the wards, population proportionate sampling for selecting the sample numbers from each wards and purposive sampling for selecting each sample. Semi-structured questionnaire was used to collect data. Descriptive and inferential statistics were used to interpret the data considering p-value 0.05. Results: The mean ± SD age of the respondents was 30.01 ± 8.12 years. Majority 92.3% had ever heard of contraception. Popular known method was Inj. Depo (92.7%). Mass media (85.8%) was the major source of information. Mean percentage score of knowledge was 45.23%.less than half (45%) had adequate knowledge. Majority 90.4% had positive attitude. Only 64.6% were using contraceptives currently. Misbeliefs and fear of side effects were the main reason for not using contraceptives. Education, occupation, and total income of the family was associated with knowledge regarding contraceptives. Results for Binary Logistic Regression showed significant correlates of attitude with distance to the nearest health facility (OR=7.97, p<0.01), education (OR=0.24, p<0.05) and age group (0.03, p<0.01). Regarding practice, likelihood of being current user of contraceptives increased significantly by being literate (OR=5.97, p<0.01), having nuclear family (OR=4.96, p<0.01), living in less than 30 minute walk distance from nearest health facility (OR=3.34, p<0.05), women’s participation in decision making regarding household and fertility choices (OR=5.23, p<0.01) and husband’s support on using contraceptives (OR=9.05, p<0.01). Significant and positive correlation between knowledge-attitude, knowledge-practice and attitude-practice were observed. Conclusion: Results of the study indicates that there is need to increase awareness programs in order to intensify the knowledge and practices of contraception. The positive correlation indorses that better knowledge can lead to positive attitude and hence good practice. Further, projects aiming to increase better counselling about contraceptives, its side effects and the positive effects that outweighs the negative aspects should be enrolled appropriately.Keywords: attitude, contraceptives, knowledge, practice
Procedia PDF Downloads 253232 Tardiness and Self-Regulation: Degree and Reason for Tardiness in Undergraduate Students in Japan
Authors: Keiko Sakai
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In Japan, all stages of public education aim to foster a zest for life. ‘Zest’ implies solving problems by oneself, using acquired knowledge and skills. It is related to the self-regulation of metacognition. To enhance this, establishing good learning habits is important. Tardiness in undergraduate students should be examined based on self-regulation. Accordingly, we focussed on self-monitoring and self-planning strategies among self-regulated learning factors to examine the causes of tardiness. This study examines the impact of self-monitoring and self-planning learning skills on the degree and reason for tardiness in undergraduate students. A questionnaire survey was conducted, targeted to undergraduate students in University X in the autumn semester of 2018. Participants were 247 (average age 19.7, SD 1.9; 144 males, 101 females, 2 no answers). The survey contained the following items and measures: school year, the number of classes in the semester, degree of tardiness in the semester (subjective degree and objective times), active participation in and action toward schoolwork, self-planning and self-monitoring learning skills, and reason for tardiness (open-ended question). First, the relation between strategies and tardiness was examined by multiple regressions. A statistically significant relationship between a self-monitoring learning strategy and the degree of subjective and objective tardiness was revealed, after statistically controlling the school year and the number of classes. There was no significant relationship between a self-planning learning strategy and the degree of tardiness. These results suggest that self-monitoring skills reduce tardiness. Secondly, the relation between a self-monitoring learning strategy and the reason of tardiness was analysed, after classifying the reason for tardiness into one of seven categories: ‘overslept’, ‘illness’, ‘poor time management’, ‘traffic delays’, ‘carelessness’, ‘low motivation’, and ‘stuff to do’. Chi-square tests and Fisher’s exact tests showed a statistically significant relationship between a self-monitoring learning strategy and the frequency of ‘traffic delays’. This result implies that self-monitoring skills prevent tardiness because of traffic delays. Furthermore, there was a weak relationship between a self-monitoring learning strategy score and the reason-for-tardiness categories. When self-monitoring skill is higher, a decrease in ‘overslept’ and ‘illness’, and an increase in ‘poor time management’, ‘carelessness’, and ‘low motivation’ are indicated. It is suggested that a self-monitoring learning strategy is related to an internal causal attribution of failure and self-management for how to prevent tardiness. From these findings, the effectiveness of a self-monitoring learning skill strategy for reducing tardiness in undergraduate students is indicated.Keywords: higher-education, self-monitoring, self-regulation, tardiness
Procedia PDF Downloads 125231 Expression of Ki-67 in Multiple Myeloma: A Clinicopathological Study
Authors: Kangana Sengar, Sanjay Deb, Ramesh Dawar
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Introduction: Ki-67 can be a useful marker in determining proliferative activity in patients with multiple myeloma (MM). However, using Ki-67 alone results in the erroneous inclusion of non-myeloma cells leading to false high counts. We have used Dual IHC (immunohistochemistry) staining with Ki-67 and CD138 to enhance specificity in assessing proliferative activity of bone marrow plasma cells. Aims and objectives: To estimate the proportion of proliferating (Ki-67 expressing) plasma cells in patients with MM and correlation of Ki-67 with other known prognostic parameters. Materials and Methods: Fifty FFPE (formalin fixed paraffin embedded) blocks of trephine biopsies of cases diagnosed as MM from 2010 to 2015 are subjected to H & E staining and Dual IHC staining for CD 138 and Ki-67. H & E staining is done to evaluate various histological parameters like percentage of plasma cells, pattern of infiltration (nodular, interstitial, mixed and diffuse), routine parameters of marrow cellularity and hematopoiesis. Clinical data is collected from patient records from Medical Record Department. Each of CD138 expressing cells (cytoplasmic, red) are scored as proliferating plasma cells (containing a brown Ki¬67 nucleus) or non¬proliferating plasma cells (containing a blue, counter-stained, Ki-¬67 negative nucleus). Ki-67 is measured as percentage positivity with a maximum score of hundred percent and lowest of zero percent. The intensity of staining is not relevant. Results: Statistically significant correlation of Ki-67 in D-S Stage (Durie & Salmon Stage) I vs. III (p=0.026) and ISS (International Staging System) Stage I vs. III (p=0.019), β2m (p=0.029) and percentage of plasma cells (p < 0.001) is seen. No statistically significant correlation is seen between Ki-67 and hemoglobin, platelet count, total leukocyte count, total protein, albumin, S. calcium, S. creatinine, S. LDH, blood urea and pattern of infiltration. Conclusion: Ki-67 index correlated with other known prognostic parameters. However, it is not determined routinely in patients with MM due to little information available regarding its relevance and paucity of studies done to correlate with other known prognostic factors in MM patients. To the best of our knowledge, this is the first study in India using Dual IHC staining for Ki-67 and CD138 in MM patients. Routine determination of Ki-67 will help to identify patients who may benefit with more aggressive therapy. Recommendation: In this study follow up of patients is not included, and the sample size is small. Studying with larger sample size and long follow up is advocated to prognosticate Ki-67 as a marker of survival in patients with multiple myeloma.Keywords: bone marrow, dual IHC, Ki-67, multiple myeloma
Procedia PDF Downloads 136230 Developing a Sustainable System to Deliver Early Intervention for Emotional Health through Australian Schools
Authors: Rebecca-Lee Kuhnert, Ron Rapee
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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health
Procedia PDF Downloads 89229 Understanding the Role of Concussions as a Risk Factor for Multiple Sclerosis
Authors: Alvin Han, Reema Shafi, Alishba Afaq, Jennifer Gommerman, Valeria Ramaglia, Shannon E. Dunn
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Adolescents engaged in contact-sports can suffer from recurrent brain concussions with no loss of consciousness and no need for hospitalization, yet they face the possibility of long-term neurocognitive problems. Recent studies suggest that head concussive injuries during adolescence can also predispose individuals to multiple sclerosis (MS). The underlying mechanisms of how brain concussions predispose to MS is not understood. Here, we hypothesize that: (1) recurrent brain concussions prime microglial cells, the tissue resident myeloid cells of the brain, setting them up for exacerbated responses when exposed to additional challenges later in life; and (2) brain concussions lead to the sensitization of myelin-specific T cells in the peripheral lymphoid organs. Towards addressing these hypotheses, we implemented a mouse model of closed head injury that uses a weight-drop device. First, we calibrated the model in male 12 week-old mice and established that a weight drop from a 3 cm height induced mild neurological symptoms (mean neurological score of 1.6+0.4 at 1 hour post-injury) from which the mice fully recovered by 72 hours post-trauma. Then, we performed immunohistochemistry on the brain of concussed mice at 72 hours post-trauma. Despite mice having recovered from all neurological symptoms, immunostaining for leukocytes (CD45) and IBA-1 revealed no peripheral immune infiltration, but an increase in the intensity of IBA1+ staining compared to uninjured controls, suggesting that resident microglia had acquired a more active phenotype. This microglia activation was most apparent in the white matter tracts in the brain and in the olfactory bulb. Immunostaining for the microglia-specific homeostatic marker TMEM119, showed a reduction in TMEM119+ area in the brain of concussed mice compared to uninjured controls, confirming a loss of this homeostatic signal by microglia after injury. Future studies will test whether single or repetitive concussive injury can worsen or accelerate autoimmunity in male and female mice. Understanding these mechanisms will guide the development of timed and targeted therapies to prevent MS from getting started in people at risk.Keywords: concussion, microglia, microglial priming, multiple sclerosis
Procedia PDF Downloads 90228 Identification of a Lead Compound for Selective Inhibition of Nav1.7 to Treat Chronic Pain
Authors: Sharat Chandra, Zilong Wang, Ru-Rong Ji, Andrey Bortsov
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Chronic pain (CP) therapeutic approaches have limited efficacy. As a result, doctors are prescribing opioids for chronic pain, leading to opioid overuse, abuse, and addiction epidemic. Therefore, the development of effective and safe CP drugs remains an unmet medical need. Voltage-gated sodium (Nav) channels act as cardiovascular and neurological disorder’s molecular targets. Nav channels selective inhibitors are hard to design because there are nine closely-related isoforms (Nav1.1-1.9) that share the protein sequence segments. We are targeting the Nav1.7 found in the peripheral nervous system and engaged in the perception of pain. The objective of this project was to screen a 1.5 million compound library for identification of inhibitors for Nav1.7 with analgesic effect. In this study, we designed a protocol for identification of isoform-selective inhibitors of Nav1.7, by utilizing the prior information on isoform-selective antagonists. First, a similarity search was performed; then the identified hits were docked into a binding site on the fourth voltage-sensor domain (VSD4) of Nav1.7. We used the FTrees tool for similarity searching and library generation; the generated library was docked in the VSD4 domain binding site using FlexX and compounds were shortlisted using a FlexX score and SeeSAR hyde scoring. Finally, the top 25 compounds were tested with molecular dynamics simulation (MDS). We reduced our list to 9 compounds based on the MDS root mean square deviation plot and obtained them from a vendor for in vitro and in vivo validation. Whole-cell patch-clamp recordings in HEK-293 cells and dorsal root ganglion neurons were conducted. We used patch pipettes to record transient Na⁺ currents. One of the compounds reduced the peak sodium currents in Nav1.7-HEK-293 stable cell line in a dose-dependent manner, with IC50 values at 0.74 µM. In summary, our computer-aided analgesic discovery approach allowed us to develop pre-clinical analgesic candidate with significant reduction of time and cost.Keywords: chronic pain, voltage-gated sodium channel, isoform-selective antagonist, similarity search, virtual screening, analgesics development
Procedia PDF Downloads 119227 Integrating Data Mining with Case-Based Reasoning for Diagnosing Sorghum Anthracnose
Authors: Mariamawit T. Belete
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Cereal production and marketing are the means of livelihood for millions of households in Ethiopia. However, cereal production is constrained by technical and socio-economic factors. Among the technical factors, cereal crop diseases are the major contributing factors to the low yield. The aim of this research is to develop an integration of data mining and knowledge based system for sorghum anthracnose disease diagnosis that assists agriculture experts and development agents to make timely decisions. Anthracnose diagnosing systems gather information from Melkassa agricultural research center and attempt to score anthracnose severity scale. Empirical research is designed for data exploration, modeling, and confirmatory procedures for testing hypothesis and prediction to draw a sound conclusion. WEKA (Waikato Environment for Knowledge Analysis) was employed for the modeling. Knowledge based system has come across a variety of approaches based on the knowledge representation method; case-based reasoning (CBR) is one of the popular approaches used in knowledge-based system. CBR is a problem solving strategy that uses previous cases to solve new problems. The system utilizes hidden knowledge extracted by employing clustering algorithms, specifically K-means clustering from sampled anthracnose dataset. Clustered cases with centroid value are mapped to jCOLIBRI, and then the integrator application is created using NetBeans with JDK 8.0.2. The important part of a case based reasoning model includes case retrieval; the similarity measuring stage, reuse; which allows domain expert to transfer retrieval case solution to suit for the current case, revise; to test the solution, and retain to store the confirmed solution to the case base for future use. Evaluation of the system was done for both system performance and user acceptance. For testing the prototype, seven test cases were used. Experimental result shows that the system achieves an average precision and recall values of 70% and 83%, respectively. User acceptance testing also performed by involving five domain experts, and an average of 83% acceptance is achieved. Although the result of this study is promising, however, further study should be done an investigation on hybrid approach such as rule based reasoning, and pictorial retrieval process are recommended.Keywords: sorghum anthracnose, data mining, case based reasoning, integration
Procedia PDF Downloads 73226 Clinical Outcomes and Symptom Management in Pediatric Patients Following Eczema Action Plans: A Quality Improvement Project
Authors: Karla Lebedoff, Susan Walsh, Michelle Bain
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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema
Procedia PDF Downloads 130225 Mechanical Ventilation: Relationship between Body Mass Index and Selected Patients' Outcomes at a University Hospital in Cairo
Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen
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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure
Procedia PDF Downloads 242224 Analyzing the Job Satisfaction of Silver Workers Using Structural Equation Modeling
Authors: Valentin Nickolai, Florian Pfeffel, Christian Louis Kühner
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In many industrialized nations, the demand for skilled workers rises, causing the current market for employees to be more candidate-driven than employer-driven. Therefore, losing highly skilled and experienced employees due to early or partial retirement negatively impacts firms. Therefore, finding new ways to incentivize older employees (Silver Workers) to stay longer with the company and in their job can be crucial for the success of a firm. This study analyzes how working remotely can be a valid incentive for experienced Silver Workers to stay in their job and instead work from home with more flexible working hours. An online survey with n = 684 respondents, who are employed in the service sector, has been conducted based on 13 constructs that influence job satisfaction. These have been further categorized into three groups “classic influencing factors,” “influencing factors changed by remote working,” and new remote working influencing factors,” and were analyzed using structural equation modeling (SEM). Here, Cronbach’s alpha of the individual constructs was shown to be suitable. Furthermore, the construct validity of the constructs was confirmed by face validity, content validity, convergent validity (AVE > 0.5: CR > 0.7), and discriminant validity. Additionally, confirmatory factor analysis (CFA) confirmed the model fit for the investigated sample (CMIN/DF: 2.567; CFI: 0.927; RMSEA: 0.048). It was shown in the SEM-analysis that the influencing factor on job satisfaction, “identification with the work,” is the most significant with β = 0.540, followed by “Appreciation” (β = 0.151), “Compensation” (β = 0.124), “Work-Life-Balance” (β = 0.116), and “Communication and Exchange of Information” (β = 0.105). While the significance of each factor can vary depending on the work model, the SEM-analysis also shows that the identification with the work is the most significant factor in all three work models mentioned above and, in the case of the traditional office work model, it is the only significant influencing factor. The study shows that employees between the ages of 56 and 65 years have the highest job satisfaction when working entirely from home or remotely. Furthermore, their job satisfaction score of 5.4 on a scale from 1 (very dissatisfied) to 7 (very satisfied) is the highest amongst all age groups in any of the three work models. Due to the significantly higher job satisfaction, it can be argued that giving Silver Workers the offer to work from home or remotely can incentivize them not to opt for early retirement or partial retirement but to stay in their job full-time Furthermore, these findings can indicate that employees in the Silver Worker age are much more inclined to leave their job for early retirement if they have to entirely work in the office.Keywords: home office, remote work instead of early or partial retirement, silver worker, structural equation modeling
Procedia PDF Downloads 65223 Exploration and Evaluation of the Effect of Multiple Countermeasures on Road Safety
Authors: Atheer Al-Nuaimi, Harry Evdorides
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Every day many people die or get disabled or injured on roads around the world, which necessitates more specific treatments for transportation safety issues. International road assessment program (iRAP) model is one of the comprehensive road safety models which accounting for many factors that affect road safety in a cost-effective way in low and middle income countries. In iRAP model road safety has been divided into five star ratings from 1 star (the lowest level) to 5 star (the highest level). These star ratings are based on star rating score which is calculated by iRAP methodology depending on road attributes, traffic volumes and operating speeds. The outcome of iRAP methodology are the treatments that can be used to improve road safety and reduce fatalities and serious injuries (FSI) numbers. These countermeasures can be used separately as a single countermeasure or mix as multiple countermeasures for a location. There is general agreement that the adequacy of a countermeasure is liable to consistent losses when it is utilized as a part of mix with different countermeasures. That is, accident diminishment appraisals of individual countermeasures cannot be easily added together. The iRAP model philosophy makes utilization of a multiple countermeasure adjustment factors to predict diminishments in the effectiveness of road safety countermeasures when more than one countermeasure is chosen. A multiple countermeasure correction factors are figured for every 100-meter segment and for every accident type. However, restrictions of this methodology incorporate a presumable over-estimation in the predicted crash reduction. This study aims to adjust this correction factor by developing new models to calculate the effect of using multiple countermeasures on the number of fatalities for a location or an entire road. Regression models have been used to establish relationships between crash frequencies and the factors that affect their rates. Multiple linear regression, negative binomial regression, and Poisson regression techniques were used to develop models that can address the effectiveness of using multiple countermeasures. Analyses are conducted using The R Project for Statistical Computing showed that a model developed by negative binomial regression technique could give more reliable results of the predicted number of fatalities after the implementation of road safety multiple countermeasures than the results from iRAP model. The results also showed that the negative binomial regression approach gives more precise results in comparison with multiple linear and Poisson regression techniques because of the overdispersion and standard error issues.Keywords: international road assessment program, negative binomial, road multiple countermeasures, road safety
Procedia PDF Downloads 231222 The Clinical Effectiveness of Off-The-Shelf Foot Orthoses on the Dynamics of Gait in Patients with Early Rheumatoid Arthritis
Authors: Vicki Cameron
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Background: Rheumatoid Arthritis (RA) typically effects the feet and about 20% of patients present initially with foot and ankle symptoms. Custom moulded foot orthoses (FO) in the management of foot and ankle problems in RA is well documented in the literature. Off-the-shelf FO are thought to provide an effective alternative to custom moulded FO in patients with RA, however they are not evidence based. Objectives: To determine the effects of off-the-shelf FO on; 1. quality of life (QOL) 2. walking speed 4. peak plantar pressure in the forefoot (PPPft) Methods: Thirty-five patients (six male and 29 female) participated in the study from 11/2006 to 07/2008. The age of the patients ranged from 26 to 80 years (mean 52.4 years; standard deviation [SD] 13.3 years). A repeated measures design was used, with patients presenting at baseline, three months and six months. Patients were tested walking barefoot, shod and shod with FO. The type of orthoses used was the Slimflex Plastic ® (Algeos). The Leeds Foot Impact Scale (LFIS) was used to investigate QOL. The Vicon 612 motion analysis system was used to determine the effect of FO on walking speed. The F-scan walkway and in-shoe systems provided information of the effect on PPPft. Ethical approval was obtained on 07/2006. Data was analysed using SPSS version 15.0. Results/Discussion: The LFIS data was analysed with a repeated measures ANOVA. There was a significant improvement in the LFIS score with the use of the FO over the six months (p<0.01). A significant increase in walking speed with the orthoses was observed (p<0.01). Peak plantar pressure in the forefoot was reduced with the FO, as shown by a non-parametric Friedman’s test (chi-square = 55.314, df=2, p<0.05). Conclusion: The results show that off-the-shelf FO are effective in managing foot problems in patients with RA. Patients reported an improved QOL with the orthoses, and further objective measurements were quantified to provide a rationale for this change. Patients demonstrated an increased walking speed, which has been shown to be associated with reduced pain. The FO decreased PPPft which have been reported as a site of pain and ulceration in patients with RA. Salient Clinical Points: Off-the-shelf FO offer an effective alternative to custom moulded FO, and can be dispensed at the chair side. This is crucial in the management of foot problems associated with RA as early intervention is advocated due to the chronic and progressive nature of the disease.Keywords: podiatry, rheumatoid arthritis, foot orthoses, gait analysis
Procedia PDF Downloads 252221 Effects of Evening vs. Morning Training on Motor Skill Consolidation in Morning-Oriented Elderly
Authors: Maria Korman, Carmit Gal, Ella Gabitov, Avi Karni
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The main question addressed in this study was whether the time-of-day wherein training is afforded is a significant factor for motor skill ('how-to', procedural knowledge) acquisition and consolidation into long term memory in the healthy elderly population. Twenty-nine older adults (60-75 years) practiced an explicitly instructed 5-element key-press sequence by repeatedly generating the sequence ‘as fast and accurately as possible’. Contribution of three parameters to acquisition, 24h post-training consolidation, and 1-week retention gains in motor sequence speed was assessed: (a) time of training (morning vs. evening group) (b) sleep quality (actigraphy) and (c) chronotype. All study participants were moderately morning type, according to the Morningness-Eveningness Questionnaire score. All participants had sleep patterns typical of age, with average sleep efficiency of ~ 82%, and approximately 6 hours of sleep. Speed of motor sequence performance in both groups improved to a similar extent during training session. Nevertheless, evening group expressed small but significant overnight consolidation phase gains, while morning group showed only maintenance of performance level attained at the end of training. By 1-week retention test, both groups showed similar performance levels with no significant gains or losses with respect to 24h test. Changes in the tapping patterns at 24h and 1-week post-training were assessed based on normalized Pearson correlation coefficients using the Fisher’s z-transformation in reference to the tapping pattern attained at the end of the training. Significant differences between the groups were found: the evening group showed larger changes in tapping patterns across the consolidation and retention windows. Our results show that morning-oriented older adults effectively acquired, consolidated, and maintained a new sequence of finger movements, following both morning and evening practice sessions. However, time-of-training affected the time-course of skill evolution in terms of performance speed, as well as the re-organization of tapping patterns during the consolidation period. These results are in line with the notion that motor training preceding a sleep interval may be beneficial for the long-term memory in the elderly. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype.Keywords: time-of-day, elderly, motor learning, memory consolidation, chronotype
Procedia PDF Downloads 126220 Tourists' Perception to the Service Quality of White Water Rafting in Bali: Case Study of Ayung River
Authors: Ni Putu Evi Wijayanti, Made Darmiati, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono
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This research study discusses the tourists’ perception to white water rafting service quality in Bali (Case Study: Ayung River). The aim is to determine the tourists’ perception to: firstly, the services quality of white water rafting trip in Bali, secondly, is to determine which dimensions of the service quality that need to take main handling priority in accordance with the level of important service of white water rafting company’s working performance toward the service quality of rafting in Bali especially on Ayung Riveri, lastly, is to know the efforts are needed to improve the service quality of white water rafting trip for tourist in Bali, specifically on Ayung River. This research uses the concept of the service quality with five principal dimensions, namely: Tangibles, Reliability, Responsiveness, Assurance, Empathy. Location of the research is tourist destination area of the Ayung River, that lies between the boundary of Badung Regency at Western part and Gianyar Regency eastern side. There are three rafting companies located on the Ayung River. This research took 100 respondents who were selected as a sample by using purposive sampling method. Data were collected through questionnaires distributed to domestic tourists then tabulated using the weighting scale (Likert scale) and analyzed using analysis of the benefit performance (important performance analysis) in the form of Cartesian diagram. The results of the research are translated into three points. Firstly, there are 23 indicators assessed by the service aspect of domestic tourists where the highest value is the aspect of familiarity between the tourist and employees with points (0.29) and the lowest score is the aspect of the clarity of the Ayung River water discharge value (-0.35). This shows that the indicator has not been fully able to meet the expectations of service aspects of the rating. Secondly, the dimensions of service quality that requires serious attention is the dimension of tangibles. The third point is the efforts that needs to be done adapted to the results of the Cartesian diagram breaks down into four quadrants. Based on the results of the research suggested to the manager of the white water rafting tour in order to continuously improve the service quality to tourists, performing new innovations in terms of product variations, provide insight and training to its employees to increase their competence, especially in the field of excellent service so that the satisfaction rating can be achieved.Keywords: perception, rafting, service quality, tourist satisfaction
Procedia PDF Downloads 234219 Bartlett Factor Scores in Multiple Linear Regression Equation as a Tool for Estimating Economic Traits in Broilers
Authors: Oluwatosin M. A. Jesuyon
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In order to propose a simpler tool that eliminates the age-long problems associated with the traditional index method for selection of multiple traits in broilers, the Barttlet factor regression equation is being proposed as an alternative selection tool. 100 day-old chicks each of Arbor Acres (AA) and Annak (AN) broiler strains were obtained from two rival hatcheries in Ibadan Nigeria. These were raised in deep litter system in a 56-day feeding trial at the University of Ibadan Teaching and Research Farm, located in South-west Tropical Nigeria. The body weight and body dimensions were measured and recorded during the trial period. Eight (8) zoometric measurements namely live weight (g), abdominal circumference, abdominal length, breast width, leg length, height, wing length and thigh circumference (all in cm) were recorded randomly from 20 birds within strain, at a fixed time on the first day of the new week respectively with a 5-kg capacity Camry scale. These records were analyzed and compared using completely randomized design (CRD) of SPSS analytical software, with the means procedure, Factor Scores (FS) in stepwise Multiple Linear Regression (MLR) procedure for initial live weight equations. Bartlett Factor Score (BFS) analysis extracted 2 factors for each strain, termed Body-length and Thigh-meatiness Factors for AA, and; Breast Size and Height Factors for AN. These derived orthogonal factors assisted in deducing and comparing trait-combinations that best describe body conformation and Meatiness in experimental broilers. BFS procedure yielded different body conformational traits for the two strains, thus indicating the different economic traits and advantages of strains. These factors could be useful as selection criteria for improving desired economic traits. The final Bartlett Factor Regression equations for prediction of body weight were highly significant with P < 0.0001, R2 of 0.92 and above, VIF of 1.00, and DW of 1.90 and 1.47 for Arbor Acres and Annak respectively. These FSR equations could be used as a simple and potent tool for selection during poultry flock improvement, it could also be used to estimate selection index of flocks in order to discriminate between strains, and evaluate consumer preference traits in broilers.Keywords: alternative selection tool, Bartlet factor regression model, consumer preference trait, linear and body measurements, live body weight
Procedia PDF Downloads 198218 Proximate Composition, Minerals and Sensory Attributes of Cake, Cookies, Cracker, and Chin-Chin Prepared from Cassava-Gari Residue Flour
Authors: Alice Nwanyioma Ohuoba, Rose Erdoo Kukwa, Ukpabi Joseph Ukpabi
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Cassava root (Manihot esculenta) is one of the important carbohydrates containing crops in Nigeria. It is a staple food, mostly in the southern part of the country, and a source of income to farmers and processors. Cassava gari processing methods result to residue fiber (solid waste) from the sieving operation, these residue fibers ( solid wastes) can be dried and milled into flour and used to prepare cakes, cookies, crackers and chin-chin instead of being thrown away mostly on farmland or near the residential area. Flour for baking or frying may contain carbohydrates and protein (wheat flour) or rich in only carbohydrates (cassava flour). Cake, cookies, crackers, and chin-chin were prepared using the residue flour obtained from the residue fiber of cassava variety NR87184 roots, processed into gari. This study is aimed at evaluating the proximate composition, mineral content and sensory attributes of these selected snacks produced. The proximate composition results obtained showed that crackers had the lowest value in moisture (2.3390%) and fat (1.7130%), but highest in carbohydrates (85.2310%). Amongst the food products, cakes recorded the highest value in protein (8.0910%). Crude fibre values ranges from 2.5265% (cookies) to 3.4165% (crackers). The result of the mineral contents showed cookies ranking the highest in Phosphorus (65.8535 ppm) and Iron (0.1150 mg/L), Calcium (1.3800mg/L) and Potassium (7.2850 mg/L) contents, while chin-chin and crackers were lowest in Sodium ( 2.7000 mg/L). The food products were also subjected to sensory attributes evaluation by thirty member panelists using 9-hedonic scale which ranged from 1 ( dislike extremely) to 9 (like extremely). The means score obtained shows all the food products having above 7.00 (above “like moderately”). This study has shown that food products that may be functional or nutraceuticals could be prepared from the residue flour. There is a call for the use of gluten-free flour in baking due to ciliac disease and other allergic causes by gluten. Therefore local carbohydrates food crops like cassava residue flour that are gluten-free, could be the solution. In addition, this could aid cassava gari processing waste management thereby reducing post-harvest losses of cassava root.Keywords: allergy, flour, food-products, gluten-free
Procedia PDF Downloads 146217 The Outcome of Using Machine Learning in Medical Imaging
Authors: Adel Edwar Waheeb Louka
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Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.Keywords: artificial intelligence, convolutional neural networks, deeplearning, image processing, machine learningSarapin, intraarticular, chronic knee pain, osteoarthritisFNS, trauma, hip, neck femur fracture, minimally invasive surgery
Procedia PDF Downloads 57216 Effects of Dietary Supplementation with Fermented Feed Mulberry(Morus alba L.) on Reproductive Performance and Fecal M Icro Biota of Pregnant Sows
Authors: Yuping Zhang, Teng Ma, Nadia Everaert, Hongfu Zhang
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Supplying dietary fiber during gestation is known to improve the welfare of feed-restricted sows. However, whether high fiber supplementation during pregnancy can improve the performance of sows and their offspring depends on the type, amount, source, etc., in which the solubility plays a key important role. Insoluble fibers have been shown to increase feed intake of sows in lactation, meet the needs of sows for milk production, reduce sow’s weight and backfat loss, and thus improve the performance of sows and their offspring. In this study, we investigated the effect of the addition of fermented feed mulberry (FFM), rich in insoluble fiber, during the whole gestation on the performance of sows and their offspring and explored possible mechanisms by determining serum hormones and fecal microbiota. The FFM-diet contained 25.5% FFM (on dry matter basis) and was compared with the control–diet (CON, corn, and soybean meal diet). The insoluble fiber content of the FFM and CON diet are respectively 29.3% and 19.1%. both groups were allocated 20 multiparous sows, and they are fed different feed allowance to make sure all the sows get the same digestible energy for each day. After farrowing, all sows were fed the same lactation diet ad libitum. The serum estradiol, progesterone concentration, blood glucose, and insulin levels at gestation day 0, 20, and 60 were tested. And also, the composition and differences fecal microbiota at day 60 of gestation were analyzed. Fecal consistency was determined with Bristol stool scale method, those with a score below 3 were counted as constipation The results showed that there was no impact of the FFM treatment on sows’ backfat, bodyweight changes, blood glucose, serum estradiol, and progesterone concentration, litter size, and performance of the offspring(p > 0.05), Except significant decrease in the concentration of insulin in sows’ serum at 60 days of gestation were observed in the FFM group compare to the CON group (P < 0.01). FFM diet also significantly increased feed intake on the first, third, and 21st days of sow lactation. (p < 0.01); The α- and β- diversity and abundance of the microbiota were significant increased (p < 0.01) compared with the CON group, The abundance of Firmicutes and Bacteroidetes were significantly increased, meanwhile the abundances of Spirochetes, Proteobacteria, and Euryarchaeota, were significantly reduced in the feces of the FFM group. We also analyzed the fecal microbiota of constipated sows vs non-constipated sows and found that the diversity and abundance did also differ between these two groups. FFM and CON group < 0.01). The relationship between sow’s constipation and microbiota merits further investigation.Keywords: fermented feed mulberry, reproductive performance, fecal flora, sow
Procedia PDF Downloads 144215 Continuous Glucose Monitoring Systems and the Improvement in Hypoglycemic Awareness Post-Islet Transplantation: A Single-Centre Cohort Study
Authors: Clare Flood, Shareen Forbes
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Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder affecting >400,000 people in the UK alone, with the global prevalence expected to double in the next decade. Islet transplant offers a minimally-invasive procedure with very low morbidity and almost no mortality, and is now as effective as whole pancreas transplant. The procedure was introduced to the UK in 2011 for patients with the most severe type 1 diabetes mellitus (T1DM) – those with unstable blood glucose, frequently occurring episodes of severe hypoglycemia and impaired awareness of hypoglycemia (IAH). Objectives: To evaluate the effectiveness of islet transplantation in improving glycemic control, reducing the burden of hypoglycemia and improving awareness of hypoglycemia through a single-centre cohort study at the Royal Infirmary of Edinburgh. Glycemic control and degree of hypoglycemic awareness will be determined and monitored pre- and post-transplantation to determine effectiveness of the procedure. Methods: A retrospective analysis of data collected over three years from the 16 patients who have undergone islet transplantation in Scotland. Glycated haemoglobin (HbA1c) was measured and continuous glucose monitoring systems (CGMS) were utilised to assess glycemic control, while Gold and Clarke score questionnaires tested IAH. Results: All patients had improved glycemic control following transplant, with optimal control seen visually at 3 months post-transplant. Glycemic control significantly improved, as illustrated by percentage time in hypoglycemia in the months following transplant (p=0.0211) and HbA1c (p=0.0426). Improved Clarke (p=0.0034) and Gold (p=0.0001) scores indicate improved glycemic awareness following transplant. Conclusion: While the small sample of islet transplant recipients at the Royal Infirmary of Edinburgh prevents definitive conclusions being drawn, it is indicated that through our retrospective, single-centre cohort study of 16 patients, islet transplant is capable of improving glycemic control, reducing the burden of hypoglycemia and IAH post-transplant. Data can be combined with similar trials at other centres to increase statistical power but from research in Edinburgh, it can be suggested that the minimally invasive procedure of islet transplantation offers selected patients with extremely unstable T1DM the incredible opportunity to regain control of their condition and improve their quality of life.Keywords: diabetes, islet, transplant, CGMS
Procedia PDF Downloads 265214 Impact Evaluation and Technical Efficiency in Ethiopia: Correcting for Selectivity Bias in Stochastic Frontier Analysis
Authors: Tefera Kebede Leyu
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The purpose of this study was to estimate the impact of LIVES project participation on the level of technical efficiency of farm households in three regions of Ethiopia. We used household-level data gathered by IRLI between February and April 2014 for the year 2013(retroactive). Data on 1,905 (754 intervention and 1, 151 control groups) sample households were analyzed using STATA software package version 14. Efforts were made to combine stochastic frontier modeling with impact evaluation methodology using the Heckman (1979) two-stage model to deal with possible selectivity bias arising from unobservable characteristics in the stochastic frontier model. Results indicate that farmers in the two groups are not efficient and operate below their potential frontiers i.e., there is a potential to increase crop productivity through efficiency improvements in both groups. In addition, the empirical results revealed selection bias in both groups of farmers confirming the justification for the use of selection bias corrected stochastic frontier model. It was also found that intervention farmers achieved higher technical efficiency scores than the control group of farmers. Furthermore, the selectivity bias-corrected model showed a different technical efficiency score for the intervention farmers while it more or less remained the same for that of control group farmers. However, the control group of farmers shows a higher dispersion as measured by the coefficient of variation compared to the intervention counterparts. Among the explanatory variables, the study found that farmer’s age (proxy to farm experience), land certification, frequency of visit to improved seed center, farmer’s education and row planting are important contributing factors for participation decisions and hence technical efficiency of farmers in the study areas. We recommend that policies targeting the design of development intervention programs in the agricultural sector focus more on providing farmers with on-farm visits by extension workers, provision of credit services, establishment of farmers’ training centers and adoption of modern farm technologies. Finally, we recommend further research to deal with this kind of methodological framework using a panel data set to test whether technical efficiency starts to increase or decrease with the length of time that farmers participate in development programs.Keywords: impact evaluation, efficiency analysis and selection bias, stochastic frontier model, Heckman-two step
Procedia PDF Downloads 63213 The Impact of Psychopathology Course on Students' Attitudes towards Mental Illness
Authors: Lorato Itumeleng Kenosi
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Background: Negative attitudes towards the mentally ill are widespread and a course for concern as they have a detrimental impact on individuals affected by mental illness. A possible avenue for changing attitudes towards mental illness is through mental health literacy. In a college or university setting, an abnormal psychology course may be introduced in an attempt to change student’s attitudes towards the mentally ill. Objective: To determine if and how students’ attitudes towards the mentally ill change as a result of taking a course in abnormal psychology. Methods: Twenty nine (29) students were recruited from an abnormal psychology class at the University of Botswana. Attitude Scale for Mental Illness (ASMI) questionnaire was administered to participants at the beginning and end of the semester. SPSS was employed to analyze data. Pooled means were used to determine whether the student’s attitudes towards mental illness were negative or positive. A mean of 2.5 translated to negative attitude for both total attitude and attitudes in different domains of the scale. Paired sample t-test was then used to assess whether any changes noted in attitudes were statistically significant or not. Statistical significance was assumed at p < 0.05. Results: Students’ general attitude towards mental illness remained positive although the pooled mean value increased from 2.08 to 2.24. The change was not statistically significant. In relation to different sub scales, the values of the pooled means for all the sub scales showed an increase although the changes were not statistically significant except for the Stereotyping sub scale (p = 0.031). The stereotyping domain reflected a statistically significant change in student’s attitude from positive attitude to negative (X² = 2.06 to X² = 2.55). For the pessimistic prediction domain, students consistently showed a negative attitude (X² = 3.34 to X² = 3.55). The other 4 domains indicated that students had positive attitude toward mentally ill throughout. Discussion: Abnormal psychology students have a positive attitude towards the mentally ill generally. This could be attributed to the fact that all students in the abnormal psychology course are majoring in psychology and research has shown that interest in psychology can affect one’s attitude towards mental illness. The students continuously held the view that people with mental illness are unlikely to improve as evidenced by a high score for Pessimistic prediction domain for both pre and post-test. Students initially had no stereotyping attitude towards the mentally ill, but at the end of the course, they were of the opinion that people with mental illness can be defined in a certain behavioural pattern and mental ability. This results could be an indication that students have learnt well how to differentiate abnormal from normal behaviour not necessarily that students had developed a negative attitude. Conclusion: A course in abnormal psychology does have an impact on the students’ attitudes towards the mentally ill. The impact does not solely depend on knowledge of mental illness but also on several other factors such as contact with the mentally ill, interest in psychology, and teaching methods. However, it should be noted that sometimes improved knowledge in mental illness can be misunderstood for a negative attitude. For example, stereotyping attitudes may be a reflection of the ability to differentiate between abnormal and normal behaviour.Keywords: attitudes, mental illness, psychopathology, students
Procedia PDF Downloads 273212 Building the Professional Readiness of Graduates from Day One: An Empirical Approach to Curriculum Continuous Improvement
Authors: Fiona Wahr, Sitalakshmi Venkatraman
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Industry employers require new graduates to bring with them a range of knowledge, skills and abilities which mean these new employees can immediately make valuable work contributions. These will be a combination of discipline and professional knowledge, skills and abilities which give graduates the technical capabilities to solve practical problems whilst interacting with a range of stakeholders. Underpinning the development of these disciplines and professional knowledge, skills and abilities, are “enabling” knowledge, skills and abilities which assist students to engage in learning. These are academic and learning skills which are essential to common starting points for both the learning process of students entering the course as well as forming the foundation for the fully developed graduate knowledge, skills and abilities. This paper reports on a project created to introduce and strengthen these enabling skills into the first semester of a Bachelor of Information Technology degree in an Australian polytechnic. The project uses an action research approach in the context of ongoing continuous improvement for the course to enhance the overall learning experience, learning sequencing, graduate outcomes, and most importantly, in the first semester, student engagement and retention. The focus of this is implementing the new curriculum in first semester subjects of the course with the aim of developing the “enabling” learning skills, such as literacy, research and numeracy based knowledge, skills and abilities (KSAs). The approach used for the introduction and embedding of these KSAs, (as both enablers of learning and to underpin graduate attribute development), is presented. Building on previous publications which reported different aspects of this longitudinal study, this paper recaps on the rationale for the curriculum redevelopment and then presents the quantitative findings of entering students’ reading literacy and numeracy knowledge and skills degree as well as their perceived research ability. The paper presents the methodology and findings for this stage of the research. Overall, the cohort exhibits mixed KSA levels in these areas, with a relatively low aggregated score. In addition, the paper describes the considerations for adjusting the design and delivery of the new subjects with a targeted learning experience, in response to the feedback gained through continuous monitoring. Such a strategy is aimed at accommodating the changing learning needs of the students and serves to support them towards achieving the enabling learning goals starting from day one of their higher education studies.Keywords: enabling skills, student retention, embedded learning support, continuous improvement
Procedia PDF Downloads 238211 Identification of Potent and Selective SIRT7 Anti-Cancer Inhibitor via Structure-Based Virtual Screening and Molecular Dynamics Simulation
Authors: Md. Fazlul Karim, Ashik Sharfaraz, Aysha Ferdoushi
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Background: Computational medicinal chemistry approaches are used for designing and identifying new drug-like molecules, predicting properties and pharmacological activities, and optimizing lead compounds in drug development. SIRT7, a nicotinamide adenine dinucleotide (NAD+)-dependent deacylase which regulates aging, is an emerging target for cancer therapy with mounting evidence that SIRT7 downregulation plays important roles in reversing cancer phenotypes and suppressing tumor growth. Activation or altered expression of SIRT7 is associated with the progression and invasion of various cancers, including liver, breast, gastric, prostate, and non-small cell lung cancer. Objectives: The goal of this work was to identify potent and selective bioactive candidate inhibitors of SIRT7 by in silico screening of small molecule compounds obtained from Nigella sativa (N. sativa). Methods: SIRT7 structure was retrieved from The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB), and its active site was identified using CASTp and metaPocket. Molecular docking simulation was performed with PyRx 0.8 virtual screening software. Drug-likeness properties were tested using SwissADME and pkCSM. In silico toxicity was evaluated by Osiris Property Explorer. Bioactivity was predicted by Molinspiration software. Antitumor activity was screened for Prediction of Activity Spectra for Substances (PASS) using Way2Drug web server. Molecular dynamics (MD) simulation was carried out by Desmond v3.6 package. Results: A total of 159 bioactive compounds from the N. Sativa were screened against the SIRT7 enzyme. Five bioactive compounds: chrysin (CID:5281607), pinocembrin (CID:68071), nigellidine (CID:136828302), nigellicine (CID:11402337), and epicatechin (CID:72276) were identified as potent SIRT7 anti-cancer candidates after docking score evaluation and applying Lipinski's Rule of Five. Finally, MD simulation identified Chrysin as the top SIRT7 anti-cancer candidate molecule. Conclusion: Chrysin, which shows a potential inhibitory effect against SIRT7, can act as a possible anti-cancer drug candidate. This inhibitor warrants further evaluation to check its pharmacokinetics and pharmacodynamics properties both in vitro and in vivo.Keywords: SIRT7, antitumor, molecular docking, molecular dynamics simulation
Procedia PDF Downloads 63210 Effective Counseling Techniques Working with At-Risk Youth in Residential and Outpatient Settings
Authors: David A. Scott, Michelle G. Scott
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The problem of juvenile crime, school suspensions and oppositional behaviors indicates a need for a wide range of intervention programs for at-risk youth. Juvenile court systems and mental health agencies are examining alternative ways to deal with at-risk youth that will allow the adolescent to live within their home community. The previous trend that treatment away from home is more effective than treatment near one's community has shifted. Research now suggests that treatment be close to home for several reasons, such as increased treatment success, parental involvement, and reduced costs. Treatment options consist of a wide range of interventions, including outpatient, inpatient, and community-based services (therapeutic group homes, foster care and in-home preservation services). The juvenile justice system, families and other mental health agencies continue to seek the most effective treatment for at-risk youth in their communities. This research examines two possible treatment modalities, a multi-systemic outpatient program and a residential program. Research examining effective, evidence- based counseling will be discussed during this presentation. The presenter recently completed a three-year research grant examining effective treatment modalities for at-risk youth participating in a multi-systemic program. The presenter has also been involved in several research activities gathering data on effective techniques used in residential programs. The data and discussion will be broken down into two parts, each discussing one of the treatment modalities mentioned above. Data on the residential programs was collected on both a sample of 740 at- risk youth over a five-year period and also a sample of 63 participants during a one-year period residing in a residential programs. The effectiveness of these residential services was measured in three ways: services are evaluated by primary referral sources; follow-up data is obtained at various intervals after program participation to measure recidivism (what percentage got back into trouble with the Department of Juvenile Justice); and a more sensitive, "Offense Seriousness Score", has been computed and analyzed prior to, during and after treatment in the residential program. Data on the multi-systemic program was gathered over the past three years on 190 participants. Research will discuss pre and post test results, recidivism rates, academic performance, parental involvement, and effective counseling treatment modalities.Keywords: at-risk youth, group homes, therapeutic group homes, recidivism rates
Procedia PDF Downloads 67209 Evaluation of Antioxidant and Anticancer Activity of Tinospora cordifolia against Ehrlich Ascites Carcinoma: In Vitro, in vivo and in silico Approach
Authors: Anik Barua, Rabiul Hossain, Labonno Barua, Rashadul Hossain, Nurul Absar
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Background: Globally, the burden of cancer is increasing consistently. Modern cancer therapies include lots of toxicity in the non-targeted organs reducing the life expectancy of the patients. Hence, scientists are trying to seek noble compounds from natural sources to treat cancer. Objectives: The objectives of the present study are to evaluate the phytochemicals, in vitro antioxidants, and in vivo and in silico anticancer study of various solvent fractions of Tinospora cordifolia (Willd.). Methodology: In this experiment, standard quantitative and qualitative assay methods were used to analyze the phytochemicals. The antioxidant activity was measured using the DPPH and ABTS scavenging methods. The in vivo antitumor activity is evaluated against Ehrlich ascites carcinoma (EAC) cell bearing in Swiss albino mice. In-silico ADME/T and molecular docking study were performed to assess the potential of stated phytochemicals against Transcription Factor STAT3b/DNA Complex of adenocarcinoma. Findings: Phytochemical screening confirmed the presence of flavonoids, alkaloids, glycosides, tannins, and carbohydrates. A significant amount of phenolic (20.19±0.3 mg/g GAE) and flavonoids (9.46±0.18 mg/g GAE) were found in methanolic extract in quantitative screening. Tinospora cordifolia methanolic extract showed promising DPPH and ABTS scavenging activity with the IC50 value of 1222.99 µg/mL and 1534.34 µg/mL, respectively, which was concentration dependent. In vivo anticancer activity in EAC cell-bearing mice showed significant (P < 0.05) percent inhibition of cell growth (60.12±1.22) was found at the highest dose compared with standard drug 5-Fluorouracil (81.18±1.28). Forty-two phytochemicals exhibit notable pharmacokinetics properties and passed drug-likeness screening tests in silico. In molecular docking study, (25S)-3Beta-acetoxy-5-alpha-22-beta-spirost-9(11)-en-12-beta-ol showed docking score (-8.5 kJ/mol) with significant non-bonding interactions with target enzyme. Conclusions: The results were found to be significant and confirmed that the methanolic extract of Tinospora cordifolia has remarkable antitumor activity with antioxidant potential. The Tinospora cordifolia methanolic extract may be considered a potent anticancer agent for advanced research.Keywords: anticancer, antioxidant, Tinospora cordifolia, EAC cell
Procedia PDF Downloads 106208 The Impact of a Prior Haemophilus influenzae Infection in the Incidence of Prostate Cancer
Authors: Maximiliano Guerra, Lexi Frankel, Amalia D. Ardeljan, Sarah Ghali, Diya Kohli, Omar M. Rashid.
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Introduction/Background: Haemophilus influenzae is present as a commensal organism in the nasopharynx of most healthy adults from where it can spread to cause both systemic and respiratory tract infection. Pathogenic properties of this bacterium as well as defects in host defense may result in the spread of these bacteria throughout the body. This can result in a proinflammatory state and colonization particularly in the lungs. Recent studies have failed to determine a link between H. Influenzae colonization and prostate cancer, despite previous research demonstrating the presence of proinflammatory states in preneoplastic and neoplastic prostate lesions. Given these contradictory findings, the primary goal of this study was to evaluate the correlation between H. Influenzae infection and the incidence of prostate cancer. Methods: To evaluate the incidence of Haemophilus influenzae infection and the development of prostate cancer in the future we used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. We were afforded access to this database by Holy Cross Health, Fort Lauderdale for the express purpose of academic research. Standard statistical methods were employed in this study including Pearson’s chi-square tests. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 13, 691 patients in both the control and C. difficile infected groups, respectively. The two groups were matched by age range and CCI score. In the Haemophilus influenzae infected group, the incidence of prostate cancer was 1.46%, while the incidence of the prostate cancer control group was 4.56%. The observed difference in cancer incidence was determined to be a statistically significant p-value (< 2.2x10^-16). This suggests that patients with a history of C. difficile have less risk of developing prostate cancer (OR 0.425, 95% CI: 0.382 - 0.472). Treatment bias was considered, the data was analyzed and resulted in two groups matched groups of 3,208 patients in both the infected with H. Influenzae treated group and the control who used the same medications for a different cause. Patients infected with H. Influenzae and treated had an incidence of prostate cancer of 2.49% whereas the control group incidence of prostate cancer was 4.92% with a p-value (< 2.2x10^-16) OR 0.455 CI 95% (0.526 -0.754), proving that the initial results were not due to the use of medications. Conclusion: The findings of our study reveal a statistically significant correlation between H. Influenzae infection and a decreased incidence of prostate cancer. Our findings suggest that prior infection with H. Influenzae may confer some degree of protection to patients and reduce their risk for developing prostate cancer. Future research is recommended to further characterize the potential role of Haemophilus influenzae in the pathogenesis of prostate cancer.Keywords: Haemophilus Influenzae, incidence, prostate cancer, risk.
Procedia PDF Downloads 192207 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery
Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez
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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training
Procedia PDF Downloads 55206 Musculoskeletal Disorders among Employees of an Assembly Industrial Workshop: Biomechanical Constrain’s Semi-Quantitative Analysis
Authors: Lamia Bouzgarrou, Amira Omrane, Haithem Kalel, Salma Kammoun
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Background: During recent decades, mechanical and electrical industrial sector has greatly expanded with a significant employability potential. However, this sector faces the increasing prevalence of musculoskeletal disorders with heavy consequences associated with direct and indirect costs. Objective: The current intervention was motivated by large musculoskeletal upper limbs and back disorders frequency among the operators of an assembly workshop in a leader company specialized in sanitary equipment and water and gas connections. We aimed to identify biomechanical constraints among these operators through activity and biomechanical exposures semi-quantitative analysis based on video recordings and MUSKA-TMS software. Methods: We conducted, open observations and exploratory interviews at first, in order to overall understand work situation. Then, we analyzed operator’s activity through systematic observations and interviews. Finally, we conducted a semi-quantitative biomechanical constraints analysis with MUSKA-TMS software after representative activity period video recording. The assessment of biomechanical constrains was based on different criteria; biomechanical characteristics (work positions), aggravating factor (cold, vibration, stress, etc.) and exposure time (duration and frequency of solicitations, recovery phase); with a synthetic score of risk level variable from 1 to 4 (1: low risk of developing MSD and 4: high risk). Results: Semi-quantitative analysis objective many elementary operations with higher biomechanical constrains like high repetitiveness, insufficient recovery time and constraining angulation of shoulders, wrists and cervical spine. Among these risky elementary operations we sited the assembly of sleeve with the body, the assembly of axis, and the control on testing table of gas valves. Transformation of work situations were recommended, covering both the redevelopment of industrial areas and the integration of new tools and equipment of mechanical handling that reduces operator exposure to vibration. Conclusion: Musculoskeletal disorders are complex and costly disorders. Moreover, an approach centered on the observation of the work can promote the interdisciplinary dialogue and exchange between actors with the objective to maximize the performance of a company and improve the quality of life of operators.Keywords: musculoskeletal disorders, biomechanical constrains, semi-quantitative analysis, ergonomics
Procedia PDF Downloads 154205 Antimicrobial Resistance: Knowledge towards Antibiotics in a Mexican Population
Authors: L. D. Upegui, Isabel Alvarez-Solorza, Karina Garduno-Ulloa, Maren Boecker
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Introduction: The increasing prevalence rate of resistant and multiresistant bacterial strains to antibiotics is a threat to public health and requires a rapid multifunctional answer. Individuals that are affected by resistant strains present a higher morbidity and mortality than individuals that are infected with the same species of bacteria but with sensitive strains. There have been identified risk factors that are related to the misuse and overuse of antibiotics, like socio-demographic characteristics and psychological aspects of the individuals that have not been explored objectively due to a lack of valid and reliable instruments for their measurement. Objective: To validate a questionnaire for the evaluation of the levels of knowledge related to the use of antibiotics in a Mexican population. Materials and Methods: Analytical cross-sectional observational study. The questionnaire consists of 12 items to evaluated knowledge (1=no, 2=not sure, 3=yes) regarding the use of antibiotics, with higher scores corresponding to a higher level of knowledge. Data are collected in a sample of students. Data collection is still ongoing. In this abstract preliminary results of 30 respondents are reported which were collected during pilot-testing. The validation of the instrument was done using the Rasch model. Fit to the Rasch model was tested checking overall fit to the model, unidimensionality, local independence and evaluating the presence of Differential Item Functioning (DIF) by age and gender. The software Rumm2030 and the SPSS were used for the analyses. Results: The participants of the pilot-testing presented an average age of 32 years ± 12.6 and 53% were women. The preliminary results indicated that the items showed good fit to the Rasch model (chi-squared=12.8 p=0.3795). Unidimensionality (number of significant t-tests of 3%) could be proven, the items were locally independent, and no DIF was observed. Knowledge was the smallest regarding statements on the role of antibiotics in treating infections, e.g., most of the respondents did not know that antibiotics would not work against viral infections (70%) and that they could also cause side effects (87%). The knowledge score ranged from 0 to 100 points with a transformed measurement (mean of knowledge 27.1 ± 4.8). Conclusions: The instrument showed good psychometric proprieties. The low scores of knowledge about antibiotics suggest that misinterpretations on the use of these medicaments were prevalent, which could influence the production of antibiotic resistance. The application of this questionnaire will allow the objective identification of 'Hight risk groups', which will be the target population for future educational campaigns, to reduce the knowledge gaps on the general population as an effort against antibiotic resistance.Keywords: antibiotics, knowledge, misuse, overuse, questionnaire, Rasch model, validation
Procedia PDF Downloads 149