Search results for: therapeutic management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10593

Search results for: therapeutic management

10413 Use of Dual-Energy CT Post Endovascular Treatment of Cerebral Aneurysm

Authors: Mitchell Stanton

Abstract:

Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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10412 Buddhist Cognitive Behavioral Therapy to Address Depression Among Elderly Population: Multi-cultural Model of Buddhist Based Cognitive Behavioral Therapy to Address Depression Among Elderly Population

Authors: Ashoke Priyadarshana Premananda

Abstract:

As per the suggestions of previously conducted research in Counseling Psychology, the necessity of forming culture- friendly approaches has been strongly emphasized by a number of scholars in the field. In response to that, Multicultural-model of Buddhist Based Cognitive Behavioral Therapy (MMBCBT) has been formed as a culture-friendly therapeutic approach to address psychological disturbances (depression) in late adulthood. Elderly population in the world is on the rise by leaps and bounds, and forming a culture-based therapeutic model which is blended with Buddhist teachings has been the major objective of the study. Buddhist teachings and cultural applications, which were mapped onto Cognitive Behavioral Therapy (CBT) in the West, ultimately resulted in MMBCBT. Therefore, MMBCBT is a blend of cultural therapeutic techniques and the essence of certain Buddhist teachings extracted from five crucial suttas, which include CBT principles. In the process of mapping, MeghiyaSutta, GirimānandaSutta, SallekhaSutta, DvedhāvitakkaSutta, and Vitakka- SaṇṭhānaSutta have been taken into consideration mainly because of their cognitive behavioral content. The practical components of Vitakka- Saṇṭhānasutta (Aññanimittapabbaṃ) and Sallekhasutta (SallekhaPariyāya and CittuppādaPariyāya) have been used in the model while mindfulness of breathing was also carried out with the participants. Basically, multi-cultural therapeutic approaches of MMBCBT aim at modifying behavior (behavioral modification), whereas the rest is centered to the cognitive restructuring process. Therefore, MMBCBT is endowed with Behavioral Therapy (BT) and Cognitive Therapy(CT). In order to find out the validation of MMBCBT as a newly formed approach, it was then followed by mixed research (quantitative and qualitative research) with a sample selected from the elderly population following the purposive sampling technique. 40 individuals were selected from three elderly homes as per the purposive sampling technique. Elderly people identified to be depressed via Geriatric Depression Scale underwent MMBCBT for two weeks continuously while action research was being conducted simultaneously. Additionally, a Focus Group interview was carried out to support the action research. As per the research findings, people who identified depressed prior to the exposure to MMBCBT were found to be showing positive changes after they were exposed to the model. “Paired Sample t test” showed that the Multicultural Model of Buddhist based Cognitive Behavioral Therapy reduced depression of elderly people (The mean value (x̄) of the sample (level of depression) before the model was 10.7 whereas the mean value after the model was 7.5.). Most importantly, MMBCBT has been found to be effectively used with people from all walks of life despite religious diversities.

Keywords: buddhist psychotherapy, cognitive behavioral therapy in buddhism, counseling in cultural context, gerontology, and buddhism

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10411 Therapeutic Drug Monitoring by Dried Blood Spot and LC-MS/MS: Novel Application to Carbamazepine and Its Metabolite in Paediatric Population

Authors: Giancarlo La Marca, Engy Shokry, Fabio Villanelli

Abstract:

Epilepsy is one of the most common neurological disorders, with an estimated prevalence of 50 million people worldwide. Twenty five percent of the epilepsy population is represented in children under the age of 15 years. For antiepileptic drugs (AED), there is a poor correlation between plasma concentration and dose especially in children. This was attributed to greater pharmacokinetic variability than adults. Hence, therapeutic drug monitoring (TDM) is recommended in controlling toxicity while drug exposure is maintained. Carbamazepine (CBZ) is a first-line AED and the drug of first choice in trigeminal neuralgia. CBZ is metabolised in the liver into carbamazepine-10,11-epoxide (CBZE), its major metabolite which is equipotent. This develops the need for an assay able to monitor the levels of both CBZ and CBZE. The aim of the present study was to develop and validate a LC-MS/MS method for simultaneous quantification of CBZ and CBZE in dried blood spots (DBS). DBS technique overcomes many logistical problems, ethical issues and technical challenges faced by classical plasma sampling. LC-MS/MS has been regarded as superior technique over immunoassays and HPLC/UV methods owing to its better specificity and sensitivity, lack of interference or matrix effects. Our method combines advantages of DBS technique and LC-MS/MS in clinical practice. The extraction process was done using methanol-water-formic acid (80:20:0.1, v/v/v). The chromatographic elution was achieved by using a linear gradient with a mobile phase consisting of acetonitrile-water-0.1% formic acid at a flow rate of 0.50 mL/min. The method was linear over the range 1-40 mg/L and 0.25-20 mg/L for CBZ and CBZE respectively. The limit of quantification was 1.00 mg/L and 0.25 mg/L for CBZ and CBZE, respectively. Intra-day and inter-day assay precisions were found to be less than 6.5% and 11.8%. An evaluation of DBS technique was performed, including effect of extraction solvent, spot homogeneity and stability in DBS. Results from a comparison with the plasma assay are also presented. The novelty of the present work lies in being the first to quantify CBZ and its metabolite from only one 3.2 mm DBS disc finger-prick sample (3.3-3.4 µl blood) by LC-MS/MS in a 10 min. chromatographic run.

Keywords: carbamazepine, carbamazepine-10, 11-epoxide, dried blood spots, LC-MS/MS, therapeutic drug monitoring

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10410 Knowledge Management Best Practice Model in Higher Learning Institution: A Systematic Literature Review

Authors: Ismail Halijah, Abdullah Rusli

Abstract:

Introduction: This systematic literature review aims to identify the Knowledge Management Best Practice components in the Knowledge Management Model for Higher Learning Institutions environment. Study design: Systematic literature review. Methods: A systematic literature re-view of Knowledge Management Best Practice to identify and define the components of Best Practice from the Knowledge Management models was conducted recently. Results: This review of published papers of conference and journals’ articles shows the components of Best Practice in Knowledge Management are basically divided into two aspect which is the soft aspect and the hard aspect. The lacks of combination of these two aspects into an integrated model decelerate Knowledge Management Best Practice to fully throttle. Evidence from the literature shows the lack of integration of this two aspects leads to the immaturity of the Higher Learning Institution (HLI) towards the implementation of Knowledge Management System. Conclusion: The first steps of identifying the attributes to measure the Knowledge Management Best Practice components from the models in the literature will led to the definition of the Knowledge Management Best Practice component for the higher learning environment.

Keywords: knowledge management, knowledge management system, knowledge management best practice, knowledge management higher learning institution

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10409 Determination of Energy and Nutrients Composition of Potential Ready-to-Use Therapeutic Food Formulated from Locally Available Resources

Authors: Amina Sa'id Muhammad, Asmau Ishaq Alhassan, Beba Raymond, Fatima Bello

Abstract:

Severe acute malnutrition (SAM) remains a major killer of children under five years of age. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), and 3.9% of children in northwest Nigeria suffer from SAM, which is significantly higher than the national average of 2.1%. Community-Based Management of Acute Malnutrition (CMAM) has proven to be an effective intervention in the treatment of SAM in children using Ready-to-Use Therapeutic Food (RUTF). Ready-to-use therapeutic food (RUTF) is a key component for the treatment of Severe Acute Malnutrition. It contains all the energy and nutrients required for rapid catch-up growth and used particularly in the treatment of children over 6 months of age with SAM without medical complications. However, almost all RUTFs are currently imported to Nigeria from other countries. Shortages of RUTF due to logistics (shipping costs, delays, donor fatigue etc) and funding issues present a threat to the achievement of the 2030 World Health Assembly (WHA) targets for reducing malnutrition in addition to 2030 SDGs 2 (Zero Hunger), 3 (Good Health and Wellbeing), 12 (Responsible Consumption and Production), and 17 (Partnerships for the Goals), thus undermining its effectiveness in combating malnutrition On the other hand, the availability of human and material resources that will aid local production of RUTF presents an opportunity to fill in the gap in regular RUTF supply. About one thousand Nigerian children die of malnutrition-related causes every day, reaching a total of 361,000 each year. Owing to the high burden of malnutrition in Nigeria, the local production of RUTF is a logical step, that will ensure increased availability, acceptability, access, and efficiency in supply, and at lower costs. Objective(s): The objectives of this study were therefore, to formulate RUTF from locally available resources and to determine its energy and nutrients composition, incommensurate with the standard/commercial RUTF. Methods: Three samples of RUTF were formulated using locally available resources (soya beans, wheat, rice, baobab, brown-sugar, date palm and soya oil); which were subjected to various analysis to determine their energy/proximate composition, vitamin and mineral contents and organoleptic properties were also determined using sensory evaluation. Results: The energy values of the three samples of locally produced RUTF were found to be in conformity with WHO recommendation of ≥ 500 kcal per 100g. The energy values of the three RUTF samples produced in the current study were found to be 563.08, 503.67 and 528.98 kcal respectively. Sample A, B and C had protein content of 13.56% 16.71% and 14.62% respectively, which were higher than that of commercial RUTF (10.9%). Conclusions/recommendations: The locally formulated RUTF samples had energy value of more than 500 kcal per 100g; with an appreciable amount of macro and micro nutrients. The appearance, taste, flavor and general acceptability of the formulated RUTF samples were also commendable.

Keywords: energy, malnutrition, nutrients, RUTF

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10408 GC-MS Analysis of Essential Oil From Satureja Hispidula: A Medicinal Plant from Algeria

Authors: Habiba Rechek, Ammar Haouat, Ratiba Mekkiou, Diana C. G. A. Pinto, Artur M. S. Silva

Abstract:

Satureja hispidula is an aromatic and medicinal plant belonging to the family of Lamiaceae native to Algeria, just like mint or thyme. Although she is less known to the general public than her more famous cousins, this species has many therapeutic properties that have been used for centuries in traditional medicine of some regions. For generations, Satureja hispidula has been used in traditional medicine to treat various ailments, including respiratory diseases and diabetes. Its aroma, often described as close to that of mint, gives it a special interest in aromatherapy. Due to the growing interest in the beneficial properties of plant-derived essential oils, the aim of this study is to analyze the chemical composition of S. hispidula essential oil by gas chromatography coupled with mass spectrometry (GC-MS). Identifying the main constituents of essential oil will allow better understanding its chemical nature and exploring its potential for culinary and therapeutic application. The study of the essential oil of S. hispidula reveals a composition rich in 83 compounds, including menthone, pulegone and piperitone as main constituents. This gas chromatography analysis coupled with mass spectrometry provides valuable information about the chemical nature of this oil. However, more in-depth studies are needed to explore the potentially health-enhancing properties of this essential oil.

Keywords: satureja hispidula, GC-MS, essential oil, menthone, pulegone

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10407 Assessment of the Effect of Orally Administered Itopride on Gall Bladder Ejection Fraction by a Fatty Meal Cholescintigraphy in Patients with Diabetes

Authors: Avani Jain, Hasmukh Jain, S. Shelley, M. Indirani, Shilpa Kalal, Jayakanth Amalachandran

Abstract:

Aim of the Study: To assess the effect of orally administered Itopride on gall bladder ejection fraction by fatty meal cholescintigraphy in patients with diabetes. Materials and Methods: Thirty patients (20 males, 10 females, mean age 46+10 yrs) with history of diabetes mellitus (mean duration 4.8+4.1 yrs, fasting blood glucose level 130+35 mg/dl and 2-hours post-prandial blood glucose level 196+76 mg/dl) and found to have gall bladder dysfunction on fatty-meal stimulated cholescintigraphy were selected for this study. These patients underwent a repeat cholescintigraphy similar to baseline study, with 50 mg of Itopride orally along with fatty meal. Pre- and post-Itopride GBEF were then compared to assess the effect of Itopride on gall bladder contraction. Results: Out of these 30 patients, 2 had dyskinetic, 4 had akinetic, 22 had moderately hypokinetic and the remaining 2 had hypokinetic gall bladder function in the baseline study with > 60% GBEF being taken as the normal value. Mean percentage of GBEF in the baseline study was 32%+13% and the mean percentage of GBEF in the post-Itopride study was 57%+17% with change in mean percentage of GBEF being 24%+21%. GBEF of the “baseline study” was significantly lower as compared to GBEF in the “post-Itopride study” (p < 0.05). Conclusion: Diabetic patients with biliary-type pain often tend to have impaired gallbladder function. Cholescintigraphy with fatty meal-stimulation is a simple, cheap and useful investigation for assessment of gallbladder dysfunction in these patients, before any structural changes occur within the lumen or wall of the gall bladder. Improvement in gallbladder ejection fraction after oral administration of a single dose of Itopride, a newer prokinetic drug with fewer side effects, as assessed by cholescintigraphy, provides enough evidence of future therapeutic response. Administration of Itopride, in therapeutic dosage, therefore may be expected to cause significant improvement in gallbladder ejection fraction and hence prolong stone formation within the gall bladder and also prevent the associated long term complications. Hence, based on scintigraphic evidence, Itopride may be recommended, by clinicians, for management of symptomatic diabetic patients having gallbladder dysfunction.

Keywords: itopride, gall bladder ejection fraction, fatty meal, cholescintigraphy, diabetes

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10406 An Assessment of Existing Material Management Process in Building Construction Projects in Nepal

Authors: Uttam Neupane, Narendra Budha, Subash Kumar Bhattarai

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Material management is an essential part in construction project management. There are a number of material management problems in the Nepalese construction industry, which contribute to an inefficient material management system. Ineffective material management can cause waste of time and money thus increasing the problem of time and cost overrun. An assessment of material management system with gap and solution was carried out on 20 construction projects implemented by the Federal Level Project Implementation Unit (FPIU); Kaski district of Nepal. To improve the material management process, the respondents have provided possible solutions to overcome the gaps seen in the current material management process. The possible solutions are preparation of material schedule in line with the construction schedule for material requirement planning, verifications of material and locating of source, purchasing of the required material in advance before commencement of work, classifying the materials, and managing the inventory based on their usage value and eliminating and reduction in wastages during the overall material management process.

Keywords: material management, construction site, inventory, construction project

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10405 Real Activities Manipulation vs. Accrual Earnings Management: The Effect of Political Risk

Authors: Heba Abdelmotaal, Magdy Abdel-Kader

Abstract:

Purpose: This study explores whether a firm’s effective political risk management is preventing real and accrual earnings management . Design/methodology/approach: Based on a sample of 130 firms operating in Egypt during the period 2008-2013, two hypotheses are tested using the panel data regression models. Findings: The empirical findings indicate a significant relation between real and accrual earnings management and political risk. Originality/value: This paper provides a statistically evidence on the effects of the political risk management failure on the mangers’ engagement in the real and accrual earnings management practices, and its impact on the firm’s performance.

Keywords: political risk, risk management failure, real activities manipulation, accrual earnings management

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10404 Diagnostic Accuracy in the Detection of Cervical Lymph Node Metastases in Head and Neck Squamous Cell Carcinoma Patients: A Comparison of Sonography, CT, PET/CT and MRI

Authors: Di Luo, Maria Buchberger, Anja Pickhard

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Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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10403 Acute Bronchiolitis: Impact of an Educational Video on Mothers’ Knowledge, Attitudes, and Practices

Authors: Atitallah Sofien, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Bouyahia Olfa, Boukthir Samir

Abstract:

Introduction: Acute bronchiolitis (AB) is a real public health problem on a global and national scale. Its treatment is most often outpatient. The use of audio-visual supports, such as educational videos, is an innovation in therapeutic education in outpatient treatment. The aim of our study was to evaluate the impact of an educational video on the knowledge, attitudes, and practices of mothers of infants with AB. Methodology: This was a descriptive, analytical, and cross-sectional study with prospective data collection, including mothers of infants with AB. We assessed mothers' knowledge, attitudes, and practices regarding AB, and we created an educational video. We used a questionnaire written in Tunisian Arabic concerning sociodemographic data, mothers' knowledge and attitudes regarding AB, and their opinions on the video, as well as an observation grid to evaluate their practices on the nasopharyngeal unblocking technique. We compared the different parameters before and after watching the video. Results: We noted a statistically significant improvement in mothers' knowledge scores on AB (7.46 in the pre-test versus 14.08 in the post-test; p≤0.05), practices (12.42 in the pre-test versus 18 in the post-test; p≤0.05) and attitudes (5.86 in pre-test versus 9.02 in post-test; p≤0.05). Conclusion: The use of an educational video has a positive impact on the knowledge, practices, and attitudes of mothers towards AB.

Keywords: acute bronchiolitis, therapeutic education, mothers, educational video

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10402 The Management Information System for Convenience Stores: Case Study in 7 Eleven Shop in Bangkok

Authors: Supattra Kanchanopast

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The purpose of this research is to develop and design a management information system for 7 eleven shop in Bangkok. The system was designed and developed to meet users’ requirements via the internet network by use of application software such as My SQL for database management, Apache HTTP Server for Web Server and PHP Hypertext Preprocessor for an interface between web server, database and users. The system was designed into two subsystems as the main system, or system for head office, and the branch system for branch shops. These consisted of three parts which are classified by user management as shop management, inventory management and Point of Sale (POS) management. The implementation of the MIS for the mini-mart shop, can lessen the amount of paperwork and reduce repeating tasks so it may decrease the capital of the business and support an extension of branches in the future as well.

Keywords: convenience store, the management information system, inventory management, 7 eleven shop

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10401 Antimicrobial Effect of Essential Oil of Plant Schinus molle on Some Bacteria Pathogens

Authors: Mehani Mouna, Ladjel segni

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Humans use plants for thousands of years to treat various ailments, In many developing countries, Much of the population relies on traditional doctors and their collections of medicinal plants to cure them. Essential oils have many therapeutic properties. In herbal medicine, They are used for their antiseptic properties against infectious diseases of fungal origin, Against dermatophytes, Those of bacterial origin. The aim of our study is to determine the antimicrobial effect of essential oils of the plant Schinus molle on some pathogenic bacteria. It is a medicinal plant used in traditional therapy. Essential oils have many therapeutic properties. In herbal medicine, They are used for their antiseptic properties against infectious diseases of fungal origin, Against dermatophytes, Those of bacterial origin. The test adopted is based on the diffusion method on solid medium (Antibiogram), This method allows to determine the susceptibility or resistance of an organism according to the sample studied. Our study reveals that the essential oil of the plant Schinus molle has a different effect on the resistance of germs: For Pseudomonas aeruginosa strain is a moderately sensitive with an inhibition zone of 10 mm, Further Antirobactere, Escherichia coli and Proteus are strains that represent a high sensitivity, A zone of inhibition equal to 14.66 mm.

Keywords: Essential oil, microorganism, antibiogram, shinus molle

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10400 ERP Implementation in Iran: A Successful Experience in DGC

Authors: Mohammad Reza Ostad Ali Naghi Kashani

Abstract:

Nowadays, the amounts of companies which tend to have an Enterprise Resource Planning (ERP) application are increasing. Although ERP projects are expensive, time consuming, and complex, there are some successful experiences. These days, developing countries are striving to implement ERP projects successfully; however, there are many obstacles. Therefore, these projects would be failed or partially failed. This paper concerns the implementation of a successful ERP implementation, IFS, in Iran at Dana Geophysics Company (DGC). After a short review of ERP and ERP market in Iran, we propose a three phases deployment methodology (phase 1: Preparation and Business Process Management (BPM) phase 2: implementation and phase 3: testing, golive-1 (pilot) and golive-2 (final)). Then, we present five guidelines (Project Management, Change Management, Business Process Management (BPM), Training& Knowledge Management, and Technical Management), which were chose as work streams. In this case study we present lessons learned in Project management and Business process Management.

Keywords: business process management, critical success factors, ERP, project management

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10399 Development of Model for Effective Sub- District Municipality Wastewater Management

Authors: Vitool Suksankavanich

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This preliminary research aimed to explore the development of wastewater management of Bang Pu Sub- District Municipality, Samutprakan Province, in order to establish appropriate model for effective wastewater management that fit to the context of the area. The research posed three questions: [i] to what extent the promotion of social responsibility awareness built among the local community resulted in effectiveness of the local wastewater management; [ii] did the waste disposal management of Bang Pu Industrial Estate contribute to the overall environmental quality of Bang Pu Sub- District Municipality; and [iii] did the relationship between the community and the industrial factories have any effect on the wastewater management. The in- depth interview revealed main obstacles occurred in the process of wastewater management in the area. The fieldwork also contributed to a product of an appropriate model of effective wastewater management.

Keywords: legitimacy theory, stakeholder theory, social responsibility, wastewater management

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10398 Maintaining Healthy Body Weight: Beyond Exercise Routines

Authors: Nahwera L., Constance A. N. Nsibamb, Mukana R., Daniel T. Goon

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Regular physical activity is a cornerstone of maintaining good health. Studies have shown that physical inactivity leads to overweight and obesity, a risk factor for non-communicable diseases and a public health challenge. Health clubs provide therapeutic exercises to clients desiring to reduce their weight; however, the exercise routines offered in these health clubs are insufficient to reduce their body weight. A convenient sample of 100 clients. Exercise routines were determined using a questionnaire. Height, weight, waist, and hip circumferences were measured. Body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) assessed body weight status. About 75% of clients exercised three or more times per week; 96% participated in modern intensity exercises for 30 minutes, aerobic dance (88%), treadmill (56%), cycling (51%), rope skipping (45%), and 14% in strengthening activities. The BMI of male and female clients was 64.2% and 83.0%, respectively. There was no significant correlation (p≤0.05) between BMI and WHR (p=0.336), although there was a significant correlation between BMI and waist circumference (p=0.000). There was no significant relationship between BMI and WHR for males (p= .336) and between BMI and WHR for females (p=.806). Although most clients visiting health clubs meet the recommended frequency, intensity, and duration of exercise, they are overweight and obese. Appropriate exercise and nutritional programs should be incorporated into health clubs offering therapeutic and rehabilitative exercises to clients.

Keywords: Body weight status, exercise routines, health clubs, exercises

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10397 Practice Patterns of Physiotherapists for Learners with Disabilities at Special Schools: A Scoping Review

Authors: Lubisi L. V., Madumo M. B., Mudau N. P., Makhuvele L., Sibuyi M. M.

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Background and Aims: Learners with disabilities can be integrated into mainstream schools, whereas there are those learners that are accommodated in special schools based on the support needs they require. These needs, among others, pertain to access to high-intensity therapeutic support by physiotherapists, occupational therapists, and speech therapists. However, access to physiotherapists in low- and middle-income countries is limited, and this creates a knowledge gap in identifying, to the best of our knowledge, best practice patterns aligned with physiotherapy at special schools. This gap compromises the quality of support to be rendered towards strengthening rehabilitation and optimising the participation of learners with disabilities in special schools. The aim of the scoping review was to map the evidence on practice patterns employed by physiotherapists at special schools for learners with disabilities. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. Key terms regarding physiotherapy practice patterns for learners with disabilities at special schools were used to search the literature on the databases. Literature was sourced from Google Scholar, EBSCO, PEDro, PubMed, and Research Gate from 2013 to 2023. A total of 28 articles were initially retrieved and after a process of screening and exclusion, nine articles were included. All the researchers reviewed the articles for eligibility. Articles were initially screened based on the titles, followed by full text. Articles written in English or translated into English mentioned physical / physiotherapy interventions in special schools, both published and unpublished, were included. A qualitative data extraction template was developed and an inductive approach to thematic data analysis was used for included articles to see which themes emerged. Results: Three themes emerged after inductive thematic data analysis. 1. Collaboration with educators, parents, and therapists 2. Family Centred Approach 3. Telehealth. Conclusion: Collaboration is key in delivering therapeutic support to learners with disabilities at special schools. Physiotherapists need to be collaborators at the level of interprofessional and transprofessional. In addition, they need to explore technology to work remotely, especially when learners become absent physically from school.

Keywords: learners with disabilities, special school, physiotherapists, therapeutic support

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10396 Endometrial Thickness Cut-Off for Evacuation of Retained Product of Conception

Authors: Nambiar Ritu, Ali Ban, Munawar Farida, Israell Imelda, T. Farouk Eman Rasheeda, Jangalgi Renuka, S. Boma Nellie

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Aim: To define the ultrasonographic endometrial thickness (USG ET) cutoff for evacuation of retained pieces of conception (ERPC). Background: Studies of conservative management of 1st trimester miscarriage have questioned the need for post miscarriage curettage. Therapeutic decision making with transvaginal scan post miscarriage endometrial thickness in patients clinically thought to be incomplete miscarriage is often not clear. Method: Retrospective analysis of all 1ST trimester ERPC at Al Rahba Hospital from June 2012 to July 2013 was done. Total of 164 patients underwent ERPC. All cases were reviewed for pre-operative USG ET and post ERPC histopathological examination. TVS was done to evaluate the maximum ET of the uterine cavity along the long axis of the uterus and features of retained products was noted. All cases without preoperative USG ET measurement were excluded from the study, therefore only 62 out of 164 cases were included in the study. The patients were divided into three groups: o Group A: have retained products within endometrial cavity. o Group B: endometrial thickness equal or more than 20 mm. o Group C: endometrial thickness equal or less than 19.9 mm. o Post ERPC product was sent for HPE and the results were compared. Transvaginal sonographic findings can be used as a deciding factor in the management of patients with 1st trimester miscarriage who need ERPC. Our proposed cutoff in clinically stable patients requiring ERPC is more than 20 mm.

Keywords: ERPC, histopathological examination, long axis of the uterus, USG ET

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10395 Therapeutic Effects of Guar Gum Nanoparticles in Oxazolone-Induced Atopic Dermatitis

Authors: Nandita Ghosh, Shinjini Mitra, Ena Ray Banerjee

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Atopic dermatitis (AD) is a chronic disease of the skin, involving itchy, reddish, and scaly lesions. It mainly affects children and has a high prevalence in developing countries. The AD may occur due to environmental or genetic factors. There is no permanent cure for the AD. Currently, all therapeutic strategies involve methods to simply alleviate the symptoms, and include lotions and corticosteroids, which have adverse effects. Use of phytochemicals and natural products has not yet been exploited fully. The particle used in this study is derived from Cyamopsis tetragonoloba, an edible polysaccharide with a galactomannan component. The mannose component mainly increases its specificity towards cellular uptake by mannose receptors, highly expressed by the macrophage. The aim of this study was to determine the therapeutic effect of guar gum nanoparticles (GN) in vitro and in vivo in the AD. To assess the wound healing capacity of the guar gum nanoparticle (GN), we first treated adherent NIH3T3 cells, with a scratch injury, with GN. GN successfully healed the wound caused by the scratch. In the in vivo experiment, Balb/c mice ear were topically treated with oxazolone (oxa) to induce AD and then were topically treated with GN. The ear thickness was increased significantly till day 28 on the treatment of Oxa. The GN application showed a significant decrease in the thickness as assessed on day 28. The total cell count of skin cells showed fold increase when treated with oxa, was again decreased on topical application of GN on the affected skin. The eosinophil count, as assessed by Giemsa staining was also increased when treated with oxa, GN application led to a significant decrease. The IgE level was assessed in the serum samples which showed that GN helped in restoring the alleviated IgE level. The T helper cells and the macrophage population showed increased percentage when treated with oxa, the GN application. This was examined by flow cytometry. The H&E staining of the ear tissue showed epidermal thickness in the oxa treated mice, GN application showed reduced cellular filtration followed by epidermal thickness. Thus our assays showed that GN was successful in alleviating the disease caused by Oxa when administered topically.

Keywords: allergen, inflammation, nanodrug, wound

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10394 Relevance for Traditional Medicine in South Africa: Experiences of Urban Traditional Healers, Izinyanga

Authors: Ntokozo Mthembu

Abstract:

Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners- izinyanga. However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.

Keywords: indigenous healing practice, inyanga, COVID-19, therapeutic, urban, experience

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10393 Institutional Superposition, over Management and Coastal Economic Development: Coastal Areas in China

Authors: Mingbao Chen, Mingli Zhao

Abstract:

The coastal zone is the intersection of land and sea system, and also is the connecting zone of the two economic systems of land and sea. In the world, all countries attach great importance to the coastal zone management and the coastal zone economy. In China, the government has developed a number of related coastal management policies and institutional, such as marine functional zoning, main function zoning, integrated coastal zone management, to ensure the sustainable utilization of the coastal zone and promote the development of coastal economic. However, in practice, the effect is not satisfactory. This paper analyses the coastal areas of coastal zone management on coastal economic growth contribution based on coastal areas economic development data with the 2007-2015 in China, which uses the method of the evaluation index system of coastal zone management institutional efficiency. The results show that the coastal zone management institutional objectives are not clear, and the institutional has high repeatability. At the same time, over management of coastal zone leads to low economic efficiency because the government management boundary is blurred.

Keywords: institutional overlap, over management, coastal zone management, coastal zone economy

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10392 Using Hybrid Method for Inactivation of Microorganism and Enzymes in a Berry Juice

Authors: Golnoosh Torabian, P. Valtchev, F. Dehghani

Abstract:

The need for efficient nutraceutical products has been dramatically changing the approach of the industrial processes. The development of novel mild processes is highly demanded for the production of such products; especially when both quality and safety need to be guaranteed during their long shelf life. Within this research, for the first time, we investigated the effect of supercritical carbon dioxide treatment for the inactivation of microbes and enzymes in a berry juice possessing therapeutic effect. We demonstrated that a complete inactivation of microbes can be achieved at optimized conditions of treatment. However, the bottle neck of the process was represented by the unpromising inactivation of the degradative enzyme by supercritical carbon dioxide treatment. However, complete enzyme inactivation was achieved by applying two strategies: the first was optimizing juicing method by adding a mechanical step and the second strategy was addition of natural inhibitors to the juice. Overall these results demonstrate that our hybrid process has a significant effect on the inactivation of microorganism and enzymes in the fresh juice. The developed process opens the possibility for the evolution of new products with optimal nutritional and sensorial characteristics, as well as offering a competitive cost and an environmentally friendly alternative for pasteurization and extension of shelf life in a wide range of natural therapeutic products.

Keywords: hybrid method, berry juice, pasteurization, enzymes inactivation

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10391 A Case Study on the Guidelines for Application of Project Management Methods in Infrastructure Projects

Authors: Fernanda Varella Borges, Silvio Burrattino Melhado

Abstract:

Motivated by the importance of public infrastructure projects in the civil construction chain, this research shows the study of project management methods and the infrastructure projects’ characteristics. The research aims at the objective of improving management efficiency by proposing guidelines for the application of project management methods in infrastructure projects. Through literature review and case studies, the research analyses two major infrastructure projects underway in Brazil, identifying the critical points for achieving its success. As a result, the proposed guidelines indicate that special attention should be given to the management of stakeholders, focusing on their knowledge and experience, their different interests, the efficient management of their communication, and their behavior in the day-by-day project management process.

Keywords: construction, infrastructure, project management, public projects

Procedia PDF Downloads 478
10390 Botulinum Toxin type A for Lower Limb Lengthening and Deformity Correction: A Systematic Review and Meta-analysis

Authors: Jawaher F. Alsharef, Abdullah A. Ghaddaf, Mohammed S. Alomari, Abdullah A. Al Qurashi, Ahmed S. Abdulhamid, Mohammed S. Alshehri, Majed Alosaimi

Abstract:

Botulinum toxin type A (BTX-A) is the most popular therapeutic agent for muscle relaxation and pain control. Lately, BTX-A injection received great interest as a part of multimodal pain management for lower limb lengthening and deformity correction. This systematic review aimed to determine the role of BTX-A injection in pain management for during lower limb lengthening and/or deformity correction. We searched Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared the BTX-A injection to placebo for individuals undergoing lower limb lengthening and/or deformity correction. We sought to evaluate the following outcomes: pain on visual analogue scale (VAS), range of motion parameters, average opioid consumption, and adverse events. The standardized mean difference (SMD) was used to represent continuous outcomes while risk ratio (RR) was used to represent dichotomous outcomes. A total of 4 RCTs that enrolled 257 participants (337 limbs) deemed eligible. Adjuvant BTX-A injection showed a significant reduction in post-operative pain compared to placebo (SMD=–0.28, 95% CI –0.53 to –0.04). No difference was found between BTX-A injection and placebo in terms of range of motion parameters, average opioid consumption, or adverse events after surgical limb lengthening and/or deformity correction (RR= 0.77, 95% CI –0.58 to 1.03). Conclusions: Adjuvant BTX-A injection conferred a discernible reduction in post-operative pain during surgical limb lengthening and/or deformity without increasing the risk of adverse events.

Keywords: botulinum toxin type A, limb lengthening, distraction osteogenesis, deformity correction, pain management

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10389 Hydrogel Hybridizing Temperature-Cured Dissolvable Gelatin Microspheres as Non-Anchorage Dependent Cell Carriers for Tissue Engineering Applications

Authors: Dong-An Wang

Abstract:

All kinds of microspheres have been extensively employed as carriers for drug, gene and therapeutic cell delivery. Most therapeutic cell delivery microspheres rely on a two-step methodology: fabrication of microspheres and subsequent seeding of cells onto them. In this study, we have developed a novel one-step cell encapsulation technique using a convenient and instant water-in-oil single emulsion approach to form cell-encapsulated gelatin microspheres. This technology is adopted for hyaline cartilage tissue engineering, in which autologous chondrocytes are used as therapeutic cells. Cell viability was maintained throughout and after the microsphere formation (75-100 µm diameters) process that avoids involvement of any covalent bonding reactions or exposure to any further chemicals. Further encapsulation of cell-laden microspheres in alginate gels were performed under 4°C via a prompt process. Upon the formation of alginate constructs, they were immediately relocated into CO2 incubator where the temperature was maintained at 37°C; under this temperature, the cell-laden gelatin microspheres dissolved within hours to yield similarly sized cavities and the chondrocytes were therefore suspended within the cavities inside the alginate gel bulk. Hence, the gelatin cell-laden microspheres served two roles: as cell delivery vehicles which can be removable through temperature curing, and as porogens within an alginate hydrogel construct to provide living space for cell growth and tissue development as well as better permeability for mutual diffusions. These cell-laden microspheres, namely “temperature-cured dissolvable gelatin microsphere based cell carriers” (tDGMCs), were further encapsulated in a chondrocyte-laden alginate scaffold system and analyzed by WST-1, gene expression analyses, biochemical assays, histology and immunochemistry stains. The positive results consistently demonstrated the promise of tDGMC technology in delivering these non-anchorage dependent cells (chondrocytes). It can be further conveniently translated into delivery of other non-anchorage dependent cell species, including stem cells, progenitors or iPS cells, for regeneration of tissues in internal organs, such as engineered hepatogenesis or pancreatic regeneration.

Keywords: biomaterials, tissue engineering, microsphere, hydrogel, porogen, anchorage dependence

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10388 Important Management Competencies: University of Technology Perspective

Authors: Courtley Pharaoh, D. J. Visser

Abstract:

University management is often caught between competing interests from stakeholders like students, trustees, donors, government and the community it serves. This study aimed to identify what management competencies are required by executive management members of universities of technology to effectively manage a university of technology in South Africa from the perspective of the executive management members. This exploratory study will make use of a qualitative methodology to establish what management competencies are deemed as important to manage a university of technology in South Africa from the executive management perspective. Due to the consequences of the COVID-19 Pandemic, the study made use of online face-to-face interviews to ascertain from executive management members of universities of technology what the required management competencies needed by executive management members of universities of technology to effectively manage a University of Technology in South Africa. Qualitative Content Analysis was used to analyse the data collected. The findings of the study identified a total of 26 management competencies which were categorised into three groupings or themes. This study identified a list of required management competencies needed by executive management members of universities of technology to effectively manage a university of technology in South Africa, as per the lived experience of executive management members. The researcher recommends further studies at traditional and comprehensive universities and compares the results of those future studies with the results of this study. A comprehensive list of management competencies could then be identified, which could assist with the compilation of job descriptions of executive management members of universities in South Africa.

Keywords: university of technology, management competencies, executive management, executive management members, important

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10387 Green Logistics Management and Performance for Thailand’s Logistic Enterprises

Authors: Kittipong Tissayakorn, Fumio Akagi, Yu Song

Abstract:

Logistics is the integrated management of all of the activities required to move products through the supply chain. For a typical product, this supply chain extends from a raw material source through the production and distribution system to the point of consumption and the associated reverse logistics. The logistical activities are comprised of freight transport, storage, inventory management, materials handling and all related information processing. This paper analyzes the green management system of logistics enterprise for Thailand and advances the concept of Green Logistics, which should be held by the public. In addition, it proposes that the government should strengthen its supervision and support for green logistics, and companies should construct self-disciplined green logistics management systems and corresponding processes, a reverse logistics management system and a modern green logistics information collection and management system.

Keywords: logistics, green logistics, management system, ecological economics

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10386 The Protection of Assets in the Crisis Management Processes

Authors: Jiri Barta

Abstract:

This paper deals with the prevention and management of emergencies. It focuses on the protection of assets of the critical infrastructure entities that are important to preventing, preparing for and management of emergencies and crisis situations. The paper defines assets and specifies their use and place in the process of crisis management and planning. Critical assets that are protected from the negative effects of emergency or crisis situation we can use in crisis management and response. This basic rule applies mainly to the substantial assets used in the protection of critical infrastructure processes.

Keywords: asset, continuity, critical infrastructure, crisis management process

Procedia PDF Downloads 507
10385 Exploring Non-Governmental Organizations’ Performance Management: Bahrain Athletics Association as a Case Study

Authors: Nooralhuda Aljlas

Abstract:

In the ever-growing field of non-governmental organizations, the enhancement of performance management and measurement systems has been increasingly acknowledged by political, economic, social, legal, technological and environmental factors. Within Bahrain Athletics Association, such enhancement results from the key factors leading performance management including collaboration, feedback, human resource management, leadership and participative management. The exploratory, qualitative research conducted reviewed performance management theory. As reviewed, the key factors leading performance management were identified. Drawing on a non-governmental organization case study, the key factors leading Bahrain Athletics Association’s performance management were explored. By exploring the key factors leading Bahrain Athletics Association’s performance management, the research study proposed a theoretical framework of the key factors leading performance management in non-governmental organizations in general. The research study recommended further investigation of the role of the two key factors of command and control and leadership, combining military and civilian approaches to enhancing non-governmental organizations’ performance management.

Keywords: Bahrain athletics association, exploratory, key factor, performance management

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10384 Simultaneous Targeting of MYD88 and Nur77 as an Effective Approach for the Treatment of Inflammatory Diseases

Authors: Uzma Saqib, Mirza S. Baig

Abstract:

Myeloid differentiation primary response protein 88 (MYD88) has long been considered a central player in the inflammatory pathway. Recent studies clearly suggest that it is an important therapeutic target in inflammation. On the other hand, a recent study on the interaction between the orphan nuclear receptor (Nur77) and p38α, leading to increased lipopolysaccharide-induced hyperinflammatory response, suggests this binary complex as a therapeutic target. In this study, we have designed inhibitors that can inhibit both MYD88 and Nur77 at the same time. Since both MYD88 and Nur77 are an integral part of the pathways involving lipopolysaccharide-induced activation of NF-κB-mediated inflammation, we tried to target both proteins with the same library in order to retrieve compounds having dual inhibitory properties. To perform this, we developed a homodimeric model of MYD88 and, along with the crystal structure of Nur77, screened a virtual library of compounds from the traditional Chinese medicine database containing ~61,000 compounds. We analyzed the resulting hits for their efficacy for dual binding and probed them for developing a common pharmacophore model that could be used as a prototype to screen compound libraries as well as to guide combinatorial library design to search for ideal dual-target inhibitors. Thus, our study explores the identification of novel leads having dual inhibiting effects due to binding to both MYD88 and Nur77 targets.

Keywords: drug design, Nur77, MYD88, inflammation

Procedia PDF Downloads 292