Search results for: relative risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8159

Search results for: relative risk

5819 Use of Proton Pump Inhibitors Medications during the First Years of Life and Late Complications

Authors: Kamelia Hamza

Abstract:

Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

Procedia PDF Downloads 95
5818 Development and Experimental Evaluation of a Semiactive Friction Damper

Authors: Juan S. Mantilla, Peter Thomson

Abstract:

Seismic events may result in discomfort on occupants of the buildings, structural damage or even buildings collapse. Traditional design aims to reduce dynamic response of structures by increasing stiffness, thus increasing the construction costs and the design forces. Structural control systems arise as an alternative to reduce these dynamic responses. A commonly used control systems in buildings are the passive friction dampers, which adds energy dissipation through damping mechanisms induced by sliding friction between their surfaces. Passive friction dampers are usually implemented on the diagonal of braced buildings, but such devices have the disadvantage that are optimal for a range of sliding force and out of that range its efficiency decreases. The above implies that each passive friction damper is designed, built and commercialized for a specific sliding/clamping force, in which the damper shift from a locked state to a slip state, where dissipates energy through friction. The risk of having a variation in the efficiency of the device according to the sliding force is that the dynamic properties of the building can change as result of many factor, even damage caused by a seismic event. In this case the expected forces in the building can change and thus considerably reduce the efficiency of the damper (that is designed for a specific sliding force). It is also evident than when a seismic event occurs the forces in each floor varies in the time what means that the damper's efficiency is not the best at all times. Semi-Active Friction devices adapt its sliding force trying to maintain its motion in the slipping phase as much as possible, because of this, the effectiveness of the device depends on the control strategy used. This paper deals with the development and performance evaluation of a low cost Semiactive Variable Friction Damper (SAVFD) in reduced scale to reduce vibrations of structures subject to earthquakes. The SAVFD consist in a (1) hydraulic brake adapted to (2) a servomotor which is controlled with an (3) Arduino board and acquires accelerations or displacement from (4) sensors in the immediately upper and lower floors and a (5) power supply that can be a pair of common batteries. A test structure, based on a Benchmark structure for structural control, was design and constructed. The SAVFD and the structure are experimentally characterized. A numerical model of the structure and the SAVFD is developed based on the dynamic characterization. Decentralized control algorithms were modeled and later tested experimentally using shaking table test using earthquake and frequency chirp signals. The controlled structure with the SAVFD achieved reductions greater than 80% in relative displacements and accelerations in comparison to the uncontrolled structure.

Keywords: earthquake response, friction damper, semiactive control, shaking table

Procedia PDF Downloads 378
5817 Sustainable Tourism from a Multicriteria Analysis Perspective

Authors: Olga Blasco-Blasco, Vicente Liern

Abstract:

The development of tourism since the mid-20th century has raised problems of overcrowding, indiscriminate construction in seaside areas and gentrification. Increasingly, the World Tourism Organisation and public institutions are promoting policies that encourage sustainability. From the perspective of sustainability, three types of tourism can be established: traditional tourism, sustainable tourism and sustainable impact tourism. Measuring sustainability is complex due to its multiple dimensions of different relative importance and diversity in nature. In order to try to answer this problem and to identify the benefits of applying policies that promote sustainable tourism, a decision-making analysis will be carried out through the application of a multicriteria analysis method. The proposal is applied to hotel reservations and to the evaluation and management of tourism sustainability in the Spanish Autonomous Communities.

Keywords: sustainable tourism, multicriteria analysis, flexible optimization, composite indicators

Procedia PDF Downloads 312
5816 Occupational Safety and Health in the Wake of Drones

Authors: Hoda Rahmani, Gary Weckman

Abstract:

The body of research examining the integration of drones into various industries is expanding rapidly. Despite progress made in addressing the cybersecurity concerns for commercial drones, knowledge deficits remain in determining potential occupational hazards and risks of drone use to employees’ well-being and health in the workplace. This creates difficulty in identifying key approaches to risk mitigation strategies and thus reflects the need for raising awareness among employers, safety professionals, and policymakers about workplace drone-related accidents. The purpose of this study is to investigate the prevalence of and possible risk factors for drone-related mishaps by comparing the application of drones in construction with manufacturing industries. The chief reason for considering these specific sectors is to ascertain whether there exists any significant difference between indoor and outdoor flights since most construction sites use drones outside and vice versa. Therefore, the current research seeks to examine the causes and patterns of workplace drone-related mishaps and suggest possible ergonomic interventions through data collection. Potential ergonomic practices to mitigate hazards associated with flying drones could include providing operators with professional pieces of training, conducting a risk analysis, and promoting the use of personal protective equipment. For the purpose of data analysis, two data mining techniques, the random forest and association rule mining algorithms, will be performed to find meaningful associations and trends in data as well as influential features that have an impact on the occurrence of drone-related accidents in construction and manufacturing sectors. In addition, Spearman’s correlation and chi-square tests will be used to measure the possible correlation between different variables. Indeed, by recognizing risks and hazards, occupational safety stakeholders will be able to pursue data-driven and evidence-based policy change with the aim of reducing drone mishaps, increasing productivity, creating a safer work environment, and extending human performance in safe and fulfilling ways. This research study was supported by the National Institute for Occupational Safety and Health through the Pilot Research Project Training Program of the University of Cincinnati Education and Research Center Grant #T42OH008432.

Keywords: commercial drones, ergonomic interventions, occupational safety, pattern recognition

Procedia PDF Downloads 213
5815 Enhancing Rupture Pressure Prediction for Corroded Pipes Through Finite Element Optimization

Authors: Benkouiten Imene, Chabli Ouerdia, Boutoutaou Hamid, Kadri Nesrine, Bouledroua Omar

Abstract:

Algeria is actively enhancing gas productivity by augmenting the supply flow. However, this effort has led to increased internal pressure, posing a potential risk to the pipeline's integrity, particularly in the presence of corrosion defects. Sonatrach relies on a vast network of pipelines spanning 24,000 kilometers for the transportation of gas and oil. The aging of these pipelines raises the likelihood of corrosion both internally and externally, heightening the risk of ruptures. To address this issue, a comprehensive inspection is imperative, utilizing specialized scraping tools. These advanced tools furnish a detailed assessment of all pipeline defects. It is essential to recalculate the pressure parameters to safeguard the corroded pipeline's integrity while ensuring the continuity of production. In this context, Sonatrach employs symbolic pressure limit calculations, such as ASME B31G (2009) and the modified ASME B31G (2012). The aim of this study is to perform a comparative analysis of various limit pressure calculation methods documented in the literature, namely DNV RP F-101, SHELL, P-CORRC, NETTO, and CSA Z662. This comparative assessment will be based on a dataset comprising 329 burst tests published in the literature. Ultimately, we intend to introduce a novel approach grounded in the finite element method, employing ANSYS software.

Keywords: pipeline burst pressure, burst test, corrosion defect, corroded pipeline, finite element method

Procedia PDF Downloads 58
5814 Assessment of Heavy Metal Contamination in Soil and Groundwater Due to Leachate Migration from an Open Dumping Site

Authors: Kali Prasad Sarma

Abstract:

Indiscriminate disposal of municipal solid waste (MSW) in open dumping site is a common scenario in developing countries like India which poses a risk to the environment as well as human health. The objective of the present investigation was to find out the concentration of heavy metals (Pb, Cr, Ni, Mn, Zn, Cu, and Cd) and other physicochemical parameters of leachate and soil collected from an open dumping site of Tezpur town, Assam, India and its associated potential ecological risk. Tezpur is an urban agglomeration coming under the category of Class I UAs/Towns with a population of 105,377 as per data released by Government of India for Census 2011. Impact of the leachate on the groundwater was also addressed in our study. The concentrations of heavy metals were determined using ICP-OES. Energy dispersive X-Ray (SEM-EDS) microanalysis was also conducted to see the presence of the studied metals in the soil. X-Ray diffraction analysis (XRD) and Fourier Transform Infrared (FTIR) spectroscopy were also used to identify dominant minerals present in the soil samples. The trend of measured heavy metals in the soil samples was found in the following order: Mn > Pb > Cu > Zn > Cr > Ni > Cd. The assessment of heavy metal contamination in the soil was carried out by calculating enrichment factor (EF), geo-accumulation index (Igeo), contamination factor (Cfi), degree of contamination (Cd), pollution load index (PLI) and ecological risk factor (Eri). The study showed that the concentrations of Pb, Cu, and Cd were much higher than their respective average shale value and the EF of the soil samples depicted very severe enrichment for Pb, Cu, and Cd; moderate enrichment for Cr and Zn. Calculated Igeo values indicated that the soil is moderate to strongly contaminated with Pb and uncontaminated to moderately contaminated with Cd and Cu. The Cfi value for Pb indicates a very strong contamination level of the metal in the soil. The Cfi values for Cu and Cd were 2.37 and 1.65 respectively indicating moderate contamination level. To apportion the possible sources of heavy metal contamination in soil, principal components analysis (PCA) has been adopted. From the leachate, heavy metals are accumulated at the dumping site soil which could easily percolate through the soil and reach the groundwater. The possible relation of groundwater contamination due to leachate percolation was examined by analyzing the heavy metal concentrations in groundwater with respect to distance from the dumping site. The concentrations of Cd and Pb in groundwater (at a distance of 20m from dumping site) exceeded the permissible limit for drinking water as set by WHO. Occurrence of elevated concentration of potentially toxic heavy metals such as Pb and Cd in groundwater and soil are much environmental concern as it is detrimental to human health and ecosystem.

Keywords: groundwater, heavy metal contamination, leachate, open dumping site

Procedia PDF Downloads 109
5813 High School Youth and College Freshmen Comparison Towards the Psychological Health Status under the Influence of Sleep Hygiene and Quality from a Chinese Second-Tier City Sample during the COVID-19 Pandemic

Authors: Ziyu Zhang, Xuanyu Ren, Fei Wu, Qinfei Lu, Yongmei Li, Xinyue Zhi

Abstract:

Introduction: Adolescents experience a critical period of physical and psychological growth. Few studies focus on the influence of sleep hygiene on psychological health from the high school period to freshmen year. Also, the influence of the COVID-19 pandemic has public health significance. Methods: Totally 698 students from high school and college were included in the manuscript, and a cross-sectional procedure was conducted; the objective was to make the epidemiological comparison of the social phobia/depression prevalence and discuss the effects of potential determinants. Results: Psychological problems, including social phobia and depression, are prevalent, especially among high school students, with gender differences. The current results indicated that the association between sleep status and social phobia is most obvious among high school students, while the higher MMR risk was found both for high school social phobia students and college depressive freshmen. Moreover, the interaction between social phobia and depression was also obvious for both populations. Conclusions: Psychological problems, including social phobia and depression, are more prevalent among high school girls when compared with their male and freshmen peers. Important influenced factors for the risk of psychological problems among the two populations were different, but media multitasking status should be paid attention to for both.

Keywords: adolescence, psychological health, epidemiology, social culture

Procedia PDF Downloads 74
5812 The Effect of Varying Cone Beam Computed Tomography Image Resolution and Field-of-View Centralization on the Effective Radiation Dose

Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

Abstract:

Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

Procedia PDF Downloads 264
5811 Effect of Co Substitution on Structural, Magnetocaloric, Magnetic, and Electrical Properties of Sm0.6Sr0.4CoxMn1-xO3 Synthesized by Sol-gel Method

Authors: A. A. Azab

Abstract:

In this work, Sm0.6Sr0.4CoxMn1-xO3 (x=0, 0.1, 0.2 and 0.3) was synthesized by sol-gel method for magnetocaloric effect (MCE) applications. XRD analysis confirmed formation of the required orthorhombic phase of perovskite, and there is crystallographic phase transition as a result of substitution. Maxwell-Wagner interfacial polarisation and Koops phenomenological theory were used to investigate and analyze the temperature and frequency dependency of the dielectric permittivity. The phase transition from the ferromagnetic to the paramagnetic state was demonstrated to be second order. Based on the isothermal magnetization curves obtained at various temperatures, the magnetic entropy change was calculated. A magnetocaloric effect (MCE) over a wide temperature range was studied by determining DSM and the relative cooling power (RCP).

Keywords: magnetocaloric effect, pperovskite, magnetic phase transition, dielectric permittivity

Procedia PDF Downloads 68
5810 Pattern and Risk Factors of Menstrual Regulation Service Use among Ever-married Women in Bangladesh: Evidence from a Nationally Representative Cross-sectional Study

Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

Abstract:

Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

Procedia PDF Downloads 162
5809 Age-Related Health Problems and Needs of Elderly People Living in Rural Areas in Poland

Authors: Anna Mirczak

Abstract:

Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

Procedia PDF Downloads 264
5808 Human Immunodeficiency Virus Infection/AIDS Abandoned Children in Kenya

Authors: Ruth Muturi Wanjiku

Abstract:

HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.

Keywords: AIDS, HIV, children, pregnant

Procedia PDF Downloads 72
5807 Delay in the Diagnosis of Tuberculosis and Initiation of TB Treatment in the Private and Public Health Sectors, Udaipur District, Rajasthan, India, Nov 2013

Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

Abstract:

Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

Procedia PDF Downloads 428
5806 The Implementation of Entrepreneurial Marketing in Small Business Enterprise

Authors: Iin Mayasari

Abstract:

This study aims at exploring the influence of aspects of entrepreneurial marketing on a firm’s performance. Entrepreneurs are not only supported by resources control to obtain sustainable competitive advantage, but it should also be supported by intangible resources. Entrepreneurial marketing provides the opportunity for entrepreneurs to proactively find better ways to create value for desired customers, to create innovation, and to build customer equity. Entrepreneurial marketing has the medium between entrepreneurship and marketing, and serves as an umbrella for many of the emergent perspectives on marketing. It has eight underlying dimensions. They are proactiveness, calculated risk-taking, innovativeness, an opportunity focus, entrepreneurial orientation, resource leveraging, customer intensity, and value creating. The research method of the study was a qualitative study by having an interview with 8 small companies in Kudus Region, the Central Java, Indonesia. The interviewees were the owner and the manager of the company that had the scope work of small business enterprise in wood crafting industry. The interview was related to the implementation of the elements of the entrepreneurial marketing. The result showed that the small business enterprises had implemented the elements of entrepreneurial marketing in supporting their daily activities. The understanding based on the theoretical implementation was well executed by the owner and managers. The problems in managing small business enterprises were related to the full support by the government and the branding management. Furthermore, the innovation process should be improved especially the use of internet to promote the product, to expand the market and to increase the firm’s performance.

Keywords: entrepreneurial marketing, innovativeness, risk taking, opportunity focus

Procedia PDF Downloads 300
5805 Applications of Multi-Path Futures Analyses for Homeland Security Assessments

Authors: John Hardy

Abstract:

A range of future-oriented intelligence techniques is commonly used by states to assess their national security and develop strategies to detect and manage threats, to develop and sustain capabilities, and to recover from attacks and disasters. Although homeland security organizations use future's intelligence tools to generate scenarios and simulations which inform their planning, there have been relatively few studies of the methods available or their applications for homeland security purposes. This study presents an assessment of one category of strategic intelligence techniques, termed Multi-Path Futures Analyses (MPFA), and how it can be applied to three distinct tasks for the purpose of analyzing homeland security issues. Within this study, MPFA are categorized as a suite of analytic techniques which can include effects-based operations principles, general morphological analysis, multi-path mapping, and multi-criteria decision analysis techniques. These techniques generate multiple pathways to potential futures and thereby generate insight into the relative influence of individual drivers of change, the desirability of particular combinations of pathways, and the kinds of capabilities which may be required to influence or mitigate certain outcomes. The study assessed eighteen uses of MPFA for homeland security purposes and found that there are five key applications of MPFA which add significant value to analysis. The first application is generating measures of success and associated progress indicators for strategic planning. The second application is identifying homeland security vulnerabilities and relationships between individual drivers of vulnerability which may amplify or dampen their effects. The third application is selecting appropriate resources and methods of action to influence individual drivers. The fourth application is prioritizing and optimizing path selection preferences and decisions. The fifth application is informing capability development and procurement decisions to build and sustain homeland security organizations. Each of these applications provides a unique perspective of a homeland security issue by comparing a range of potential future outcomes at a set number of intervals and by contrasting the relative resource requirements, opportunity costs, and effectiveness measures of alternative courses of action. These findings indicate that MPFA enhances analysts’ ability to generate tangible measures of success, identify vulnerabilities, select effective courses of action, prioritize future pathway preferences, and contribute to ongoing capability development in homeland security assessments.

Keywords: homeland security, intelligence, national security, operational design, strategic intelligence, strategic planning

Procedia PDF Downloads 139
5804 Psychosocial Risks and Occupational Health in a Mexican Small and Medium-Sized Enterprises

Authors: Magdalena Escamilla Quintal, Thelma Cetina Canto, Cecilia Aguilar Ortega

Abstract:

Due to the importance that people represent for companies, the setting of a clear control of the risks that threaten the health and the material and financial resources of workers is essential. It is irrelevant if the company is a small and medium-sized enterprise (SME) or a large multinational, or if it is in the construction or service sector. The risk prevention importance is related to a constitutional and human right that all people have; working in a risk-free environment to prevent accidents or illnesses that may influence their quality of life and the tranquility of their family. Therefore, the objective of this study was to determine the level of psychosocial risks (physical and emotional) of the employees of an SME. The participants of this study were 186 employees of a productive sector SME; 151 men and 35 women, all with an average age of 31.77 years. Their seniority inside the SME was between one month and 19.91 years. Ninety-six workers were from the production area, 28 from the management area, as well as 25 from the sales area and 40 from the supplies area. Ninety-three workers were found in Uman, 78 in Playa del Carmen, 11 in Cancun and seven in Cd. del Carmen. We found a statistically significant relationship between the burnout variable and the engagement and psychosomatic complaints as well as between the variables of sex, burnout and psychosomatic complaints. We can conclude that, for benefit of the SME, that there are low levels of burnout and psychosomatic complaints, the women experience major levels of burnout and the men show major levels of psychosomatic complaints. The findings, contributions, limitations and future proposals will be analyzed.

Keywords: psychosocial risks, SME, burnout, engagement, psychosomatic complaints

Procedia PDF Downloads 369
5803 A Comparison of qCON/qNOX to the Bispectral Index as Indices of Antinociception in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

Procedia PDF Downloads 137
5802 Finding the Theory of Riba Avoidance: A Scoping Review to Set the Research Agenda

Authors: Randa Ismail Sharafeddine

Abstract:

The Islamic economic system is distinctive in that it implicitly recognizes money as a separate, independent component of production capable of assuming risk and so entitled to the same reward as other Entrepreneurial Factors of Production (EFP). Conventional theory does not identify money capital explicitly as a component of production; rather, interest is recognized as a reward for capital, the interest rate is the cost of money capital, and it is also seen as a cost of physical capital. The conventional theory of production examines how diverse non-entrepreneurial resources (Land, Labor, and Capital) are selected; however, the economic theory community is largely unaware of the reasons why these resources choose to remain as non-entrepreneurial resources as opposed to becoming entrepreneurial resources. Should land, labor, and financial asset owners choose to work for others in return for rent, income, or interest, or should they engage in entrepreneurial risk-taking in order to profit. This is a decision made often in the actual world, but it has never been effectively treated in economic theory. This article will conduct a critical analysis of the conventional classification of factors of production and propose a classification for resource allocation and income distribution (Rent, Wages, Interest, and Profits) that is more rational, even within the conventional theoretical framework for evaluating and developing production and distribution theories. Money is an essential component of production in an Islamic economy, and it must be used to sustain economic activity.

Keywords: financial capital, production theory, distribution theory, economic activity, riba avoidance, institution of participation

Procedia PDF Downloads 94
5801 Production of Bricks Using Mill Waste and Tyre Crumbs at a Low Temperature by Alkali-Activation

Authors: Zipeng Zhang, Yat C. Wong, Arul Arulrajah

Abstract:

Since automobiles became widely popular around the early 20th century, end-of-life tyres have been one of the major types of waste humans encounter. Every minute, there are considerable quantities of tyres being disposed of around the world. Most end-of-life tyres are simply landfilled or simply stockpiled, other than recycling. To address the potential issues caused by tyre waste, incorporating it into construction materials can be a possibility. This research investigated the viability of manufacturing bricks using mill waste and tyre crumb by alkali-activation at a relatively low temperature. The mill waste was extracted from a brick factory located in Melbourne, Australia, and the tyre crumbs were supplied by a local recycling company. As the main precursor, the mill waste was activated by the alkaline solution, which was comprised of sodium hydroxide (8m) and sodium silicate (liquid). The introduction ratio of alkaline solution (relative to the solid weight) and the weight ratio between sodium hydroxide and sodium silicate was fixed at 20 wt.% and 1:1, respectively. The tyre crumb was introduced to substitute part of the mill waste at four ratios by weight, namely 0, 5, 10 and 15%. The mixture of mill waste and tyre crumbs were firstly dry-mixed for 2 min to ensure the homogeneity, followed by a 2.5-min wet mixing after adding the solution. The ready mixture subsequently was press-moulded into blocks with the size of 109 mm in length, 112.5 mm in width and 76 mm in height. The blocks were cured at 50°C with 95% relative humidity for 2 days, followed by a 110°C oven-curing for 1 day. All the samples were then placed under the ambient environment until the age of 7 and 28 days for testing. A series of tests were conducted to evaluate the linear shrinkage, compressive strength and water absorption of the samples. In addition, the microstructure of the samples was examined via the scanning electron microscope (SEM) test. The results showed the highest compressive strength was 17.6 MPa, found in the 28-day-old group using 5 wt.% tyre crumbs. Such strength has been able to satisfy the requirement of ASTM C67. However, the increasing addition of tyre crumb weakened the compressive strength of samples. Apart from the strength, the linear shrinkage and water absorption of all the groups can meet the requirements of the standard. It is worth noting that the use of tyre crumbs tended to decrease the shrinkage and even caused expansion when the tyre content was over 15 wt.%. The research also found that there was a significant reduction in compressive strength for the samples after water absorption tests. In conclusion, the tyre crumbs have the potential to be used as a filler material in brick manufacturing, but more research needs to be done to tackle the durability problem in the future.

Keywords: bricks, mill waste, tyre crumbs, waste recycling

Procedia PDF Downloads 123
5800 Injury Prevention among Construction Workers: A Case Study on Iranian Steel Bar Bending Workers

Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

Abstract:

Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

Procedia PDF Downloads 312
5799 Non-Burn Treatment of Health Care Risk Waste

Authors: Jefrey Pilusa, Tumisang Seodigeng

Abstract:

This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: autoclave, disposal, fuel, incineration, medical waste

Procedia PDF Downloads 178
5798 Simulation and Experimental of Solid Mixing of Free Flowing Material Using Solid Works in V-Blender

Authors: Amina Bouhaouche, Zineb Kaoua, Lila Lahreche, Sid Ali Kaoua, Kamel Daoud

Abstract:

The objective of this study is to present a novel approach for analyzing the solid dispersion and mixing performance by a numerical simulation method using solid works software of a monodisperse particles for a large span of time reached 20 minutes. To assure the viability of a numerical simulation, an experimental study of a binary mixture of monodiperse particles taken as free flowing material in a V blender was developed on the basis of relative standard deviation curves, and the arrangement of the particles in the vessel. The experimental results were discussed and compared to the numerical simulation results.

Keywords: non-cohesive material, solid mixing, solid works, v-blender

Procedia PDF Downloads 391
5797 A Cros Sectional Observational Study of Prescription Pattern of Gastro-Protective Drugs with Non-Steroidal Anti-Inflammatory Drugs in Nilgiris, India

Authors: B.S. Roopa

Abstract:

Objectives: To investigate the prevalence of concomitant use of GPDs in patients treated with NSAIDs and GPDs in recommended dose and frequency as prophylaxis. And also to know the association between risk factors and prescription of GPDs in patients treated with NSAIDs. Methods: Study was a prospective, observational, cross-sectional survey. Data from patients with prescription of NSAIDs at the out-patient departments of secondary care Hospital, Nilgiris, India were collected in a specially designed proforma for a period of 45 days. Analysis using χ2 tests for discrete variables. Factors that might be associated with prescription of GPD with NSIADs were assessed in multiple logistic regression models. Results: Three hundred and three patients were included in this study, and the rate of GPD prescription was 89.1%. Most of the patients received H2-receptor antagonist, and, to a lesser degree, antacid and proton pump inhibitor. Patients with history of GI ulcer/bleeding were much more likely to be co-prescribed GPD than those who had no history of GI disorders .Compared with patients who were managed in general outpatient clinic, those managed in Secondary care hospital in Nilgrisis, India were more likely to receive GPD. Conclusions: The prescription rate of GPD with NSAIDs is high. Patients were prescribed with H2RA with dose of 150mg twice daily, which are not effective in reducing the risk of NSAIDs induced gastric ulcer. Only the frequency of NSAIDs prescription was considered significant determinant for the co-prescription with GPAs in patients who are < 65 years and ≥ 65 years old.

Keywords: gastro protective agents, non steridol anti inlfammatory agents

Procedia PDF Downloads 296
5796 A Description Logics Based Approach for Building Multi-Viewpoints Ontologies

Authors: M. Hemam, M. Djezzar, T. Djouad

Abstract:

We are interested in the problem of building an ontology in a heterogeneous organization, by taking into account different viewpoints and different terminologies of communities in the organization. Such ontology, that we call multi-viewpoint ontology, confers to the same universe of discourse, several partial descriptions, where each one is relative to a particular viewpoint. In addition, these partial descriptions share at global level, ontological elements constituent a consensus between the various viewpoints. In order to provide response elements to this problem we define a multi-viewpoints knowledge model based on viewpoint and ontology notions. The multi-viewpoints knowledge model is used to formalize the multi-viewpoints ontology in description logics language.

Keywords: description logic, knowledge engineering, ontology, viewpoint

Procedia PDF Downloads 313
5795 The Association between ABO-Rh Blood Groups and the Risk of COVID-19 Infection

Authors: Abbas Sedighinejad, Hossein Khoshrang, Mohammad Haghighi, Ali Ashraf, Mostafa Saeedinia, Gelareh Biazar, Zahra Atrkarroushan, Mahdi Ajdadi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) as an alarming attack broke out in China and spread rapidly worldwide. Objectives: Based on a theory indicating the correlation between some viral diseases and blood types, we investigated the relationship between blood groups and coronavirus infection risk in Guilan Province, Iran. Methods: Retrospectively, all the files of the admitted patients with suspected COVID-19, in peak conditions of the disease between March 1 and May 30, 2020, were reviewed using the Census method. The required data, including epidemiological and clinical information and outcomes, were obtained from electronic records. Results: A total of 249 cases were analyzed, of whom 109 were collected from governmental centers, and the rest were collected from private hospitals. The most common co-morbidity was diabetes with 71 (37.6%) cases and the main symptom at the admission time was dyspnea with 170 (24.5%) cases. Of the total patients, 155 (62.2%) were discharged, and the rest died. The most common blood group among our patients was O Rh-positive with 91 (36.5%) cases. No meaningful correlation was found between outcomes and blood groups in terms of ABO types (P = 0.89) or Rh factor (P = 0.456). The Rh-positive proportion was significantly higher in the COVID-19 cases than in the general population (P = 0.038). Conclusions: We found that the Rh-positive proportion was significantly higher in the COVID-19 cases than in the healthy individuals. However, no correlation was observed between the groups regarding ABO typing.

Keywords: ABO blood group, COVID 19, association, personal protection

Procedia PDF Downloads 69
5794 Investigate and Compare the Characteristics of Entrepreneurship among Students in Senior Secondary Schools in the Academic

Authors: Khalil Aryanfar, Shahrzad Sanjari, Pariya Gholipor, Elmira Hafez

Abstract:

The present study aimed to investigate and compare the characteristics of entrepreneurship among students in senior secondary schools in the academic year 2008-2009 in Tabriz city. Research employed survey method respectively. The study population consisted of all students in the senior branch of theoretical, technical, professional and vocational (1033 patients) were included. Sample size of 493 was calculated according to Morgan table. Sampling method was random cluster and stratified sampling. Data collected by researcher made questionnaire based on the theory of MC clleland (1963) and Brvkhavs (1980). These tools would indicators be for achievement, Independence, disposition, creativity, risk-taking, self-control, tolerance for ambiguity, team work approach in the future. To determine the psychometric properties of the questionnaire, content validity of the survey was approved by relevant experts. In addition, to estimate the internal consistency of Cronbach's alpha coefficient was calculated for 84% of total inventory. Collected data Using mean, standard deviation and were analyzed by ANOVA. The results showed that there is a significant difference between students' entrepreneurial potential fields of theoretical, technical, professional and vocational level (0/01).

Keywords: entrepreneurship, achievement motivation, risk taking, creativity, self-control, independence, tolerance of ambiguity, foresight

Procedia PDF Downloads 402
5793 Decision-Making Under Uncertainty in Obsessive-Compulsive Disorder

Authors: Helen Pushkarskaya, David Tolin, Lital Ruderman, Ariel Kirshenbaum, J. MacLaren Kelly, Christopher Pittenger, Ifat Levy

Abstract:

Obsessive-Compulsive Disorder (OCD) produces profound morbidity. Difficulties with decision making and intolerance of uncertainty are prominent clinical features of OCD. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants’ choices were used to assess individual decision-making characteristics. Compared to controls, individuals with OCD were less consistent in their choices and less able to identify options that were unambiguously preferable. These differences correlated with symptom severity. OCD participants did not differ from controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). These results suggest that the underlying neural mechanisms of valuation and value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention.

Keywords: obsessive compulsive disorder, decision-making, uncertainty intolerance, risk aversion, ambiguity aversion, valuation

Procedia PDF Downloads 616
5792 User-Centered Design in the Development of Patient Decision Aids

Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

Abstract:

Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

Procedia PDF Downloads 355
5791 Asymmetric of the Segregation-Enhanced Brazil Nut Effect

Authors: Panupat Chaiworn, Soraya lama

Abstract:

We study the motion of particles in cylinders which are subjected to a sinusoidal vertical vibration. We measure the rising time of a large intruder from the bottom of the container to free surface of the bed particles and find that the rising time as a function of intruder density increases to a maximum and then decreases monotonically. The result is qualitatively accord to the previous findings in experiments using relative humidity of the bed particles and found speed convection of the bed particles containers it moving slowly, and the rising time of the intruder where a minimal instead of maximal rising time in the small density region was found. Our experimental results suggest that the topology of the container plays an important role in the Brazil nut effect.

Keywords: granular particles, Brazil nut effect, cylinder container, vertical vibration, convection

Procedia PDF Downloads 531
5790 Evaluation of Prehabilitation Prior to Surgery for an Orthopaedic Pathway

Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

Abstract:

Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

Procedia PDF Downloads 190