Search results for: aged care

Authors: Erika Ruiz, Nestor Ortiz

Abstract:

Lean philosophy has evolved over time and has been implemented both in manufacturing and services, more recently lean has been integrated in the companies of the health sector. Currently it is important to understand the successful way to implement this philosophy and try to identify barriers and enablers to the sustainability of lean healthcare. The main purpose of this research is to identify the barriers and enablers in the implementation of Lean Healthcare based on case studies of Colombian healthcare centers. In order to do so, we conducted semi-structured interviews based on a maturity model. The main results indicate that the success of Lean implementation depends on its adaptation to contextual factors. In addition, in the Colombian context were identified new factors such as organizational culture, management models, integration of the care and administrative departments and triple helix relationship.

Keywords: barriers, enablers, implementation, lean healthcare, sustainability

Procedia PDF Downloads 347

Authors: Honey Bryant, Elvina Chu

Abstract:

Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

Procedia PDF Downloads 95

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

Abstract:

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 109

Authors: Il-Ho Kim, Samuel Noh, Kwame McKenzie, Cyu-Chul Choi

Abstract:

Many members of immigrant minorities choose to operate microbusinesses that involve emotionally taxing interactions with customers and discriminatory exposures in the workplace. This study investigated the psychological risks of emotional demands and discrimination as well as the buffering roles of two types of job resources (job autonomy and job security) among immigrant microbusiness owners (MBOs). Data were derived from a cross-sectional survey of 550 Korean immigrant MBOs, aged 30 to 70, living in Toronto and its surrounding areas. Face-to-face interviews were conducted between March and November 2013. Results showed that emotional suppression and discrimination were positively associated with depressive symptoms. However, the direct effect of positive emotional demands was insignificant. For job resources, the beneficial effect of job security on depressive symptom was apparent, but the effect of job autonomy was trivial. Regarding the moderating effect, job security buffered the psychological harm of both emotional suppression and workplace discrimination. Although job autonomy buffered the link between discrimination and depressive symptoms, the buffering effect of job autonomy on the emotional suppression-depression link was insignificant. This study’s finding implies that emotional demands and workplace discrimination seem to be important factors in contributing to occupational psychological problems, but the psychological impact can differ according to the types of emotional demands and job resources among immigrant MBOs.

Keywords: immigrant microbusiness owners, emotional demands, discrimination, job resources, depression

Procedia PDF Downloads 204

Authors: Shiau-Fang Chao, Yu-Chih Chen

Abstract:

Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.

Keywords: activity, environment, mental health, older LTC residents

Procedia PDF Downloads 171

Authors: Hadura Abu Hasan, Zairi Jaal, P. J. McCall

Abstract:

Dengue is a serious problem in Malaysia, particularly in high-density urban communities with lower socio-economic levels. This study evaluated the susceptibility of local populations of Aedesaegypti (Linnaeus), Aedesalbopictus (Skuse) and Culexquinquefasciatus (Say) from the traditional community of BaganDalam, Penang, Malaysia to lambdacyhalothrin and pirimiphos-methyl using standard World Health Organization (WHO) adult bioassay test. Unfed female mosquitoes aged 3-5 days were exposed to WHO recommended dosages of insecticides over fixed time periods with results presented as knock-down time (KT50) for each strain.The insecticide susceptible VCRU laboratory strain was usedas control. All three specieswere highly resistant to lambda-cyhalothrin with less than 10% mortality at 24 hours after treatment. In contrast, Ae.aegypti and Ae. albopictus were susceptible to pirimiphos-methyl, showing 100% mortality recorded 24 hoursafter treatment. Cx. quinquefasciatuswasclassed as ‘suspected resistant’ to pirimiphos-methyl as mortality recorded 24 hours after treatment was 94-96%. The results indicate that organophosphates such as pirimiphos-methyl might be used as alternative to pyrethroid for dengue vector control in this dengue-prone area.

Keywords: vector control, aedes aegypti, aedes albopictus, dengue, culex quinquefasciatus, residuals insecticides, pyrethroid, organophosphate, resistant, mosquito

Procedia PDF Downloads 247

Authors: Man Chung Chu

Abstract:

In the dynamic family interaction, parental self-efficacy is connected with parent-child attachment. Parental self-efficacy and its corresponding behavior played an influential role in the lifespan development of the child. Recently, Mindful parenting is popularly addressed as it lightens parents’ awareness to their own thoughts feelings and behaviors by adapting a nonjudgmental attitude in the present moment being with the child. The effectiveness of mindful parent is considerably significant in enhancing parent-child relationship as well as family functioning. Parenting in early developmental stage is always challenging and essential for later growth, however, literature is rarely exploring the mediation of mindful parenting on the effect of parent self-efficacy on parent-child attachment in preschoolers’ families. The mediation effect of the research shed light on how mindful parenting should head, where parental self-efficacy training should be incorporated together with mindful family program in attempt to yield the best outcome in the family of young-aged children. Two hundred and eight (208) parents, of two to six years old children, were participated in the study and results supported the significance in the mediator effect of mindful parenting in both facets, i.e. Parent-focused - ‘Mindful Discipline’ and Child-focused – ‘Being in the moment with the child’ where parental self-efficacy is a significant predictor of mindful parenting. The implication of the result suggests that mindful parenting would be a therapeutic framework in promoting family functioning and child’s well-being, it would also be a ‘significant helping hand’ in maintaining continuous secure attachment relationship and growing their mindful children in a family.

Keywords: mediation effect, mindful parenting, parental self efficacy, parent-child attachment, preschoolers

Procedia PDF Downloads 186

Authors: Saeed Alshahri

Abstract:

Introduction: Our study aims to estimate the characteristics & causes of TSCI at King Fahad Medical City (KFMC) in Riyadh city in order to hypothesize strategy for primary prevention of traumatic spinal cord injury. Method: Cross-sectional, retrospective study was conducted on all TSCI patients who aged 14 and above and who were admitted to rehabilitation center of King Fahad Medical City from January 2012 to December 2015. Furthermore, a descriptive analysis was conducted while considering factors including age, gender, marital status, educational level and causes of injury and characteristics of injury. Results: Total of 216 patients were admitted during this period, mean age was 28.94, majority of patients were male (86.5%), 71.7% of total patients were high school level of education or less, 68% were single, RTA was the main cause with 90.7% and the main result of TSCI was complete paraplegia 37%. Furthermore, statistically, we found that males are at a low risk of having incomplete paraplegia compared to female (p = 0.035, RRR=0.35). Conclusion: The rate of TSCI related to RTA has increased in Saudi Arabia in previous years despite the government’s efforts to decrease RTA. It’s clear that we need TSCI registry data developed on the basis of international data standards to have a clear idea about the exact etiology of TSCI in Saudi Arabia. This will assist in planning for primary prevention.

Keywords: traumatic spinal cord injury, road traffic accident, Saudi Arabia, spinal cord injury

Procedia PDF Downloads 334

Authors: S. Bilal, S. A. Bhat, I. Hussain, J. D. Parrah, S. P. Ahmad, M. R. Mir

Abstract:

Background: The wound healing involves a highly coordinated cascade of cellular and immunological response over a period including coagulation, inflammation, granulation tissue formation, epithelialization, collagen synthesis and tissue remodeling. Wounds in aged heal more slowly than those in younger, mainly because of comorbidities that occur as one age. The present study is about the influence of age on wound healing. 1x1cm^2 (100 mm) wounds were created on the back of the animal. The animals were divided into two groups; one group had animals in the age group of 3-9 months while another group had animals in the age group of 15-21 months. Materials and Methods: 24 clinically healthy rabbits in the age group of 3-21 months were used as experimental animals and divided into two groups viz A and B. All experimental parameters, i.e., Excision wound model, Measurement of wound area, Protein extraction and estimation, Protein extraction and estimation and DNA extraction and estimation were done by standard methods. Results: The parameters studied were wound contraction, hydroxyproline, glucosamine, protein, and DNA. A significant increase (p<0.005) in the hydroxyproline, glucosamine, protein and DNA and a significant decrease in wound area (p<0.005) was observed in the age group of 3-9 months when compared to animals of an age group of 15-21 months. Wound contraction together with hydroxyproline, glucosamine, protein and DNA estimations suggest that advanced age results in retarded wound healing. Conclusion: The decrease wound contraction and accumulation of hydroxyproline, glucosamine, protein and DNA in group B animals may be associated with the reduction or delay in growth factors because of the advancing age.

Keywords: age, wound healing, excision wound, hydroxyproline, glucosamine

Procedia PDF Downloads 643

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

Procedia PDF Downloads 187

Authors: Kalpana Poudel-Tandukar

Abstract:

Background: Human Immunodeficiency Virus (HIV) infection has been frequently associated with vitamin D deficiency and depression. Vitamin D deficiency increases the risk of depression in people without HIV. We assessed the cross-sectional and prospective associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and depression in a HIV-positive people. Methods: A survey was conducted among 316 HIV-positive people aged 20-60 years residing in Kathmandu, Nepal for a cross-sectional association at baseline, and among 184 participants without depressive symptoms at baseline who responded to both baseline (2010) and follow-up (2011) surveys for prospective association. The competitive protein-binding assay was used to measure 25(OH)D levels and the Beck Depression Inventory-Ia method was used to measure depression, with cut off score 20 or higher. Relationships were assessed using multiple logistic regression analysis with adjustment of potential confounders. Results: The proportion of participants with 25(OH)D level of <20ng/mL, 20-30ng/mL, and >30ng/mL were 83.2%, 15.5%, and 1.3%, respectively. Only four participants with 25(OH)D level of >30ng/mL were excluded in the further analysis. The mean 25(OH)D level in men and women were 15.0ng/mL and 14.4ng/mL, respectively. Twenty six percent of participants (men:23%; women:29%) were depressed. Participants with 25(OH)D level of < 20 ng/mL had a 1.4 fold higher odds of depression in a cross-sectional and 1.3 fold higher odds of depression after 18 months of baseline compared to those with 25(OH)D level of 20-30ng/mL (p=0.40 and p=0.78, respectively). Conclusion: Vitamin D may not have significant impact against depression among HIV-positive people with 25(OH)D level below normal ( > 30ng/mL).

Keywords: depression, HIV, Nepal, vitamin D

Procedia PDF Downloads 319

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

Abstract:

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

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

Procedia PDF Downloads 52

Authors: Hung-Yu Lin

Abstract:

Background: Parts of researchers assert that external hyperactivity behaviors of ADHD children interfere with their abilities to perform internal cognitive tasks; however, there are still other researchers hold the opposite viewpoint, the external high level of activity may serve as the role of improving internal executive function.Objectives: Thisstudy explored the effects of external motor behavior of ADHD on internal visual attentional performance. Methods: A randomized, two-period crossover design was used in this study, a total of 80 children (aged 6-12) were recruited in this study. 40participants have received ADHD diagnosis, and others are children with typically developing. These children were measured through the visual edition of TOVA (The Test of Variables of Attention) when they wore actigraphy, their testing behavior and movement data werecollected through closely observation and the actigraphies under different research conditions. Result: According to the research result, the author found (1) Higherfrequencyof movement under attentional testing condition was found in children with ADHD, comparing to children with typically developing, and (2) Higher frequency of foot movement showed better attentional performance of the visual attentional test in children with ADHD. However, these results were not showed in children with typically developing. Conclusions: The findings support the functional working memory model, which advocated that a positive relation between gross motor activity and attentional performance within the context of attentive behavior in children with ADHD.

Keywords: ADHD, movement, visual attention, children

Procedia PDF Downloads 177

Authors: Ankur Chauhan, Amol Singh

Abstract:

The increasing human resource has led to the rapid increment in the generation of healthcare waste across the world. Since, this waste consists of the infectious and hazardous components emerged from the patient care activities in different healthcare facilities; therefore, its proper management becomes vital for mitigating its negative impact on society and environment. The present research work focuses on the identification of the key success factors for developing a successful healthcare waste management plan. In addition, the key success factors have been studied by developing a causal diagram with the help of a decision making trial and evaluation (DEMATEL) approach. The findings of the study would help in the filtration of dominant key success factors which would further help in making a comparative assessment of the waste management plan of different hospitals.

Keywords: healthcare waste disposal, environment and society, multi-criteria decision making, DEMATEL

Procedia PDF Downloads 366

Authors: L. Ereku, R. E. Mackay, A. Naveenathayalan, K. Ajayi, W. Balachandran

Abstract:

Over the past decade the increase of sexually transmitted infections (STIs) especially in the developing world due to high cost and lack of sufficient medical testing have given rise to the need for a rapid, low cost point of care medical diagnostic that is disposable and most significantly reproduces equivocal results achieved within centralised laboratories. This paper present the development of a disposable PDMS microfluidic cartridge incorporating blisters filled with reagents required for isothermal DNA amplification in clinical diagnostics and point-of-care testing. In view of circumventing the necessity for external complex microfluidic pumps, designing on-chip pressurised fluid reservoirs is embraced using finger actuation and blister storage. The fabrication of the blisters takes into consideration three proponents that include: material characteristics, fluid volume and structural design. Silicone rubber is the chosen material due to its good chemical stability, considerable tear resistance and moderate tension/compression strength. The case of fluid capacity and structural form go hand in hand as the reagent need for the experimental analysis determines the volume size of the blisters, whereas the structural form has to be designed to provide low compression stress when deformed for fluid expulsion. Furthermore, the top and bottom section of the blisters are embedded with miniature polar opposite magnets at a defined parallel distance. These magnets are needed to lock or restrain the blisters when fully compressed so as to prevent unneeded backflow as a result of elasticity. The integrated chip is bonded onto a large microscope glass slide (50mm x 75mm). Each part is manufactured using a 3D printed mould designed using Solidworks software. Die-casting is employed, using 3D printed moulds, to form the deformable blisters by forcing a proprietary liquid silicone rubber through the positive mould cavity. The set silicone rubber is removed from the cast and prefilled with liquid reagent and then sealed with a thin (0.3mm) burstable layer of recast silicone rubber. The main microfluidic cartridge is fabricated using classical soft lithographic techniques. The cartridge incorporates microchannel circuitry, mixing chamber, inlet port, outlet port, reaction chamber and waste chamber. Polydimethylsiloxane (PDMS, QSil 216) is mixed and degassed using a centrifuge (ratio 10:1) is then poured after the prefilled blisters are correctly positioned on the negative mould. Heat treatment of about 50C to 60C in the oven for about 3hours is needed to achieve curing. The latter chip production stage involves bonding the cured PDMS to the glass slide. A plasma coroner treater device BD20-AC (Electro-Technic Products Inc., US) is used to activate the PDMS and glass slide before they are both joined and adequately compressed together, then left in the oven over the night to ensure bonding. There are two blisters in total needed for experimentation; the first will be used as a wash buffer to remove any remaining cell debris and unbound DNA while the second will contain 100uL amplification reagents. This paper will present results of chemical cell lysis, extraction using a biopolymer paper membrane and isothermal amplification on a low-cost platform using the finger actuated blisters for reagent storage. The platform has been shown to detect 1x105 copies of Chlamydia trachomatis using Recombinase Polymerase Amplification (RPA).

Keywords: finger actuation, point of care, reagent storage, silicone blisters

Procedia PDF Downloads 357

Authors: B.-Y.-S. Lau, Y.-C.-T. Jonathan, M.-S. Alias

Abstract:

Heritage trees are natural large, individual trees with exceptionally value due to association with age or event or distinguished people. In Malaysia, there is an abundance of tropical heritage trees throughout the country. It is essential to set up a repository of heritage trees to prevent valuable trees from being cut down. In this cross domain study, a web-based online expert system namely the Heritage Tree Expert Assessment and Classification (HTEAC) is developed and deployed for public to nominate potential heritage trees. Based on the nomination, tree care experts or arborists would evaluate and verify the nominated trees as heritage trees. The expert system automatically rates the approved heritage trees according to pre-defined grades via Delphi technique. Features and usability test of the expert system are presented. Preliminary result is promising for the system to be used as a full scale public system.

Keywords: arboriculture, Delphi, expert system, heritage tree, urban forestry

Procedia PDF Downloads 295

Authors: Nevruz Zogu, Shpetim Rezniqi

Abstract:

In the framework of transformational economic development social pluralism and the free, market health systems operating in the countries of our region are naturally involved in a process of profound change and reform. Health systems actually represent complex ensembles centers and public and private institutions (domestic and foreign), who administer substantial amounts of human, technological, material, financial, information and scientific facts • The goal of health systems is much more than medical care. It includes the promotion, protection, treatment and rehabilitation of health of the population. • Meeting the needs of increasingly diverse broader health services efficient, secure the quality and affordability of their increasing cost of unstoppable, requires the necessary reform of health systems and implementing policies and new management methods, to ensure effectiveness and health benefits as higher population.

Keywords: health, management, economy, finance

Procedia PDF Downloads 406

Authors: Amr Hamdy

Abstract:

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

Procedia PDF Downloads 182

Authors: Jiraphorn Satechan, Thanaphon Khamthieng, Warunee Phanwong

Abstract:

This action research aimed at designing and developing the cleaning equipment to preventing dust diffusion of bus air filter. Quantitative and qualitative data collection methods were used to conduct data from October 1st, 2018 to September 30th, 2019. All of participants were male (100.0%) with aged 40- 49 years and 57.15%, of them finish bachelor degree. 71.43% of them was a driver and 57.15% of them had the working experience between 10 and 15 years. Research revealed that the participants assessed the quality of the bus air filter cleaning equipment for preventing dust diffusion at a moderate level (σ= 0.29), and 71.43 of them also suggested the development methods in order to improve the quality of bus air filters cleaning equipment as follows: 1) to install the circuit breaker for cutting the electricity and controlling the on-off of the equipment and to change the motor to the DC system, 2) should install the display monitor for wind pressure and electricity system as well as to install the air pressure gauge, 3) should install the tank lid lock for preventing air leakage and dust diffusion by increasing the blowing force and sucking power, 4) to stabilize the holding points for preventing the filter shaking while rotating and blowing for cleaning and to reduce the rotation speed in order to allow the filters to move slowly for the air system to blow for cleaning more thoroughly, 5) the amount of dust should be measured before and after cleaning and should be designed the cleaning equipment to be able to clean with a variety of filters, and sizes. Moreover, the light-weight materials should be used to build the cleaning equipment and the wheels should be installed at the base of the equipment in order to make it easier to move.

Keywords: Cleaning Equipment, Bus Air Filters, Preventing Dust Diffusion, Innovation

Procedia PDF Downloads 92

Authors: N. Das, N. Samanta, L. Pandey, C. Roy Chaudhuri

Abstract:

Early diagnosis of infection like Hep-B virus in blood is important for low cost medical treatment. For this purpose, it is desirable to develop a point of care device which should be able to detect trace quantities of the target molecule in blood. In this paper, we report a nanoporous silicon oxide sensor which is capable of detecting down to 1fM concentration of Hep-B surface antigen in blood without the requirement of any centrifuge or pre-concentration. This has been made possible by the presence of resonant peak in the sensitivity characteristics. This peak is observed to be dependent only on the concentration of the specific antigen and not on the interfering species in blood serum. The occurrence of opposite impedance change within the pores and at the bottom of the pore is responsible for this effect. An electronic interface has also been designed to provide a display of the virus concentration.

Keywords: impedance spectroscopy, ultrasensitive detection in blood, peak frequency, electronic interface

Procedia PDF Downloads 385

Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Li-Yun Chen, Ching-Yu Tseng

Abstract:

The purpose of this study was to determine whether progressive aerobic exercise intensity effects the changes in insulin resistance indicators among obese college students in Taiwan. Forty-eight obese subjects [body mass index (BMI) ≧ 27 kg/m2, aged 18-26 years old] were randomized into four equal groups (n = 12): light-intensity training group (LITG): 40-50% of their heart rate reserve (HRR); middle-intensity training group (MITG): 50-70% of their HRR; high-intensity training group (HITG): 70-80% of their HRR, and control group (CG). The aerobic exercise training program was performed 60 minutes per day on a treadmill three days/week in a training period of 12 weeks. All subjects’ anthropometric data, blood biochemical parameters, and health-related physical fitness components were measured at baseline and after 12 weeks. At baseline, all insulin resistance indicators did not differ significantly among the four groups (p > 0.05). After 12-week exercise intervention, the HITG had significantly more changes in insulin level than the MITG, LITG, and CG. Our findings suggested that a short-term aerobic exercise program can play an important role in improving insulin resistance indicators; either middle-intensity training significantly increases the insulin level, but the high-intensity exercise training program effectively improves obese college students’ insulin resistance.

Keywords: aerobic training, exercise intensity, insulin resistance, obesity

Procedia PDF Downloads 283

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

Abstract:

Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

Procedia PDF Downloads 252

Authors: Gracie Tredget, Raymond McGrath, Karen Ang, Julie Williams, Nick Sevdalis, Fiona Gaughran, Jorge Aria de la Torre, Ioannis Bakolis, Andy Healey, Zarnie Khadjesari, Euan Sadler, Natalia Stepan

Abstract:

Background: Preventable physical health problems have been found to increase morbidity rates amongst adults living with serious mental illness (SMI). Community mental health clinicians have a role in identifying, and preventing physical health problems worsening, and supporting primary care services to administer routine physical health checks for their patients. However, little is known about how mental health staff perceive and approach their role when providing physical healthcare amongst patients with SMI, or the impact these attitudes have on routine practice. Methods: The present study involves a prospective service evaluation specific to Adult Community Mental Health Services at South London and Maudsley NHS Foundation Trust (SLaM). A qualitative methodology will use semi-structured interviews, focus groups and observations to explore attitudes, perceptions and experiences of staff, patients, and carers (n=64) towards physical healthcare, and barriers or facilitators that impact upon it. 1South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK 2 Centre for Implementation Science, King’s College London, London, SE5 8AF, UK 3 Psychosis Studies, King's College London, London, SE5 8AF, UK 4 Department of Biostatistics and Health Informatics, King’s College London, London, SE5 8AF, UK 5 Kings Health Economics, King's College London, London, SE5 8AF, UK 6 Behavioural and Implementation Science (BIS) research group, University of East Anglia, Norwich, UK 7 Department of Nursing, Midwifery and Health, University of Southampton, Southampton, UK 8 Mind and Body Programme, King’s Health Partners, Guy’s Hospital, London, SE1 9RT *[email protected] Analysis: Data from across qualitative tasks will be synthesised using Framework Analysis methodologies. Staff, patients, and carers will be invited to participate in co-development of recommendations that can improve routine physical healthcare within Adult Community Mental Health Teams at SLaM. Results: Data collection is underway at present. At the time of the conference, early findings will be available to discuss. Conclusions: An integrated approach to mind and body care is needed to reduce preventable deaths amongst people with SMI. This evaluation will seek to provide a framework that better equips staff to approach physical healthcare within a mental health setting.

Keywords: severe mental illness, physical healthcare, adult community mental health, nursing

Procedia PDF Downloads 84

Authors: Albert Suryaprawira

Abstract:

Patients requiring correction of severe Class III skeletal discrepancy historically has been among the most challenging treatments for orthodontists. Correction of an aesthetic and functional problem is crucially important. This is a case report of an adult male aged 18 years who complained of difficulty in chewing and speaking. Patient has a prominent profile with mandibular excess. The pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. The panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, the pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, the post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition between those radiographs was performed to analyse the outcome. It includes the superimposition of the cranial base, maxilla, and mandible. Superimposition is important to describe the amount of hard and soft tissue movement. It is also important to predict the possibility of relapse after the surgery. The patient needs to understand all the surgical plan, outcome and relapse prevention. The surgery included mandibular set back by bilateral sagittal split osteotomies. Although the discrepancy was severe using this combination of treatment and the use of radiographic superimposition, an aesthetically pleasing and stable result was achieved.

Keywords: cephalometric, mandibular set back, orthognathic, superimposition

Procedia PDF Downloads 248

Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut

Abstract:

Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.

Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women

Procedia PDF Downloads 307

Authors: Parveen Kundu, Nitika Chawla, Ruchi Agarwal, Swaran Kaur

Abstract:

Background: Mature cystic teratoma is a benign, most common tumor of the ovary occurring mostly in young and middle-aged females. This study consists of 19 cases of mature cystic teratomas which were received in the Department Of Pathology over a period of two years. There were malignant transformations observed in three cases, which makes it very important for pathologists to thoroughly examine the entire specimen of mature cystic teratomas. Material and Methods: Nineteen reported cases of mature cystic teratomas were received in Deptt. Of Pathology, BPS GMC Khanpur Kalan, Sonepat, over a two-year period from November 2020 to October 2022 and reviewed retrospectively. Data regarding age, size, laterality, gross, morphological features, and surgery performed were retrieved from pathological archives. Results: In our study, the most common age of presentation was the 20-40 year age group. The most common presenting complaint was fullness in the abdomen or abdominal distension. Four out of 19 cases studied cases presented with bilateral ovarian cysts. Tumor size ranged from 6 to 20 cm in diameter. In seven cases, cysts were greater than or equal to 10 cm in diameter. Three cases showed malignant transformation. Conclusion: It is very important to thoroughly examine the contralateral ovary to rule out bilateral presentation. A furthermost thorough examination is advised in tumors of size >10 cm and in tumors with solid areas to rule out any malignant transformation.

Keywords: teratoma, ovary, malignant, transformation

Procedia PDF Downloads 69

Authors: Wasse Uddin Ahmed Saleh, Nawreenbinte Anwar

Abstract:

A well-written operating note is crucial as a teaching tool for providing patients with high-quality medical care and fending off medico-legal claims. In this review article, some adjustments have been advised to the operative note guidelines by the Royal College of Surgeons (RCS) for different methods of ocular anesthesia and ophthalmic procedures like cataract surgeries, kerato-refractive surgeries, glaucoma surgeries, oculoplastic surgeries, etc. Some modifications of the WHO Surgical Safety Checklist have also been mentioned, including pre-operative responsibilities of the nurses, operative assistants and operating ophthalmologists. It has become essential to assemble globally accepted structured operative note guidelines modified for each ocular surgery.

Keywords: ocular surgeries, operation notes, cataract surgery, kerato-refractive surgery, Oculoplastic surgeries, guidelines

Procedia PDF Downloads 115

Authors: Leen Sulaimani, Maryam Hafiz, Naba Ali, Roba Alsharif

Abstract:

One of Amazon’s most crucial online systems is artificial intelligence. Amazon would not have a worldwide successful online store, an easy and secure way of payment, and other services if it weren’t for artificial intelligence and machine learning. Amazon uses AI to expand its operations and enhance them by upgrading the website daily; having a strong base of artificial intelligence in a worldwide successful business can improve marketing, decision-making, feedback, and more qualities. Aiming to have a rational AI system in one’s business should be the start of any process; that is why Amazon is fortunate that they keep taking care of the base of their business by using modern artificial intelligence, making sure that it is stable, reaching their organizational goals, and will continue to thrive more each and every day. Artificial intelligence is used daily in our current world and is still being amplified more each day to reach consumer satisfaction and company short and long-term goals.

Keywords: artificial intelligence, Amazon, business, customer, decision making

Procedia PDF Downloads 86

Authors: Madeline V. Henry

Abstract:

Sex work is a contested subject in academia. Many authors now argue that the practice should be recognized as a legitimate and rationally chosen form of labor, and that decriminalization is necessary to ensure the safety of sex workers and reduce their stigmatization. However, a prevailing argument remains that the work is inherently violent and oppressive and that all sex workers are directly or indirectly coerced into participating in the industry. This argument has been complicated by the recent proliferation of computer-mediated technologies that allow people to conduct sex work without the need to be physically co-present with customers or pimps. One example of this is the practice of ‘camming’, wherein ‘webcam models’ stream themselves stripping and/or performing autoerotic stimulation in an online chat-room for payment. In this presentation, interviews with eight ‘camgirls’ (aged 22-34) will be discussed. Their talk has been analyzed using Foucauldian discourse analysis, focusing on common discursive threads in relation to the work and their subjectivities. It was found that the participants demonstrated appreciation for the lack of physical danger they were in, but emphasized the unique and significant dangers of online-based sex work (their images and videos being recorded and shared without their consent, for example). Participants also argued that their largest concerns were based around stigma, which they claimed remained prevalent despite the decriminalized legal model in Aotearoa/New Zealand (which has been in place for over 14 years). Overall, this project seeks to challenge commonplace academic approaches to sex work, adding further research to support sex workers’ rights and highlighting new issues to consider in a digital environment.

Keywords: camming, sex work, stigma, risk

Procedia PDF Downloads 142

Authors: G. Chipili, J. Msuya

Abstract:

The Central Province of Zambia contains the majority of the nation’s malnourished children, despite being the most productive province in terms of Agriculture. Most studies in the province have not paid attention to the linkages between agriculture performance and nutrition outcomes of the population. In light of this knowledge gap, this study focused on the linkage between nutrition and agriculture. In 2010 the Ministry of Agriculture in the Central Province while working with Non-Governmental Organizations (NGOs), the Ministry of Health and the Ministry of Education started a pilot project in Kapiri-Mponshi on Orange-fleshed Sweet Potatoes and Orange Maize and educating farmers on the importance of crop diversity. The study assessed the extent to which the small scale farmers are implementing the best practices of nutrition-sensitive agriculture in the Central Province. This study sought to determine the association of crop diversity and nutritional status of children aged 6-59 months in Kapiri-Mposhi district in the Central Province of Zambia. A cross-sectional descriptive study was conducted using a structured questionnaire. A total of 365 households were randomly sampled and the nutritional status of one child from each household assessed using anthropometric measurements. A total of 100 children were included in the study. Up to 21% of the children were stunted; 2% were wasted; and 9% underweight. There was a significant relationship between crops grown in households (ground nuts, maize and mangoes) and Z-scores for stunting (HAZ) and underweight (WAZ) (p< 0.05). This study has established that farmers may not diversify if they have high market demands on the staple.

Keywords: agriculture, crop diversity, children, nutrition

Procedia PDF Downloads 288