Search results for: regional hospital

Authors: Elisa Silva, Rui Lança, Fátima Farinha, Miguel José Oliveira, Manuel Duarte Pinheiro, Cátia Miguel

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Tourism is one of the global engines of development. With good planning and management, it can be a positive force, bringing benefits to touristic destinations around the world. However, without constrains, boundaries well established and constant survey, tourism can be very harmful and induce destination’s degradation. In the interest of the tourism sector and the community it is important to develop the destination maintaining its sustainability. The OBSERVE project is an instrument for monitoring and evaluating the sustainability of the region of Algarve. Its main priority is to provide environmental, economic, social-cultural and institutional indicators to support the decision-making process towards a sustainable growth. In the pursuit of the objectives, it is being developed a digital platform where the significant indicators will be continuously updated. It is known that the successful development of a touristic region depends from the careful planning with the commitment of central and regional government, industry, services and community stakeholders. Understand the different perspectives of stakeholders is essential to engage them in the development planning. However, actual stakeholders’ engagement process is complex and not easy to accomplish. To create a consistent system of indicators designed to monitor and evaluate the sustainability performance of a touristic region it is necessary to access the local data and the consideration of the full range of values and uncertainties. This paper presents the OBSERVE project and describes the stakeholders´ engagement process highlighting the contributions, ambitions and constraints.

Keywords: sustainable tourism, stakeholders' engagement, OBSERVE project, Algarve region

Procedia PDF Downloads 174

Authors: K. Amanzoui, A. Erragh, M. Elharit, A. Afif, K. Elfakhr, S. Kalouch, A. Chlilek

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Orthopedic surgery is a provider of pre and postoperative bleeding; patients are exposed to several risks, and different measures are proposed to reduce bleeding during surgery, called the transfusion-sparing method, including tranexamic acid, which has shown its effectiveness in numerous studies. A prospective analytical study in 50 children was carried out in the orthopedic traumatology operating room of the EL HAROUCHI hospital of the CHU IBN ROCHD in Casablanca over a period of six months (April to October 2022). Two groups were randomized: one receiving tranexamic acid (Group A) and a non-receiving control group (Group B). The average age was 10.3 years, of which 58.8% were female. The first type of surgery was thoracolumbar scoliosis (52%). The average preoperative hemoglobin was 12.28 g/dl in group A, against 12.67 g/dl in the control group. There was no significant difference between the two groups (p=0.148). Mean intraoperative bleeding was 396.29 ml in group A versus 412 ml in the control group. No significant difference was observed for this parameter (p=0.632). The average hemoglobin level in the immediate postoperative period in our patients is 10.2 g/dl. In group A, it was 10.95 g/dl versus 10.93 g/dl in group B. At H24 postoperative, the mean hemoglobin value was 10.29 g/dl in group A against 9.5 g/dl in group B. For group A, the blood loss recorded during the first 24 hours was 209.43 ml, against 372 ml in group B, with a significant difference between the two groups (p=0.001). There is no statistically significant difference between the 2 groups in terms of the use of fillers, ephedrine or intraoperative transfusion. While for postoperative transfusion, we note the existence of a statistically significant difference between group A and group B. It is suggested that the use of tranexamic acid is an effective, simple, and low-cost way to limit postoperative blood loss and the need for transfusion.

Keywords: tranexamic acid, blood loss, orthopedic surgery, children

Procedia PDF Downloads 71

Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 106

Authors: Blanche Aguida, Marootpong Pooam, Nathalie Jourdan, Margaret Ahmad

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COVID-19-related morbidity is associated with exaggerated inflammation and cytokine production in the lungs, leading to acute respiratory failure. The cellular mechanisms underlying these so-called ‘cytokine storms’ are regulated through the Toll-like receptor 4 (TLR4) signaling pathway and by reactive oxygen species (ROS). Both light (photobiomodulation) and magnetic fields (e.g., pulsed electromagnetic field) stimulation are non-invasive therapies known to confer anti-inflammatory effects and regulate ROS signaling pathways. Here we show that daily exposure to two 10-minute intervals of moderate-intensity infra-red light significantly lowered the inflammatory response induced via the TLR4 receptor signaling pathway in human cell cultures. Anti-inflammatory effects were likewise achieved by electromagnetic field exposure of cells to daily 10-minute intervals of either pulsed electromagnetic fields (PEMF) or to low-level static magnetic fields. Because current illumination and electromagnetic field therapies have no known side effects and are already approved for some medical uses, we have here developed protocols for verification in clinical trials of COVID 19 infection. These treatments are affordable, simple to implement, and may help to resolve the acute respiratory distress of COVID 19 patients both in the home and in the hospital.

Keywords: COVID 19, electromagnetic fields therapy, inflammation, photobiomodulation therapy

Procedia PDF Downloads 149

Authors: Luma Hameed Abd, Ammar Hamza Hadi, Amjed Abid Ali Mahdi

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Context: The study focused on treating high blood cholesterol in individuals aged 30-40 years using rehabilitation and nutrition programs compared to medical drugs. Research aim: To compare the effectiveness of exercise rehabilitation and nutrition programs with medical drugs in reducing high blood cholesterol levels. Methodology: An experimental method with equal groups was utilized, involving 160 patients from Najaf Hospital. SPSS was used for data analysis. Findings: The study showed that both the exercise and nutrition program, as well as medical drugs, contributed to lowering cholesterol levels, with the first group showing better results. Theoretical importance: The research highlights the significance of a holistic approach combining exercise, nutrition, and medical treatment in managing high cholesterol. Data collection: Blood cholesterol tests were conducted before and after the programs to assess improvements. Analysis procedures: Statistical methods such as arithmetic mean, standard deviation, Torsion coefficient, and T-test for correlated samples were employed to analyze the results. Questions addressed: The study addressed the effectiveness of rehabilitation and nutrition programs compared to medical drugs in treating high blood cholesterol. Conclusion: The research concluded that the combination of exercise rehabilitation and nutrition programs was more effective in reducing blood cholesterol levels compared to medical drugs.

Keywords: nutrition, rehabilitation, programs, high blood cholesterol

Procedia PDF Downloads 31

Authors: Zama Mahmood

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The increasing demand of food management, monitoring of the crop growth and forecasting its yield well before harvest is very important. These days, yield assessment together with monitoring of crop development and its growth are being identified with the help of satellite and remote sensing images. Studies using remote sensing data along with field survey validation reported high correlation between vegetation indices and yield. With the development of remote sensing technique, the detection of crop and its mechanism using remote sensing data on regional or global scales have become popular topics in remote sensing applications. Punjab, specially the southern Punjab region is extremely favourable for wheat production. But measuring the exact amount of wheat production is a tedious job for the farmers and workers using traditional ground based measurements. However, remote sensing can provide the most real time information. In this study, using the Normalized Differentiate Vegetation Index (NDVI) indicator developed from Landsat satellite images, the yield of wheat has been estimated during the season of 2013-2014 for the agricultural area around Bahawalpur. The average yield of the wheat was found 35 kg/acre by analysing field survey data. The field survey data is in fair agreement with the NDVI values extracted from Landsat images. A correlation between wheat production (ton) and number of wheat pixels has also been calculated which is in proportional pattern with each other. Also a strong correlation between the NDVI and wheat area was found (R2=0.71) which represents the effectiveness of the remote sensing tools for crop monitoring and production estimation.

Keywords: landsat, NDVI, remote sensing, satellite images, yield

Procedia PDF Downloads 337

Authors: Sara Herrero Jaén, José María Santamaría García, María Lourdes Jiménez Rodríguez, Jorge Luis Gómez González, Adriana Cercas Duque, Alexandra González Aguna

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Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.

Keywords: calculator, care, eHealth, health

Procedia PDF Downloads 266

Authors: Niall Fennessy, Charlotte Yin, Vineet Gorolay, Michael Chan, Ilias Drivas

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Background: The aim of this study was to evaluate the effect of manual aspiration of air from the pleural cavity in mitigating the need for chest drain placement after a CT-guided lung biopsy. Method: This is a single institution retrospective review of CT-guided lung biopsies performed on 799 patients between September 2013 and May 2021 in a major tertiary hospital. Percutaneous manual aspiration of air was performed in 104/306 patients (34%) with pneumothoraxes as a preventative measure. Simple and multivariate analysis was performed to identify independent risk factors (modifiable and nonmodifiable) for the success of manual aspiration in mitigating the need for chest drain insertion. Results: The overall incidence of pneumothorax was 37% (295/799). Chest drains were inserted for 81/295 (27%) of the pneumothoraxes, representing 81/799 (10%) of all CT-guided lung biopsies. Of patients with pneumothoraces, 104 (36%) underwent percutaneous aspiration via either the coaxial guide needle or an 18 or 20G intravenous catheter attached to a three-way stopcock and syringe. Amongst this group, 13 patients (13%) subsequently required chest drain insertion. The success of percutaneous aspiration in avoiding subsequent pleural drain insertion decreased with aspiration volume >500mL, radial pneumothorax depth >3cm, increased subpleural depth of the lesion, and the presence of background emphysema.

Keywords: computed tomography, lung biopsy, pneumothorax, manual aspiration, chest drainage

Procedia PDF Downloads 179

Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik

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Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.

Keywords: diagnosis, serology, seroprevalence, toxoplasmosis

Procedia PDF Downloads 157

Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

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Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

Procedia PDF Downloads 80

Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath

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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.

Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics

Procedia PDF Downloads 364

Authors: Hayyan ul Haq, Zainal Asikin

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This work aims to explore the appropriate solution in solving legal problems stemmed from managing and exploiting strategic natural resources in Indonesia. This discussion will be focused on the exploitation of gold mining, i.e. divestation process in the New Mont Corporation, West Nusa Tenggara. These legal problems relate to the deviation of the national budget regulation, UU. No. 19/2012, and the implementation of the divestastion process, which infringes PP. No. 50/2007 concerning the Impelementation Procedure of Regional Cooperation, which is an implementation regulation of UU No. 1/2004 on State’s Treasury. The cooperation model, have been developed by the Provincial Government, failed to create a permanent legal solution through normative approach. It has merely used practical approach that tends (instant solution), by using some loopholes in the divestation process. The above blunders have accumulated by other secondary legal blunders, i.e. good governance principles, particularly justice, transparency, efficiency, effective principles and competitiveness principle. To solve the above problems, this work offers constitutionalisation of contract that aimed at reviewing and coherencing all deviated contracts, rules and policies that have deprived the national and societies’ interest to optimize the strategic natural resources towards the greatest benefit for the greatest number of people..

Keywords: constitutionalisation of contract, strategic national resources, divestation, the greatest benefit for the greatest number of people, Indonesian Pancasila values

Procedia PDF Downloads 461

Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier

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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.

Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas

Procedia PDF Downloads 80

Authors: Sanjaya N. Munasinghe, R. Gnanasekeram, Dimuthu Tennakoon

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During the last few years there has been a dramatic increase in the number of motorcyclists in Sri Lankan roads and thus an increase of motorcycle accidents (MCAs) with a heavy death and casualty toll. Extremity injuries due to MCAs cause a heavy burden on government hospitals. However, data on MCA injuries are limited. This study tries to determine the relationship between extremity injuries with protective gears and clothing motorcycle riders were wearing at the time of the accident. Data were collected from 410 motorcycle riders and passengers involved with MCAs and admitted to orthopedic and emergency observation wards in Teaching Hospital Kurunegala with extremity injuries between 1st February 2015 and 31st July 2015 using an interviewer administered questioner. Data were analyzed using SPSS version 17.0. Distal radial fracture is the most common upper extremity injury (12%), and Tibial fracture is the most common and severe lower extremity injury (23%). Very few participants were wearing safety gloves (2%) and jackets (10%). Most of the participants were wearing slippers (66%), short sleeved upper clothing (96%) and light cloth trousers (49%). According to Chi-square test associations were found between footwear and foot injuries (p-value - 0.001, Cramer's v-value - 0.203) and safety jacket and upper extremity injuries (p-value - 0.002, Cramer's v-value - 0.177). The results indicate that using safety gear can minimize the number of injuries in MCA victims. Thus it is necessary to ensure that motorcycle riders and pillion riders use proper safety gear.

Keywords: extremity injuries, fractures, motorcycle accidents, safety gear

Procedia PDF Downloads 297

Authors: Alice W. Theuri, Anselimo O. Makokha, Florence M. Kyallo

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Type 2 diabetes mellitus (T2DM) is a serious metabolic disorder whose prevalence among adults has been increasing in the last decade. It is estimated that by 2030, the number of cases in Africa will almost double. Diet and lifestyle modifications are considered the cornerstone for the treatment and management of T2DM. Despite this, there is minimum literature assessing the dietary practices and glycemic control in a semi arid region context in Kenya. The objective of this study was to determine the dietary practices of adult T2DM patients attending Kitui out patient clinic in Kitui County. This was a cross sectional study design where every consenting second patient attending diabetic clinic was interviewed. A total of 138 T2DM patients were interviewed using a structured interview guide on socio-economic and dietary practices administered. The study was carried out in April and May 2017. There were more female (64%) than male (36%) in this study with majority being unemployed (38.4%). Forty seven percent (47.6%) had elevated HbA1c. Majority took three meals per day while DDS was 4.3 ± 1.09. The mean energy intake for men and women was 2823.8 ± 82.45 and 2766.3.30 ± 76.74 respectively. There was a non significant positive relationship (r= 131; P value = 0.124) between amount energy consumed and glycemic control. There were suboptimal dietary practices leading to poor glycemic control among T2DM patients attending diabetic clinic at Kitui District Hospital.

Keywords: adults, dietary practices, semi arid region, T2DM

Procedia PDF Downloads 156

Authors: F. Bellali, M. Kharroubi, M. Loutfi, N.Bourhim

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In Morocco, fish processing industry is an important source income for a large amount of byproducts including skins, bones, heads, guts and scales. Those underutilized resources particularly scales contain a large amount of proteins and calcium. Scales from Sardina plichardus resulting from the transformation operation have the potential to be used as raw material for the collagen production. Taking into account this strong expectation of the regional fish industry, scales sardine upgrading is well justified. In addition, political and societal demands for sustainability and environment-friendly industrial production systems, coupled with the depletion of fish resources, drive this trend forward. Therefore, fish scale used as a potential source to isolate collagen has a wide large of applications in food, cosmetic and bio medical industry. The main aim of this study is to isolate and characterize the acid solubilize collagen from sardine fish scale, Sardina pilchardus. Experimental design methodology was adopted in collagen processing for extracting optimization. The first stage of this work is to investigate the optimization conditions of the sardine scale deproteinization on using response surface methodology (RSM). The second part focus on the demineralization with HCl solution or EDTA. Moreover, the last one is to establish the optimum condition for the isolation of collagen from fish scale by solvent extraction. The basic principle of RSM is to determinate model equations that describe interrelations between the independent variables and the dependent variables.

Keywords: Sardina pilchardus, scales, valorization, collagen extraction, response surface methodology

Procedia PDF Downloads 421

Authors: Rebar Mohammed Hussein

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Enhanced Recovery After Surgery (ERAS) protocols have transformed perioperative care, aiming to reduce surgical stress, optimize pain management, and accelerate recovery. This study evaluates the impact of ERAS on anesthesia management in high-risk surgical patients, focusing on opioid-sparing techniques and multimodal analgesia. A retrospective analysis was conducted on patients undergoing major surgeries within an ERAS program, comparing outcomes with a historical cohort receiving standard care. Key metrics included postoperative pain scores, opioid consumption, length of hospital stay, and complication rates. Results indicated that the implementation of ERAS protocols significantly reduced postoperative opioid use by 40% and improved pain management outcomes, with 70% of patients reporting satisfactory pain control on postoperative day one. Additionally, patients in the ERAS group experienced a 30% reduction in length of stay and a 20% decrease in complication rates. These findings underscore the importance of integrating ERAS principles into anesthesia practice, particularly for high-risk patients, to enhance recovery, improve patient satisfaction, and reduce healthcare costs. Future directions include prospective studies to further refine anesthesia techniques within ERAS frameworks and explore their applicability across various surgical specialties.

Keywords: ERAS protocols, high-risk surgical patients, anesthesia management, recovery

Procedia PDF Downloads 34

Authors: Tina Pujara

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Urban and regional research in the new emerging inter-disciplinary field of happiness is seemingly limited. However, it is progressively being recognized that there is enormous potential for social and behavioral scientists to add a spatial dimension to it. In fact, the happiness of communities can be notably influenced by the design and maintenance of the neighborhoods they inhabit. The probable key reasons being that places can facilitate human social connections and relationships. While it is increasingly being acknowledged that some neighborhood designs appear better suited for social connectedness than others, the plausible reasons for places to deter these characteristics and perhaps their influence on happiness are outwardly unknown. In addition, an explicit step wise methodology to assess neighborhood designs for happiness (of their communities) is not known to exist. This paper is an attempt towards developing such a methodological framework. The paper presents the development of a methodological framework for assessing neighborhood designs for happiness, with a particular focus on the outdoor shared spaces in neighborhoods. The developed methodological framework of investigation follows a mixed method approach and draws upon four different sources of information. The framework proposes an empirical examination of the contribution of neighborhood factors, particularly outdoor shared spaces, to individual happiness. One of the main tools proposed for this empirical examination is Jan Gehl’s Public Space Public Life (PSPL) Survey. The developed framework, as presented in the paper, is a contribution towards the development of a consolidated methodology for assessing neighborhood designs for happiness, which can further serve as a unique tool to inform urban designers, architects and other decision makers.

Keywords: happiness, methodology, neighbourhood design, outdoor shared spaces

Procedia PDF Downloads 165

Authors: Samet Aktaş, Nurtekin Erkmen, Faruk Guven, Halil Taskin

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This study aimed to determine the effects of 3 versus 3 small-sided games (SSG) with different recovery times on soma physiological parameters in soccer players. Twelve soccer players from Regional Amateur League volunteered for this study (mean±SD age, 20.50±2.43 years; height, 177.73±4.13 cm; weight, 70.83±8.38 kg). Subjects were performing soccer training for five days per week. The protocol of the study was approved by the local ethic committee in School of Physical Education and Sport, Selcuk University. The subjects were divided into teams with 3 players according to Yo-Yo Intermittent Recovery Test. The field dimension was 26 m wide and 34 m in length. Subjects performed two times in a random order a series of 3 bouts of 3-a-side SSGs with 3 min and 5 min recovery durations. In SSGs, each set were performed with 6 min duration. The percent of maximal heart rate (% HRmax), blood lactate concentration (LA) and Rated Perceived Exertion (RPE) scale points were collected before the SSGs and at the end of each set. Data were analyzed by analysis of variance (ANOVA) with repeated measures. Significant differences were found between %HRmax in before SSG and 1st set, 2nd set, and 3rd set in both SSG with 3 min recovery duration and SSG with 5 min recovery duration (p<0.05). Means of %HRmax in SSG with 3 min recovery duration at both 1st and 2nd sets were significantly higher than SSG with 5 min recovery duration (p<0.05). No significant difference was found between sets of either SSGs in terms of LA (p>0.05). LA in SSG with 3 min recovery duration was higher than SSG with 5 min recovery duration at 2nd sets (p<0.05). RPE in soccer players was not different between SSGs (p>0.05).In conclusion, this study demonstrates that exercise intensity in SSG with 3 min recovery durations is higher than SSG with 5 min recovery durations.

Keywords: small-sided games, soccer, heart rate, lactate

Procedia PDF Downloads 468

Authors: Aigul Abduldayeva, Gulnar Tuleshova

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Osteoporosis (OP) is a major socio-economic problem and is a major cause of disability, reduced quality of life and premature death of elderly people. In Astana, the study involved 93 respondents, of whom 17 were men (18.3%), and 76 were women (81.7%). Age distribution of the respondents is as follows: 40-59 (66.7%), 60-75 (29.0%), 75-90 (4.3%). In the city of Astana general breach of bone mass (CCM) was determined in 83.8% (nationwide figure - RRP - 79.0%) of the patients, and normal levels of ultrasound densitometry were detected in 16.1% (RRP 21.0%) of the patients. OP was diagnosed in 20.4% of people over 40 (RRP for citizens is 19.0%), 25.4% in the group older than 50 (23.4% PIU), 22,6% in the group older than 60 (RRP 32.6%), 25.0% in the group older than 70 (47.6% of RRP). OPN was detected in 63.4% (RRP 59.6%) of the surveyed population. These data indicate that, there is no sharp difference between Astana and other cities in the country regarding the incidence of OP, that is, the situation with the OP is not aggravated by any regional characteristics. In the distribution of respondents by clusters it was found that 80.0% of the respondents with CCM were in the "best urban cluster", 93.8% were in "average urban cluster", and 77.4% were in a "poor urban cluster". There is a high rate construction of new buildings in Astana, presumably, that the new settlers inhabit the outskirts of the city, and very difficult to trace the socio-economic differences there. Based on these data the following conclusions can be made: 1. According to the ultrasound densitometry of the calcaneus the prevalence rate of NCM among the residents of Astana is 83.3%, OP - 20.4%, which generally coincides with data elsewhere in the country. 2. The urban population of Astana is under a high degree of risk for low energetic fracture, 46.2% of the population had medium and high risks of fracture, while the nationwide index is 26.7%. 3. In the development of CCM residents of Akmola region play a significant role gender, age, ethnic factors. According to the ultrasound densitometry women are more prone to Astana OP - 22.4% of respondents than men - 11.8% of respondents.

Keywords: nutrition, osteoporosis, elderly, urban population

Procedia PDF Downloads 477

Authors: M. Yilmaz, I. Yilmaz, M. Uysal

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The Earth system generates different phenomena that are observable at the surface of the Earth such as mass deformations and displacements leading to plate tectonics, earthquakes, and volcanism. The dynamic processes associated with the interior, surface, and atmosphere of the Earth affect the three pillars of geodesy: shape of the Earth, its gravity field, and its rotation. Geodesy establishes a characteristic structure in order to define, monitor, and predict of the whole Earth system. The traditional and new instruments, observables, and techniques in geodesy are related to the gravity field. Therefore, the geodesy monitors the gravity field and its temporal variability in order to transform the geodetic observations made on the physical surface of the Earth into the geometrical surface in which positions are mathematically defined. In this paper, the main components of the gravity field modeling, (Free-air and Bouguer) gravity anomalies are calculated via recent global models (EGM2008, EIGEN6C4, and GECO) over a selected study area. The model-based gravity anomalies are compared with the corresponding terrestrial gravity data in terms of standard deviation (SD) and root mean square error (RMSE) for determining the best fit global model in the study area at a regional scale in Turkey. The least SD (13.63 mGal) and RMSE (15.71 mGal) were obtained by EGM2008 for the Free-air gravity anomaly residuals. For the Bouguer gravity anomaly residuals, EIGEN6C4 provides the least SD (8.05 mGal) and RMSE (8.12 mGal). The results indicated that EIGEN6C4 can be a useful tool for modeling the gravity field of the Earth over the study area.

Keywords: free-air gravity anomaly, Bouguer gravity anomaly, global model, land gravity

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Authors: Carmela Perta

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Following the example of both International and European legislation, on 15 December 1999 the national law 482/99 Regulations regarding the protection of historic language minorities was approved, providing a national framework for the preservation and renaissance of minority languages «The Italian Republic sustains the language and culture of people speaking Albanian, Catalan, German, Greek, Slovene, Croatian, French, Francoprovençal, Friulan, Ladin, Occitan and Sard». The legislation made it possible to use these languages in education, in public offices, in local government, in the judicial system, in mass media, and allowed for the reinstatement of place and personal names. However, several practical problems have emerged, particularly those concerning the variety that should be used in education, in official documents and in other formal domains, i.e. the local variety, the standard of reference (if there is any), or an over regional koinè. In minority settings, it might seem eminently sensible to use the ready made standard of reference, accepting the Ausbausprache, rather than the language as practice, that is the local variety. However, this process seems to be pointless, as is demonstrated by the results of a fieldwork that was carried out in a small town in the South of Italy where members speak Faetar, the local variety of Francoprovençal. Here the language is largely used by the community members in all domains, moreover a deep sense of loyalty towards the variety they use and a manifested minority identity can be observed analysing the speakers’ attitudes. However, these positive attitudes are towards the vehicle for their distinctive history and culture, and not for an “external” standard, a system which local authorities and planners are trying to introduce in the community. In other words, according to the speakers' reactions, there is little point in struggling to maintain a language, if what is conserved is not the group’s language but another.

Keywords: maintenance, minority languages, endangered languages, francoprovençal

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Authors: Ana Pego

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Environmental technologies were developed for decades. Clean technologies emerged a few years ago. In these perspectives, the use of cleantech technologies has become very important due the fact of new era of environmental feats. As such, the market itself has become more competitive, more collaborative towards a better use of clean technologies. This paper shows the importance of clean technologies in offshore energy sector in Portuguese market, its localization and its impact on economy. Clean technologies are directly related with renewable cluster and concomitant with economic and social resource optimization criteria, geographic aspects, climate change and soil features. Cleantech is related with regional development, socio-technical transitions in organisations. There are an economical and social combinations which allow specialisation of regions in activities, higher employment, reduce of energy costs, local knowledge spillover and, business collaboration and competitiveness. The methodology used will be quantitative (IO matrix for Portugal 2013) and qualitative (questionnaires to stakeholders). The mix of both methodologies will confirm whether the use of technologies will allow a positive impact on economic and social variables used on this model. It is expected a positive impact on Portuguese economy both in investment and employment taking in account the localization of offshore renewable activities. This means that the importance of offshore renewable investment in Portugal has a few points which should be pointed out: the increase of specialised employment, localization of specific activities in territory, and increase of value added in certain regions. The conclusion will allow researchers and organisation to compare the Portuguese model to other European regions in order to a better use of natural and human resources.

Keywords: cleantech, economic impact, localisation, territory dynamics

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Authors: Mehrdad Taghipour, Mina Rostami, Mahdi Eskandarlou

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Partial-thickness skin graft is the cornerstone for scalp defect repair. Given the potential side effects following harvesting from these sites, this study aimed to compare the outcomes of graft harvesting from scalp and lower limb. This clinical trial was conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to Plastic Surgery Clinic at Besat Hospital, Hamadan, Iran during 2018-2019. Sampling was done by simple randomization using random digit table. The donor site in case group and control group was scalp and lower limb respectively. Overall, 28 patients (70%) were male and 12 (30%) were female. Basal cell carcinoma (BCC) and trauma were the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameters of defect in both groups were statistically meaningful while no such difference between graft diameters was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale. Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, graft, scalp, partial thickness

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Authors: Ligia Florio, João Mauricio Castaldelli-Maia

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Background: Food addiction (FA) emerged in the 1990s as a possible contributor to the increasing prevalence of obesity and overweight, in conjunction with changing food environments and mental health conditions. However, FA is not yet listed as one of the disorders in the DSM-5 and/or the ICD-11. Although there are controversies and debates in the literature about the classification and construct of FA, the most common approach to access it is the use of a research tool - the Yale Food Addiction Scale (YFAS) - which approximates the concept of FA to the concept diagnosis of dependence on psychoactive substances. There is a need to explore the dimensional phenotypes accessed by YFAS in different population groups for a better understanding and scientific support of FA diagnoses. Methods: The primary objective of this project was to investigate the construct validity of the FA concept by mYFAS 2.0 in individuals who underwent bariatric surgery (n = 100) at the Hospital Estadual Mário Covas since 2011. Statistical analyzes were conducted using the STATA software. In this sense, structural or factor validity was the type of construct validity investigated using exploratory factor analysis (EFA) and item response theory (IRT) techniques. Results: EFA showed that the one-dimensional model was the most parsimonious. The IRT showed that all criteria contributed to the latent structure, presenting discrimination values greater than 0.5, with most presenting values greater than 2. Conclusion: This study reinforces a FA dimension in patients who underwent bariatric surgery. Within this dimension, we identified the most severe and discriminating criteria for the diagnosis of FA.

Keywords: obesity, food addiction, bariatric surgery, regain

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Authors: H. Noureddine, P. Rao, R. Guru, A. Chandratreya

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The nice guidance for elective total knee replacements states that patients should be given mechanical thrombo-prophylaxis, and if no contraindications chemical thromboprophylaxis in the form of Dabigatran etexilate, Rivaroxiban, UFH, LMWH, or Fondaparinux sodium (CG92, 1.5.14, January 2010). In Practice administering oral agents has been the dominant practice as it reduces the nursing needs, and shortens hospital stay and is generally received better by patients. However, there are well documented associated bleeding risks, and their effects are difficult to reverse in case of major bleeding. Our experience with oral factor 10 inhibitors used for thromboprophylaxis was marked with several patients developing complications necessitating return to the theatre for wound washouts. This has led us to try a different protocol for thromboprophylaxis that we applied on our patients undergoing total and unicondylar knee replacements. We applied mechanical thromboprophylaxis in the form of intermittent pneumatic pressure devices, and chemical thromboprophylaxis in the form of a dose of prophylactic LMWH pre-op, then 150 mg of Aspirin to start 24 hours after the surgery and to continue for 6 weeks, alongside GI cover with PPIs or antihistamines. We also administered local anaesthetics intra-operatively in line with the ERAS protocol thus encouraging early mobilization. We have identified a cohort of 133 patients who underwent one of the aforementioned procedures in the same trust, and by the same surgeon, where this protocol was applied and examined their medical notes retrospectively with a mean follow-up period of 14 months, to identify the rate and percentage of patients who had thrombo-embolic events in the post-operative period.

Keywords: aspirin, heparin, knee arthroplasty, thromboprophylaxis

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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Authors: Sherif Sabri, Nael Samir, Mohamed Ali, Ahmed ElSakhawy

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Introduction: There is growing evidence to support the hypothesis that serum matrix metalloproteinase -9 in could be an early predictor of mortality in septic patients. Aim of the work: Study the relationship of matrix metalloproteinase 9 in patients with SIRS in comparison to septic patients in day 0 and day 2. Patients and Methods: This is a prospective observational study conducted on 40 adult critically ill patients staying more than 24 hours in ICU either surgical or medical department, El Fayoum General Hospital in the period from November 2014 to March 2015. Patients met at least two of the criteria for severe inflammatory response syndrome (SIRS). Diagnostic criteria include several clinical and laboratory findings of sepsis induced tissue hypoperfusion or organ dysfunction. Samples were grouped as drawn either at admission, or at day 2 after admission. Results: Patients were divided into two groups: The non-sepsis (SIRS) group, which included 15 (37.5%) patients with no later evidence of sepsis were enrolled as controls. The Sepsis group, which included 25 patients diagnosed to have SIRS with later evidence of sepsis with positive culture. Exploring serum level of MMP-9 in non-survivors and survivors, there was significant increase in non-survivors if compared to survivors at admission p-value 0.001 (mean value in survivors 4.4mg/dl±4.1mg/dl at admission versus mean value in non-survivors 11.9mg/dl±5.8mg/dl) and after two days of admission was also significant increase p-value 0.001 (mean value in survivors 10.9mg/dl ±9.4mg/dl versus mean value in non-survivors 22.6mg/dl±10.4). Conclusion: MMP-9 levels in septic patients have a beneficial role in ICU for high-risk stratification as it is an independent marker of mortality in severe sepsis.

Keywords: matrix metalloproteinase (MMP-9), sepsis, septic shock, systemic inflamatory response syndrome

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Authors: Alina Svechkina, Boris A. Portnov

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In line with a rapid increase in pollution sources and enforcement of stricter air pollution regulation, which lowers pollution levels, it becomes more difficult to identify actual risk sources behind the observed morbidity patterns, and new approaches are required to identify potential risks and take preventive actions. In the present study, we discuss a probabilistic approach to the spatial identification of a priori unidentified environmental health hazards. The underlying assumption behind the tested approach is that the observed adverse health patterns (morbidity, mortality) can become a source of information on the geographic location of environmental risk factors that stand behind them. Using this approach, we analyzed sources of environmental exposure using data on mortality rates available for the year 2015 for NUTS 3 (Nomenclature of Territorial Units for Statistics) subdivisions of the European Union. We identified several areas in the southwestern part of Europe as primary risk sources for the observed mortality patterns. Multivariate regressions, controlled by geographical location, climate conditions, GDP (gross domestic product) per capita, dependency ratios, population density, and the level of road freight revealed that mortality rates decline as a function of distance from the identified hazard location. We recommend the proposed approach an exploratory analysis tool for initial investigation of regional patterns of population morbidity patterns and factors behind it.

Keywords: mortality, environmental hazards, air pollution, distance decay gradient, multi regression analysis, Europe, NUTS3

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Authors: G. Hosseini, A. Sadighzadeh, M. Rahimnejad, N. Hosseini, Z. Jamalzadeh

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Metal pollutants, especially heavy metals from anthropogenic sources such as metallurgical industries’ waste including mining, smelting, casting or production of nuclear fuel, including mining, concentrate production and uranium processing ends in the environment contamination (water and soil) and risk to human health around the facilities of this type of industrial activity. There are different methods that can be used to remove these contaminants from water and soil. These are very expensive and time-consuming. In this case, the people have been forced to leave the area and the decontamination is not done. For example, in the case of Chernobyl accident, an area of 30 km around the plant was emptied of human life. A very efficient and cost-effective method for decontamination of the soil and the water is phytoremediation. In this method, the plants preferentially native plants which are more adaptive to the regional climate are well used. In this study, three types of plants including Alfalfa, Sunflower and wheat were used to Barium decontamination. Alfalfa and Sunflower were not grown good enough in Saghand mine’s soil sample. This can be due to non-native origin of these plants. But, Wheat rise in Saghand Uranium Mine soil sample was satisfactory. In this study, we have investigated the effect of 4 types of acids inclusive nitric acid, oxalic acid, acetic acid and citric acid on the removal efficiency of Barium by Wheat. Our results indicate the increase of Barium absorption in the presence of citric acid in the soil. In this paper, we will present our research and laboratory results.

Keywords: phytoremediation, heavy metal, wheat, soil

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