Search results for: middle adult
Commenced in January 2007
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Paper Count: 2797

Search results for: middle adult

397 Diabetes and Medical Plant's Treatment: Ethnobotanical Studies Carried out in Morocco

Authors: Jamila Fakchich, Mostafa Jamila Lazaar Elachouri, Lakhder Fakchich, Fatna Ouali, Abd Errazzak Belkacem

Abstract:

Diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients as well as the health care system. By its nature diabetes, is a multisystem disease with wide-ranging complication that span nearly all region of the body. This epidemic problem, however, is not unique to the industrialized society, but has also hardly struck the developing countries. In Morocco, as developing country, there is an epidemic rise in diabetes, with ensuing concern about the management and control of this disease; it began a chronic burdensome disease of largely middle-aged and elderly people, with a long course and serious complications often resulting in high death-rate, the treatment of diabetes spent vast amount of resources including medicines, diets, physical training. Treatment of this disease is considered problematic due to the lack of effective and safe drugs capable of inducing sustained clinical, biochemical, and histological cure. In Moroccan society, the phytoremedies are some times the only affordable sources of healthcare, particularly for the people in remote areas. In this paper, we present a synthesis work obtained from the ethnobotanical data reported in different specialized journals. A Synthesis of four published ethnobotanical studies that have been carried out in different region of Morocco by different team seekers during the period from 1997 to 2015. Medicinal plants inventoried by different seekers in four Moroccan’s areas have been regrouped and codified, then, Factorial Analysis (FA) and Principal Components Analysis (PCA) are used to analyse the aggregated data from the four studies and plants are classified according to their frequency of use by population. Our work deals with an attempt to gather information on some traditional uses of medicinal plants from different regions of Morocco, also, it was designed to give a set of medicinal plants commonly used by Moroccan people in the treatment of diabetes; In this paper, we intended to provide a basic knowledge about plant species used by Moroccan society for treatment of diabetes. One of the most interesting aspects of this type of works is to assess the relative cultural importance of medicinal plants for specific illnesses and exploring its usefulness in the context of diabetes.

Keywords: Morocco, medicinal plants, ethnobotanical, diabetes, phytoremedies

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396 A Novel Treatment of the Arthritic Hip: A Prospective, Cross-Sectional Study on Changes Following Bone Marrow Concentrate Injection and Arthroscopic Debridement

Authors: A. Drapeaux, S. Aviles, E. Garfoot

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Stem cell injections are a promising alternative treatment for hip osteoarthritis. Current literature has focused on short-term outcomes for both knee and hip osteoarthritis; however, there is a significant gap for longitudinal benefits for hip OA and limited firm conclusions due to small sample sizes. The purpose of this prospective study was to determine longitudinal changes in pain, function, and radiographs following bone marrow concentrate injection (BMAC) into the osteoarthritic hip joint. Methods: A prospective, cross-sectional study was conducted over the course of 12 months at an orthopedic practice. The study recruited 15 osteoarthritic pre-surgical hips with mild to moderate osteoarthritic severity who were scheduled to undergo hip arthroscopy. Data was collected at both pre-operative and post-operative time frames. Data collected included: hip radiographs, i-HOT-33 questionnaire data, BMAC autologous volume, and demographics. Questionnaire data was captured using Qualtrics XM software, and participants were sent an anonymous link at the following time frames: pre-operative, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Radiographic changes and BMAC volume were collected and reviewed by an orthopedic surgeon and sent to the primary investigator. Data was exported and analyzed in IBM-SPSS. Results: A total of 15 hips from 15 participants (mean age: 49, gender: 50% males, 50% females, BMI: 29.7) were used in the final analysis. Summative i-HOT 33 mean scores significantly changed between pre-operative status and 2-6 weeks post-operative status (p <.001) and pre-operative status and 3-6 months post-operative status (p <.001). There were no significant changes between other post-operative phases or between pre-operative status and 12 months post-operative. Significant improvements were found between summative i-HOT 33 mean (p<.001), daily pain (p<.001), daily sitting (p=.02), daily distance walked (p =.003), and daily limp (p=0.03) and post-operative status (2-6 weeks). No significant differences between demographic variables (gender, age, tobacco use, or diabetes) and i-HOT 33 summative mean scores. Discussion/Implications: The purpose of this study was to determine longitudinal changes in pain and function following a hip joint bone marrow concentrate injection. Results indicate that participants experience a significant improvement in pain and function between pre-operative and 2-6 weeks and 3-6 months post-injection. Participants also self-reported a significant change in average daily pain with sitting and walking between pre-operation and 2-6 weeks post-operative. This study includes a larger sample size of hip osteoarthritis cases; however, future research is warranted to include random controlled trials with a larger sample size.

Keywords: adult stem cell, orthopedics, osteoarthritis (hip), patient outcome assessment

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395 Combination Therapies Targeting Apoptosis Pathways in Pediatric Acute Myeloid Leukemia (AML)

Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills

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Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.

Keywords: AML, drug repurposing, ABT-737, apoptosis

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394 Cognition in Crisis: Unravelling the Link Between COVID-19 and Cognitive-Linguistic Impairments

Authors: Celine Davis

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The novel coronavirus 2019 (COVID-19) is an infectious disease caused by the virus SARS-CoV-2, which has detrimental respiratory, cardiovascular, and neurological effects impacting over one million lives in the United States. New researches has emerged indicating long-term neurologic consequences in those who survive COVID-19 infections, including more than seven million Americans and another 27 million people worldwide. These consequences include attentional deficits, memory impairments, executive function deficits and aphasia-like symptoms which fall within the purview of speech-language pathology. The National Health Interview Survey (NHIS) is a comprehensive annual survey conducted by the National Center for Health Statistics (NCHS), a branch of the Centers for Disease Control and Prevention (CDC) in the United States. The NHIS is one of the most significant sources of health-related data in the country and has been conducted since 1957. The longitudinal nature of the study allows for analysis of trends in various variables over the years, which can be essential for understanding societal changes and making treatment recommendations. This current study will utilize NHIS data from 2020-2022 which contained interview questions specifically related to COVID-19. Adult cases of individuals between the ages of 18-50 diagnosed with COVID-19 in the United States during 2020-2022 will be identified using the National Health Interview Survey (NHIS). Multiple regression analysis of self-reported data confirming COVID-19 infection status and challenges with concentration, communication, and memory will be performed. Latent class analysis will be utilized to identify subgroups in the population to indicate whether certain demographic groups have higher susceptibility to cognitive-linguistic deficits associated with COVID-19. Completion of this study will reveal whether there is an association between confirmed COVID-19 diagnosis and heightened incidence of cognitive deficits and subsequent implications, if any, on activities of daily living. This study is distinct in its aim to utilize national survey data to explore the relationship between confirmed COVID-19 diagnosis and the prevalence of cognitive-communication deficits with a secondary focus on resulting activity limitations. To the best of the author’s knowledge, this will be the first large-scale epidemiological study investigating the associations between cognitive-linguistic deficits, COVID-19 and implications on activities of daily living in the United States population. These findings will highlight the need for targeted interventions and support services to address the cognitive-communication needs of individuals recovering from COVID-19, thereby enhancing their overall well-being and functional outcomes.

Keywords: cognition, COVID-19, language, limitations, memory, NHIS

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393 Drug Susceptibility and Genotypic Assessment of Mycobacterial Isolates from Pulmonary Tuberculosis Patients in North East Ethiopia

Authors: Minwuyelet Maru, Solomon Habtemariam, Endalamaw Gadissa, Abraham Aseffa

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Background: Tuberculosis is a major public health problem in Ethiopia. The burden of TB is aggravated by emergence and expansion of drug resistant tuberculosis and different lineages of Mycobacterium tuberculosis (M. tuberculosis) have been reported in many parts of the country. Describing strains of Mycobacterial isolates and drug susceptibility pattern is necessary. Method: Sputum samples were collected from smear positive pulmonary TB patients age >= 7 years between October 1, 2012 to September 30, 2013 and Mycobacterial strains isolated on Loweensten Jensen (LJ) media. Each strain was characterized by deletion typing and Spoligotyping. Drug sensitivity testing was determined with the indirect proportion method using Middle brook 7H10 media and association to determine possible risk factors to drug resistance was done. Result: A total of 144 smear positive pulmonary tuberculosis patients were enrolled. The age of participants ranged from 7 to 78 with mean age of 29.22 (±10.77) years. In this study 82.2% (n=97) of the isolates were sensitive to the four first line anti-tuberculosis drugs and resistance to any of the four drugs tested was 17.8% (n=21). A high frequency of any resistance was observed in isoniazid, 13.6%, (n=16) followed by streptomycin, 11.8% (n=14). No significant association of isoniazid resistance with HIV, sex and history of previous TB treatment was observed but there was significant association with age, high between 31-35 years of age (p=0.01). Majority, 89.9% (n=128) of participants were new cases and only 11.1% (n=16) had history of previous TB treatment. No MDR-TB from new cases and 2 MDRTB (13.3%) was isolated from re-treatment cases which was significantly associated with previous TB treatment (p<0.01). Thirty two different types of spoligotype patterns were identified and 74.1% were grouped in to 13 clusters. The dominant strains were SIT 25, 18.1% (n=21), SIT 53, 17.2% (n=20) and SIT 149, 8.6% (n=10). Lineage 4 is the predominant lineage followed by lineage 3 and lineage 7 comprising 65.5% (n=76), 28.4% (n=33) and 6% (n=7) respectively. Majority of strains from lineage 3 and 4 were SIT 25 (63.6%) and SIT 53 (26.3%) whereas SIT 343 was the dominant strain from lineage 7 (71.4%). Conclusion: Wide spread of lineage 3 and lineage 4 of the modern lineage and high number of strain cluster indicates high ongoing transmission. The high proportion resistance to any of the first line anti-tuberculosis drugs may be a potential source in the emergence of MDR-TB. Wide spread of SIT 25 and SIT 53 having a tendency of ease transmission and presence of higher resistance of isoniazid in working and mobile age group, 31-35 years of age may increase risk of drug resistant strains transmission.

Keywords: tuberculosis, drug susceptibility, strain diversity, lineage, Ethiopia, spoligotyping

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392 Epididymis in the Agouti (Dasyprocta azarae): Light Microscope Study

Authors: Bruno C. Schimming, Leandro L. Martins, PatríCia F. F. Pinheiro, Raquel F. Domeniconi, FabríCio S. Oliveira

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The agouti is a wildlife rodent that can be used as an alternative source of animal protein and this species has been raised in captivity in Brazil with the aim of providing meat. Thus, the knowledge of their reproductive biology and morphology of the reproductive organs is important. The objective of this study was to describe the morphology of epididymis in the Azara’s agouti, by light microscopy. Samples of epididymis were obtained from five adult Azara’s agouti (Dasyprocta azarae) during castration surgery performed at the Municipal Zoo of Catanduva, Brazil. Fragments of the epididymal regions (initial segment, caput, corpus and cauda) were collected. The biological samples were immediately fixed in paraformaldehyde for 24 hours, followed by histologic procedures comprising embedding in ParaplastTM (Sigma, St. Louis, MO, USA), sections of 5 µm, and staining with HE and Masson’s trichrome. The epididymis was a highly convoluted tubule that links the testis to the vas deferens. The epithelium lining was pseudostratified columnar surrounded by a periductal stroma. The epithelium contains several cell types: principal, basal, apical, clear, and hallo cells. Principal cells were the most abundant cell type. There were observed also migratory cells named halo cells. The caput epididymis was divided into two different regions: initial segment and caput. The initial segment has a very wide lumen, a high epithelium with conspicuous microvilli and the lumen was wide with exfoliated material. The other region of the caput epididymis, showed a lower epithelium when compared with the initial segment, large amounts of spermatozoa in the lumen, and a cytoplasmic vacuolization. This region presented many narrows cells. Many spermatozoa appeared in the lumen of corpus epididymis. The cauda region had a lower epithelium than the other epididymal regions in the agouti. The cauda epithelium presented plicae protruding into the lumen. Large amounts of spermatozoa are also present in the lumen. Small microvilli uniformly arranged so as to form a kind of “brush border” are observed on the apical surface of the cauda epithelium. The pattern of the epithelium lining the duct of the agouti epididymis does not differ greatly from that reported to other mammals, such as domestic and wildlife animals. These findings can cooperate with future investigations especially those related to rational exploration of these animals. All experimental procedures were approved by the institutional ethics committee (CEUA 796/2015). This study was supported by FAPESP (Grants 2015/23822-1).

Keywords: wildlife, testis excurrent ducts, epididymis, morphology

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391 Nanostructured Fluorine Doped Zinc Oxide Thin Films Deposited by Ultrasonic Spray Pyrolisys Technique: Effect of Starting Solution Composition and Substrate Temperature on the Physical Characteristics

Authors: Esmeralda Chávez Vargas, M. de la L. Olvera, A. Maldonado

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The doping it is believed as follows, at high concentration fluorine in ZnO: F films is incorporated to the lattice by substitution of O-2 ions by F-1 ions; at middle fluorine concentrations, F ions may form interstitials, whereas for low concentrations it is increased the carriers and mobility could be explained by the surface passivation effect of fluorine. ZnO:F thin films were deposited on sodocalcic glass substratesat 425 °C , 450°C, 475 during 8, 12, 15 min from a 0.2 M solution. Doping concentration in the starting solutions was varied, namely, [F]/[F+Zn] = 0, 5, 15, 30, 45, 60, and 90 at. %; solvent composition was varied as well, 100:100; 50:50; 100:50(acetic acid: water: methanol ratios, in volume). In this work it is reported the characterization results of fluorine doped zinc oxide (ZnO:F) thin films deposited by the ultrasonic spray pyrolysis technique, using zinc acetate and ammonium fluorine as Zn an F precursors, respectively. The effect of varying the fluorine concentration in the starting solutions, the solvent composition, and the ageing time of the starting solutions, on the electrical resistivity, optical transmittance, structure and surface morphology was analyzed. In order to have a quantitative evaluation of the ZnO:F thin films for its application as transparent electrodes, the Figure of Merit was estimated from the Haacke´s formula. After a thoroughly study, it can be found that optimal conditions for the deposition of transparent and conductive ZnO:F thin films on sodocalcic substrates, were as follows; substrate temperature: solution molar concentration 0.2, doping concentration in the starting solution of [F]/[Zn]= 60 at. %, (water content)/(acetic acid) in starting solution: [H2O/ CH3OH]= 50:50, substrate temperature: 450 °C. The effects of aging of the starting solution has also been analyzed thoroughly and it has been found a dramatic effect on the electric resistivity of the material, aged by 40 days, show an electrical resitivity as low as 120 Ω/□, with a transmittance around 80% in the visible range. X-ray diffraction spectra show a polycrystalline of ZnO (wurtzite structure) where the amount of fluorine doping affects to preferential orientation (002 plane). Therefore, F introduction in lattice is by the substitution of O-2 ions by F-1 ions. The results show that ZnO:F thin films are potentially adequate for application as transparent conductive oxide in thin film solar cells.

Keywords: TCOs, transparent electrodes, ultrasonic spray pyrolysis, zinc oxide, ZnO:F

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390 Frequency Domain Decomposition, Stochastic Subspace Identification and Continuous Wavelet Transform for Operational Modal Analysis of Three Story Steel Frame

Authors: Ardalan Sabamehr, Ashutosh Bagchi

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Recently, Structural Health Monitoring (SHM) based on the vibration of structures has attracted the attention of researchers in different fields such as: civil, aeronautical and mechanical engineering. Operational Modal Analysis (OMA) have been developed to identify modal properties of infrastructure such as bridge, building and so on. Frequency Domain Decomposition (FDD), Stochastic Subspace Identification (SSI) and Continuous Wavelet Transform (CWT) are the three most common methods in output only modal identification. FDD, SSI, and CWT operate based on the frequency domain, time domain, and time-frequency plane respectively. So, FDD and SSI are not able to display time and frequency at the same time. By the way, FDD and SSI have some difficulties in a noisy environment and finding the closed modes. CWT technique which is currently developed works on time-frequency plane and a reasonable performance in such condition. The other advantage of wavelet transform rather than other current techniques is that it can be applied for the non-stationary signal as well. The aim of this paper is to compare three most common modal identification techniques to find modal properties (such as natural frequency, mode shape, and damping ratio) of three story steel frame which was built in Concordia University Lab by use of ambient vibration. The frame has made of Galvanized steel with 60 cm length, 27 cm width and 133 cm height with no brace along the long span and short space. Three uniaxial wired accelerations (MicroStarin with 100mv/g accuracy) have been attached to the middle of each floor and gateway receives the data and send to the PC by use of Node Commander Software. The real-time monitoring has been performed for 20 seconds with 512 Hz sampling rate. The test is repeated for 5 times in each direction by hand shaking and impact hammer. CWT is able to detect instantaneous frequency by used of ridge detection method. In this paper, partial derivative ridge detection technique has been applied to the local maxima of time-frequency plane to detect the instantaneous frequency. The extracted result from all three methods have been compared, and it demonstrated that CWT has the better performance in term of its accuracy in noisy environment. The modal parameters such as natural frequency, damping ratio and mode shapes are identified from all three methods.

Keywords: ambient vibration, frequency domain decomposition, stochastic subspace identification, continuous wavelet transform

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389 Stereological and Morphometric Evaluation of Wound Healing Burns Treated with Ulmo Honey (Eucryphia cordifolia) Unsupplemented and Supplemented with Ascorbic Acid in Guinea Pig (Cavia porcellus)

Authors: Carolina Schencke, Cristian Sandoval, Belgica Vasquez, Mariano Del Sol

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Introduction: In a burn injury, the successful repair requires not only the participation of various cells, such as granulocytes and fibroblasts, but also of collagen, which plays a crucial role as a structural and regulatory molecule of scar tissue. Since honey and ascorbic acid have presented a great therapeutic potential to cellular and structural level, experimental studies have proposed its combination in the treatment of wounds. Aim: To evaluate stereological and morphometric parameters of healing wounds, caused by burns, treated with honey Ulmo (Eucryphia cordifolia) unsupplemented, comparing its effect with Ulmo honey supplemented with ascorbic acid. Materials and Methods: Fifteen healthy adult guinea pigs (Cavia porcellus) were used, of both sexes, average weight 450 g from the Centro de Excelencia en Estudios Morfológicos y Quirúrgicos (CEMyQ) at the Universidad de La Frontera, Chile. The animals were divided at random into three groups: positive control (C+), honey only (H) and supplemented honey (SH) and were fed on pellets supplemented with ascorbic acid and water ad libitum, under ambient conditions controlled for temperature, ambient noise and a cycle of 12h light–darkness. The protocol for the experiment was approved by the Scientific Ethics Committee of the Universidad de La Frontera, Chile. The parameters measured were number density per area (NA), volume density (VV), and surface density (SV) of fibroblast; NA and VV of polymorphonuclear cells (PMN) and, evaluation of the content of collagen fibers in the scar dermis. One-way ANOVA was used for statistics analysis and its respective Post hoc tests. Results: The ANOVA analysis for NA, VV and SV of fibroblasts, NA and VV of PMN, and evaluation of collagen content, type I and III, showed that at least one group differs from other (P≤ 0.001). There were differences (P= 0.000) in NA of fibroblast between the groups [C+= 3599.560 mm-2 (SD= 764.461), H= 3355.336 mm-2 (SD= 699.443) and SH= 4253.025 mm-2 (SD= 1041.751)]. The VV and SV of fibroblast increased (P= 0.000) in the SH group [20.400% (SD= 5.897) and 100.876 mm2/mm3 (SD= 29.431), respectively], compared to the C+ [16.324% (SD= 7.719) and 81.676 mm2/mm3 (SD= 28.884), respectively). The mean values of NA and VV of PMN were higher (P= 0.000) in the H [756.875 mm-2 (SD= 516.489) and 2.686% (SD= 2.380), respectively) group. Regarding to the evaluation of the content of collagen fibers, type I and III, the one-way analysis of ANOVA showed a statistically significant difference (P< 0.05). The content of collagen fibers type I was higher in C+ (1988.292 μm2; SD= 1312.379), while the content of collagen fibers type III was higher in SH (1967.163 μm2; SD= 1047.944 μm2) group. Conclusions: The stereological results were correlated with the stage of healing observed for each group. These results suggest that the combination of honey with ascorbic acid potentiate the healing effect, where both participated synergistically.

Keywords: ascorbic acid, morphometry, stereology, Ulmo honey

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388 Assessing In-Country Public Health Training Needs: Workforce Development to Meet Sustainable Development Goals

Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

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387 Comparative Evaluation of Ultrasound Guided Internal Jugular Vein Cannulation Using Measured Guided Needle and Conventional Size Needle for Success and Complication of Cannulation

Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

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Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

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386 Antihypertensive Effect of Formulated Apium graveolens: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Authors: Maryam Shayani Rad, Seyed Ahmad Mohajeri, Mohsen Mouhebati, Seyed Danial Mousavi

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High blood pressure is one of the most important and serious health-threatening because of no symptoms in most people, which can lead to sudden heart attack, heart failure, and stroke. Nowadays, herbal medicine is one of the best and safest strategies for treatment that have no adverse effects. Apium graveolens (celery) can be used as an alternative treatment for many health conditions such as hypertension. Natural compounds reduce blood pressure via different mechanisms in which Apium graveolens extract provides potent calcium channel blocking properties. A randomized, double-blind, placebo-controlled, cross-over clinical trial was done to evaluate the efficacy of formulated Apium graveolens extract with a maximum yield of 3-n-butylphthalide to reduce systolic and diastolic blood pressure in patients with hypertension. 54 hypertensive patients in the range of 20-68 years old were randomly assigned to the treatment group (26 cases) and the placebo control group (26 cases) and were crossed over after washout duration. The treatment group received at least 2 grams of formulated powder in hard capsules orally, before each meal, 2 times daily. The control group received 2 grams of placebo in hard capsules orally, exactly as the same as shape, time, and doses of treatment group. Treatment was administrated in 12 weeks with 4 weeks washout period at the middle of the study, meaning 4 weeks drug consumption for the treatment group, 4 weeks washout and 4 weeks placebo consumption, and vice versa for the placebo control group. The clinical assessment was done 4 times, including at the beginning and ending of the drug and placebo consumption period by 24-hour ambulatory blood pressure monitoring (ABPM) holter, which measured blood pressure every 15 minutes continuously. There was a statistically significant decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the end of drug duration compared to baseline. The changes after 4 weeks on average was about 12.34 mm Hg for the SBP (P < 0.005) and 7.83 mm Hg for the DBP (P < 0.005). The results from this clinical trial study showed this Apium graveolens extract formulation in the mentioned dosage had a significant effect on blood pressure-lowering for hypertensive patients.

Keywords: Apium graveolens extract, clinical trial, cross-over, hypertension

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385 Assessing Autism Spectrum Disorders (ASD) Challenges in Young Children in Dubai: A Qualitative Study, 2016

Authors: Kadhim Alabady

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Background: Autism poses a particularly large public health challenge and an inspiring lifelong challenge for many families; it is a lifelong challenge of a different kind. Purpose: Therefore, it is important to understand what the key challenges are and how to improve the lives of children who are affected with autism in Dubai. Method: In order to carry out this research we have used a qualitative methodology. We performed structured in–depth interviews and focus groups with mental health professionals working at: Al Jalila hospital (AJH), Dubai Autism Centre (DAC), Dubai Rehabilitation Centre for Disabilities, Latifa hospital, Private Sector Healthcare (PSH). In addition to that, we conducted quantitative approach to estimate ASD prevalence or incidence data due to lack of registry. ASD estimates are based on research from national and international documents. This approach was applied to increase the validity of the findings by using a variety of data collection techniques in order to explore issues that might not be highlighted through one method alone. Key findings: Autism is the most common of the Pervasive Developmental Disorders. Dubai Autism Center estimates it affects 1 in 146 births (0.68%). If we apply these estimates to the total number of births in Dubai for 2014, it is predicted there would be approximately 199 children (of which 58 were Nationals and 141 were Non–Nationals) suffering from autism at some stage. 16.4% of children (through their families) seek help for ASD assessment between the age group 6–18+. It is critical to understand and address factors for seeking late–stage diagnosis, as ASD can be diagnosed much earlier and how many of these later presenters are actually diagnosed with ASD. Autism spectrum disorder (ASD) is a public health concern in Dubai. Families do not consult GPs for early diagnosis for a variety of reasons including cultural reasons. Recommendations: Effective school health strategies is needed and implemented by nurses who are qualified and experienced in identifying children with ASD. There is a need for the DAC to identify and develop a closer link with neurologists specializing in Autism, to work alongside and for referrals. Autism can be attributed to many factors, some of those are neurological. Currently, when families need their child to see a neurologist they have to go independently and search through the many that are available in Dubai and who are not necessarily specialists in Autism. Training of GP’s to aid early diagnosis of Autism and increase awareness. Since not all GP’s are trained to make such assessments increasing awareness about where to send families for a complete assessment and the necessary support. There is an urgent need for an adult autism center for when the children leave the safe environment of the school at 18 years. These individuals require a day center or suitable job training/placements where appropriate. There is a need for further studies to cover the needs of people with an Autism Spectrum Disorder (ASD).

Keywords: autism spectrum disorder, autism, pervasive developmental disorders, incidence

Procedia PDF Downloads 197
384 Volume Estimation of Trees: An Exploratory Study on Pterocarpus erinaceus Logging Operations within Forest Transition and Savannah Ecological Zones of Ghana

Authors: Albert Kwabena Osei Konadu

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Pterocarpus erinaceus, also known as Rosewood, is tropical wood, endemic in forest savannah transition zones within the middle and northern portion of Ghana. Its economic viability has made it increasingly popular and in high demand, leading to widespread conservation concerns. Ghana’s forest resource management regime for these ecozones is mainly on conservation and very little on resource utilization. Consequently, commercial logging management standards are at teething stage and not fully developed, leading to a deficiency in the monitoring of logging operations and quantification of harvested trees volumes. Tree information form (TIF); a volume estimation and tracking regime, has proven to be an effective, sustainable management tool for regulating timber resource extraction in the high forest zones of the country. This work aims to generate TIF that can track and capture requisite parameters to accurately estimate the volume of harvested rosewood within forest savannah transition zones. Tree information forms were created on three scenarios of individual billets, stacked billets and conveying vessel basis. These TIFs were field-tested to deduce the most viable option for the tracking and estimation of harvested volumes of rosewood using the smallian and cubic volume estimation formula. Overall, four districts were covered with individual billets, stacked billets and conveying vessel scenarios registering mean volumes of 25.83m3,45.08m3 and 32.6m3, respectively. These adduced volumes were validated by benchmarking to assigned volumes of the Forestry Commission of Ghana and known standard volumes of conveying vessels. The results did indicate an underestimation of extracted volumes under the quotas regime, a situation that could lead to unintended overexploitation of the species. The research revealed conveying vessels route is the most viable volume estimation and tracking regime for the sustainable management of the Pterocarpous erinaceus species as it provided a more practical volume estimate and data extraction protocol.

Keywords: convention on international trade in endangered species, cubic volume formula, forest transition savannah zones, pterocarpus erinaceus, smallian’s volume formula, tree information form

Procedia PDF Downloads 69
383 Agricultural Mechanization for Transformation

Authors: Lawrence Gumbe

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Kenya Vision 2030 is the country's programme for transformation covering the period 2008 to 2030. Its objective is to help transform Kenya into a newly industrializing, middle-income, exceeding US$10000, country providing a high quality of life to all its citizens by 2030, in a clean and secure environment. Increased agricultural and production and productivity is crucial for the realization of Vision 2030. Mechanization of agriculture in order to achieve greater yields is the only way to achieve these objectives. There are contending groups and views on the strategy for agricultural mechanization. The first group are those who oppose the widespread adoption of advanced technologies (mostly internal combustion engines and tractors) in agricultural mechanization as entirely inappropriate in most situations in developing countries. This group argues that mechanically powered -agricultural mechanization often leads to displacement of labour and hence increased unemployment, and this results in a host of other socio-economic problems, amongst them, rural-urban migration, inequitable distribution of wealth and in many cases an increase in absolute poverty, balance of payments due to the need to import machinery, fuel and sometimes technical assistance to manage them. The second group comprises of those who view the use of the improved hand tools and animal powered technology as transitional step between the most rudimentary step in technological development (characterized by entire reliance on human muscle power) and the advanced technologies (characterized 'by reliance on tractors and other machinery). The third group comprises those who regard these intermediate technologies (ie. improved hand tools and draught animal technology in agriculture) as a ‘delaying’ tactic and they advocate the use of mechanical technologies as-the most appropriate. This group argues that alternatives to the mechanical technologies do not just exist as a practical matter, or, if they are available, they are inefficient and they cannot be compared to the mechanical technologies in terms of economics and productivity. The fourth group advocates a compromise between groups two and third above. This group views the improved hand tools and draught animal technology as more of an 18th century technology and the modem tractor and combine harvester as too advanced for developing countries. This group has been busy designing an ‘intermediate’, ‘appropriate’, ‘mini’, ‘micro’ tractor for use by farmers in developing countries. This paper analyses and concludes on the different agricultural mechanization strategies available to Kenya and other third world countries

Keywords: agriculture, mechanazation, transformation, industrialization

Procedia PDF Downloads 314
382 Reverse Engineering Genius: Through the Lens of World Language Collaborations

Authors: Cynthia Briggs, Kimberly Gerardi

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Over the past six years, the authors have been working together on World Language Collaborations in the Middle School French Program at St. Luke's School in New Canaan, Connecticut, USA. Author 2 brings design expertise to the projects, and both teachers have utilized the fabrication lab, emerging technologies, and collaboration with students. Each year, author 1 proposes a project scope, and her students are challenged to design and engineer a signature project. Both partners have improved the iterative process to ensure deeper learning and sustained student inquiry. The projects range from a 1:32 scale model of the Eiffel Tower that was CNC routed to a fully functional jukebox that plays francophone music, lights up, and can hold up to one thousand songs powered by Raspberry Pi. The most recent project is a Fragrance Marketplace, culminating with a pop-up store for the entire community to discover. Each student will learn the history of fragrance and the chemistry behind making essential oils. Students then create a unique brand, marketing strategy, and concept for their signature fragrance. They are further tasked to use the industrial design process (bottling, packaging, and creating a brand name) to finalize their product for the public Marketplace. Sometimes, these dynamic projects require maintenance and updates. For example, our wall-mounted, three-foot francophone clock is constantly changing. The most recent iteration uses Chat GPT to program the Arduino to reconcile the real-time clock shield and keep perfect time as each hour passes. The lights, motors, and sounds from the clock are authentic to each region, represented with laser-cut embellishments. Inspired by Michel Parmigiani, the history of Swiss watch-making, and the precision of time instruments, we aim for perfection with each passing minute. The authors aim to share exemplary work that is possible with students of all ages. We implemented the reverse engineering process to focus on student outcomes to refine our collaborative process. The products that our students create are prime examples of how the design engineering process is applicable across disciplines. The authors firmly believe that the past and present of World cultures inspire innovation.

Keywords: collaboration, design thinking, emerging technologies, world language

Procedia PDF Downloads 21
381 Development of the Family Capacity of Management of Patients with Autism Spectrum Disorder Diagnosis

Authors: Marcio Emilio Dos Santos, Kelly C. F. Dos Santos

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Caregivers of patients diagnosed with ASD are subjected to high stress situations due to the complexity and multiple levels of daily activities that require the organization of events, behaviors and socioemotional situations, such as immediate decision making and in public spaces. The cognitive and emotional requirement needed to fulfill this caregiving role exceeds the regular cultural process that adults receive in their process of preparation for conjugal and parental life. Therefore, in many cases, caregivers present a high level of overload, poor capacity to organize and mediate the development process of the child or patient about their care. Aims: Improvement in the cognitive and emotional capacities related to the caregiver function, allowing the reduction of the overload, the feeling of incompetence and the characteristic level of stress, developing a more organized conduct and decision making more oriented towards the objectives and procedural gains necessary for the integral development of the patient with diagnosis of ASD. Method: The study was performed with 20 relatives, randomly selected from a total of 140 patients attended. The family members were submitted to the Wechsler Adult Intelligence Scale III intelligence test and the Family assessment Management Measure (FaMM) questionnaire as a previous evaluation. Therapeutic activity in a small group of family members or caregivers, with weekly frequency, with a minimum workload of two hours, using the Feuerstein Instrumental Enrichment Cognitive Development Program - Feuerstein Instrumental Enrichment for ten months. Reapplication of the previous tests to verify the gains obtained. Results and Discussion: There is a change in the level of caregiver overload, improvement in the results of the Family assessment Management Measure and highlight to the increase of performance in the cognitive aspects related to problem solving, planned behavior and management of behavioral crises. These results lead to the discussion of the need to invest in the integrated care of patients and their caregivers, mainly by enabling cognitively to deal with the complexity of Autism. This goes beyond the simple therapeutic orientation about adjustments in family and school routines. The study showed that when the caregiver improves his/her capacity of management, the results of the treatment are potentiated and there is a reduction of the level of the caregiver's overload. Importantly, the study was performed for only ten months and the number of family members attended in the study (n = 20) needs to be expanded to have statistical strength.

Keywords: caregiver overload, cognitive development program ASD caregivers, feuerstein instrumental enrichment, family assessment management measure

Procedia PDF Downloads 104
380 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

Procedia PDF Downloads 308
379 Perception of Nurses and Caregivers on Fall Preventive Management for Hospitalized Children Based on Ecological Model

Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

Procedia PDF Downloads 143
378 The Prevalence of Obesity among a Huge Sample of 5-20 Years Old Jordanian Children and Adolescents Based on CDC Criteria

Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

Procedia PDF Downloads 37
377 High Injury Prevalence in Adolescent Field Hockey Players: Implications for Future Practice

Authors: Pillay J. D., D. De Wit, J. F. Ducray

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Field hockey is a popular international sport which is played in more than 100 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk of pain and injury to the lumbar spine. The aim of this study was to determine the prevalence and incidence of low back pain (LBP) in male adolescent field hockey players and the characteristics of LBP in terms of location, chronicity, disability, and treatment sought, as well as its association with selected risk factors. A survey was conducted on 112 male adolescent field hockey players in the eThekwini Municipality of KwaZulu-Natal, South Africa. The questionnaire contained sections on the demographics of participants, general characteristics of participants, health and lifestyle characteristics, low back pain patterns, treatment of low back pain, and the level of disability associated with LBP. The data were statistically analysed using IBM SPSS version 25 with statistical significance set at p-value <0.05. Descriptive statistics such as mean and standard deviation were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi-square test and t-tests as appropriate. A total of 68 questionnaires were completed for analysis (67% participation rate); the period prevalence of LBP was 63.2% (35.0%:beginning of the season, 32.4%:mid-season, 22.1%: end of season). Incidence was 38.2%. The most common location for LBP was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their LBP. An interesting finding was the association between hydration and LBP (p = 0.050), i.e., those individuals who did not hydrate frequently during matches and training were significantly more likely to experience LBP. The results of this study, although limited to a select group of adolescents, showed a higher prevalence of LBP than that of previous studies. More importantly, even though most participants did not experience LBP classified as a disability, LBP still had a large impact on participants, as nearly half of the participants consulted with a medical professional for treatment. Need for the application of further strategies in the prevention and management of LBP in field hockey, such as adequate warm-up and cool-down, stretching exercises, rest between sessions, etc., are recommended as simple strategies to reduce LBP prevalence.

Keywords: adolescents, field hockey players, incidence, low back pain, prevalence, risk factors

Procedia PDF Downloads 41
376 The Effect of Organic Matter Maturation and Porosity Evolution on Methane Storage Potential in Shale-Gas Reservoirs

Authors: T. Topór, A. Derkowski, P. Ziemiański

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Formation of organic matter (OM)-hosted nanopores upon thermal maturation are one of the key factor controlling methane storage potential in unconventional shale-gas reservoirs. In this study, the subcritical CO₂ and N₂ gas adsorption measurements combined with scanning electron microscopy and supercritical methane adsorption have been used to characterize pore system and methane storage potential in black shales from the Baltic Basin (Poland). The samples were collected from a virtually equivalent Llandovery strata across the basin and represent a complete digenetic sequence, from thermally immature to overmature. The results demonstrate that the thermal maturation is a dominant mechanism controlling the formation of OM micro- and mesopores in the Baltic Basin shales. The formation of micro- and mesopores occurs in the oil window (vitrinite reflectance; leavedVR; ~0.5-0.9%) as a result of oil expulsion from kerogenleft OM highly porous. The generated hydrocarbons then turn into solid bitumen causing pore blocking and substantial decrease in micro- and mesopore volume in late-mature shales (VR ~0.9-1.2%). Both micro- and mesopores are regenerated in a middle of the catagenesis range (VR 1.4-1.9%) due to secondary cracking of OM and gas formation. The micropore volume in investigated shales is almost exclusively controlled by the OM content. The contribution of clay minerals to micropore volume is insignificant and masked by a strong contribution from OM. Methane adsorption capacity in the Baltic Basin shales is predominantly controlled by microporous OM with pores < 1.5 nm. The mesopore volume (2-50 nm) and mesopore surface area have no effect on methane sorption behavior. The adsorbed methane density equivalent, calculated as absolute methane adsorption divided by micropore volume, reviled a decrease of the methane loading potential in micropores with increasing maturity. The highest methane loading potential in micropores is observed for OM before metagenesis (VR < 2%), where the adsorbed methane density equivalent is greater than the density of liquid methane. This implies that, in addition to physical adsorption, absorption of methane in OM may occur before metagenesis. After OM content reduction using NaOCl solution methane adoption capacity substantially decreases, suggesting significantly greater adsorption potential for OM microstructure than for the clay minerals matrix.

Keywords: maturation, methane sorption, organic matter, porosity, shales

Procedia PDF Downloads 220
375 Demographic Determinants of Spatial Patterns of Urban Crime

Authors: Natalia Sypion-Dutkowska

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Abstract — The main research objective of the paper is to discover the relationship between the age groups of residents and crime in particular districts of a large city. The basic analytical tool is specific crime rates, calculated not in relation to the total population, but for age groups in a different social situation - property, housing, work, and representing different generations with different behavior patterns. They are the communities from which criminals and victims of crimes come. The analysis of literature and national police reports gives rise to hypotheses about the ability of a given age group to generate crime as a source of offenders and as a group of victims. These specific indicators are spatially differentiated, which makes it possible to detect socio-demographic determinants of spatial patterns of urban crime. A multi-feature classification of districts was also carried out, in which specific crime rates are the diagnostic features. In this way, areas with a similar structure of socio-demographic determinants of spatial patterns on urban crime were designated. The case study is the city of Szczecin in Poland. It has about 400,000 inhabitants and its area is about 300 sq km. Szczecin is located in the immediate vicinity of Germany and is the economic, academic and cultural capital of the region. It also has a seaport and an airport. Moreover, according to ESPON 2007, Szczecin is the Transnational and National Functional Urban Area. Szczecin is divided into 37 districts - auxiliary administrative units of the municipal government. The population of each of them in 2015-17 was divided into 8 age groups: babes (0-2 yrs.), children (3-11 yrs.), teens (12-17 yrs.), younger adults (18-30 yrs.), middle-age adults (31-45 yrs.), older adults (46-65 yrs.), early older (66-80) and late older (from 81 yrs.). The crimes reported in 2015-17 in each of the districts were divided into 10 groups: fights and beatings, other theft, car theft, robbery offenses, burglary into an apartment, break-in into a commercial facility, car break-in, break-in into other facilities, drug offenses, property damage. In total, 80 specific crime rates have been calculated for each of the districts. The analysis was carried out on an intra-city scale, this is a novel approach as this type of analysis is usually carried out at the national or regional level. Another innovative research approach is the use of specific crime rates in relation to age groups instead of standard crime rates. Acknowledgments: This research was funded by the National Science Centre, Poland, registration number 2019/35/D/HS4/02942.

Keywords: age groups, determinants of crime, spatial crime pattern, urban crime

Procedia PDF Downloads 156
374 The Tourism in the Regional Development of South Caucasus

Authors: Giorgi Sulashvili, Vladimer Kekenadze, Olga Khutsishvili, Bela Khotenashvili, Tsiuri Phkhakadze, Besarion Tsikhelashvili

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The article dealt with the South Caucasus is a complex economic policy, which consists of strands: The process of deepening economic integration in the South Caucasus region; deepening economic integration with the EU in the framework of "Neighbourhood policy with Europe" and in line with the Maastricht criteria; the development of bilateral trade and economic relations with many countries of the world community; the development of sufficient conditions for the integration of the South Caucasus region in the world to enter the market. According to the author, to determine the place of Georgia in the regional policy of the South Caucasus, it is necessary to consider two views about Georgia: The first is the view of Georgia, as a part of global economic and political processes and the second look at Georgia, as a country located in the geo-economic and geopolitical space of the South Caucasus. Such approaches reveal the place of Georgia in two dimensions; in the global and regional economies. In the countries of South Caucasus, the tourism has been developing fast and has a great social and economic importance. Tourism influences deeply on the social and economic growth of the regions of the country. Tourism development formulates thousand new jobs, fixes the positions of small and middle businesses, ensures the development of the education and culture of the population. In the countries of South Caucasus, the Tourist Industry can be specified as the intersectoral complex, which consists of travel transport and it’s technical service network, tourist enterprises which are specialized in various types, wide network services. Tourists have a chance to enjoy all of these services. At the transitional stage of shifting to the market economy, tourism is among the priorities in the development of the national economy of our country. It is true that the Georgian tourism faces a range of problems at present, but its recognition and the necessity for its development may be considered as a fact. Besides, we would underline that the revitalization of the Georgian tourism is not only the question of time. This area can bring a lot of benefits as to private firms, as to specific countries. It also has many negative effects were conducted fundamental research and studies to consider both, positive and negative impacts of tourism. In the future such decisions will be taken that will bring, the maximum benefit at minimum cost, in order for tourism to take its place in Georgia it is necessary to understand the role of the tourism sector in the economic structure.

Keywords: transitional stage, national economy, Georgian tourism, positive and negative impacts

Procedia PDF Downloads 373
373 Contrastive Focus Marking in Brazilian Children under Typical and Atypical Phonological Development

Authors: Geovana Soncin, Larissa Berti

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Some aspects of prosody acquisition remain still unclear, especially regarding atypical speech development processes. This work deals with prosody acquisition and its implications for clinical purposes. Therefore, we analyze speech samples produced by adult speakers, children in typical language development, and children with phonological disorders. Phonological disorder comprises deviating manifestations characterized by inconsistencies in the phonological representation of a linguistic system under acquisition. The clinical assessment is performed mostly based on contrasts whose manifestations occur in the segmental level of a phonological system. Prosodic organization of spoken utterances is not included in the standard assessment. However, assuming that prosody is part of the phonological system, it was hypothesized that children with Phonological Disorders could present inconsistencies that also occur at a prosodic level. Based on this hypothesis, the paper aims to analyze contrastive focus marking in the speech of children with Phonological Disorders in comparison with the speech of children under Typical Language Development and adults. The participants of all groups were native speakers of Brazilian Portuguese. The investigation was designed in such a way as to identify differences and similarities among the groups that could be interpreted as clues of normal or deviant processes of prosody acquisition. Contrastive focus in Brazilian Portuguese is marked by increasing duration, f0, and intensity on the focused element as well as by a particular type of pitch accent (L*+H). Thirty-nine subjects participated, thirteen from each group. Acoustic analysis was performed, considering duration, intensity, and intonation as parameters. Children with PD were recruited in sessions from a service provided by Speech-Language Pathology Therapy; children in TD, paired in age and sex with the first group, were recruited in a regular school; and 20-24 years old adults were recruited from a University class. In a game prepared to elicit focused sentences, all of them produced the sentence “Girls love red dress,” marking focus on different syntactic positions: subject, verb, and object. Results showed that adults, children in typical language development, and children with Phonological Disorders marked contrastive focus differently: typical children used all parameters like adults do; however, in comparison with them, they exaggerated duration and, in the opposite direction, they did not increase f0 in a sufficient magnitude as adults; children with Phonological Disorder presented inconsistencies in duration, not increasing it in some syntactic positions, and also in intonation, not producing the representative pitch accent of contrastive focus. The results suggest prosody is also affected by phonological disorder and give clues of developmental processes of prosody acquisition.

Keywords: Brazilian Portuguese, contrastive focus, phonological disorder, prosody acquisition

Procedia PDF Downloads 66
372 Assessment of Dietary Patterns of Saudi Patients with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

Abstract:

Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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371 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi

Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

Abstract:

Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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370 Childhood Cataract: A Socio-Clinical Study at a Public Sector Tertiary Eye Care Centre in India

Authors: Deepak Jugran, Rajesh Gill

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Purpose: To study the demographic, sociological, gender and clinical profile of the children presented for childhood cataract at a public sector tertiary eye care centre in India. Methodology: The design of the study is retrospective, and hospital-based data is available with the Central Registration Department of the PGIMER, Chandigarh. The majority of the childhood cataract cases are being reported in this hospital, yet not each and every case of childhood cataract approaches PGI, Chandigarh. Nevertheless, this study is going to be pioneering research in India, covering five-year data of the childhood cataract patients who visited the Advanced Eye Centre, PGIMER, Chandigarh, from 1.1.2015 to 31.12.2019. The SPSS version 23 was used for all statistical calculations. Results: A Total of 354 children were presented for childhood cataract from 1.1.2015 to 31.12.2019. Out of 354 children, 248 (70%) were male, and 106 (30%) were female. In-spite of 2 flagship programmes, namely the National Programme for Control of Blindness (NPCB) and Aayushman Bharat (PM JAY) for eradication of cataract, no children received any financial assistance from these two programmes. A whopping 99% of these children belong to the poor families. In most of these families, the mothers were house-wives and did not employ anywhere. These interim results will soon be conveyed to the Govt. of India so that a suitable mechanism can be evolved to address this pertinent issue. Further, the disproportionate ratio of male and female children in this study is an area of concern as we don’t know whether the prevalence of childhood cataract is lower in female children or they are not being presented on time in the hospital by the families. Conclusion: The World Health Organization (WHO) has categorized Childhood blindness resulting from cataract as a priority area and urged all member countries to develop institutionalized mechanisms for its early detection, diagnosis and management. The childhood cataract is an emerging and major cause of preventable and avoidable childhood blindness, especially in low and middle-income countries. In the formative years, the children require a sound physical, mental and emotional state, and in the absence of either one of them, it can severely dent their future growth. The recent estimate suggests that India could suffer an economic loss of US$12 billion (Rs. 88,000 Crores) due to blindness, and almost 35% of cases of blindness are preventable and avoidable if detected at an early age. Besides reporting these results to the policy makers, synchronized efforts are needed for early detection and management of avoidable causes of childhood blindness such as childhood cataract.

Keywords: childhood blindness, cataract, Who, Npcb

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369 Personality Composition in Senior Management Teams: The Importance of Homogeneity in Dynamic Managerial Capabilities

Authors: Shelley Harrington

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As a result of increasingly dynamic business environments, the creation and fostering of dynamic capabilities, [those capabilities that enable sustained competitive success despite of dynamism through the awareness and reconfiguration of internal and external competencies], supported by organisational learning [a dynamic capability] has gained increased and prevalent momentum in the research arena. Presenting findings funded by the Economic Social Research Council, this paper investigates the extent to which Senior Management Team (SMT) personality (at the trait and facet level) is associated with the creation of dynamic managerial capabilities at the team level, and effective organisational learning/knowledge sharing within the firm. In doing so, this research highlights the importance of micro-foundations in organisational psychology and specifically dynamic capabilities, a field which to date has largely ignored the importance of psychology in understanding these important and necessary capabilities. Using a direct measure of personality (NEO PI-3) at the trait and facet level across 32 high technology and finance firms in the UK, their CEOs (N=32) and their complete SMTs [N=212], a new measure of dynamic managerial capabilities at the team level was created and statistically validated for use within the work. A quantitative methodology was employed with regression and gap analysis being used to show the empirical foundations of personality being positioned as a micro-foundation of dynamic capabilities. The results of this study found that personality homogeneity within the SMT was required to strengthen the dynamic managerial capabilities of sensing, seizing and transforming, something which was required to reflect strong organisational learning at middle management level [N=533]. In particular, it was found that the greater the difference [t-score gaps] between the personality profiles of a Chief Executive Officer (CEO) and their complete, collective SMT, the lower the resulting self-reported nature of dynamic managerial capabilities. For example; the larger the difference between a CEOs level of dutifulness, a facet contributing to the definition of conscientiousness, and their SMT’s level of dutifulness, the lower the reported level of transforming, a capability fundamental to strategic change in a dynamic business environment. This in turn directly questions recent trends, particularly in upper echelons research highlighting the need for heterogeneity within teams. In doing so, it successfully positions personality as a micro-foundation of dynamic capabilities, thus contributing to recent discussions from within the strategic management field calling for the need to empirically explore dynamic capabilities at such a level.

Keywords: dynamic managerial capabilities, senior management teams, personality, dynamism

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368 Utilization Of Medical Plants Tetrastigma glabratum (Blume) Planch from Mount Prau in the Blumah, Central Java

Authors: A. Lianah, B. Peter Sopade, C. Krisantini

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Walikadep/Tetrastigma glabratum (Blume) Planch is a traditional herb that has been used by people of Blumah village; it is believed to have a stimulant effect and ailments for many illnesses. Our survey demonstrated that the people of Blumah village has exploited walikadep from Protected Forest of Mount Prau. More than 10% of 448 households at Blumah village have used walikadep as traditional herb or jamu. Part of the walikadep plants used is the liquid extract of the stem. The population of walikadep is getting scarce and it is rarely found now. The objectives of this study are to examine the stimulant effect of walikadep, to measure growth and exploitation rate of walikadep, and to find ways to effectively propagate the plants, as well as identifying the impact on the environment through field experiments and explorative survey. Stimulant effect was tested using open-field and hole-board test. Data were collected through field observation and experiment, and data were analysed using lab test and Anova. Rate of exploitation and plant growth was measured using Regression analysis; comparison of plant growth in-situ and ex-situ used descriptive analysis. The environmental impact was measured by population structure vegetation analysis method by Shannon Weinner. The study revealed that the walikadep exudates did not have a stimulant effect. Exploitation of walikadep and the long time required to reach harvestable size resulted in the scarcity of the plant in the natural habitat. Plant growth was faster in-situ than ex-situ; and fast growth was obtained from middle part cuttings treated with vermicompost. Biodiversity index after exploitation was higher than before exploitation, possibly due to the toxic and allellopathic effect (phenolics) of the plant. Based on these findings, further research is needed to examine the toxic effects of the leave and stem extract of walikadep and their allelopathic effects. We recommend that people of Blumah village to stop using walikadep as the stimulant. The local people, village government in the regional and central levels, and perhutani should do an integrated efforts to conserve walikadep through Pengamanan Terpadu Konservasi Walikadep Lestari (PTKWL) program, so this population of this plant in the natural habitat can be maintained.

Keywords: utilization, medical plants, traditional, Tetastigma glabratum

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