Search results for: construction of symbolic group boundaries
10298 Sustainability Assessment of a Deconstructed Residential House
Authors: Atiq U. Zaman, Juliet Arnott
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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management
Procedia PDF Downloads 18310297 Interleukin-6 and Tumor Necrosis Factor-α Levels in Tear Film of Keratoconus Patients
Authors: Mazdak Ganjalikhani, Mohamad Namgar, Alireza Peyman
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Introduction: The present study was carried out to measure the levels of inflammatory markers Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in tear of keratoconus patients and investigate their relationship with the severity of keratoconus. Materials and Methods: This study was performed on 81 patients with keratoconus (cases) and 85 healthy individuals (controls) who were selected through the convenience sampling method from patients visiting the Feiz Ophthalmology Hospital affiliated with the Isfahan University of Medical Sciences. Tear levels of IL-6 and TNF-α were measured after collecting the patient's tears from the lower eyelid through the Schirmer I method using a filter paper (Schirmer tear test strip) without anesthesia. Findings: The mean levels of IL-6 and TNF-α were 26.77±8.16 and 34.58±9.82 in the control group and 103.22±51.94, and 183.76±54.61 in the case group, respectively, indicating a significant difference between two groups (p<0.05). In addition, there was a significant relationship between the severity of the keratoconus and the mean levels of TNF-α and IL-6 in the case group (p<0.05). Conclusion: According to the results, the mean levels of IL-6 and TNF-α were higher in keratoconus cases than in the controls, and the disease severity was significantly associated with the levels of inflammatory markers IL-6 and TNF-α.Keywords: keratoonus, cataract, tumor necrotic factor, interleukin 6
Procedia PDF Downloads 1210296 Full-Scale Test of a Causeway Embankment Supported by Raft-Aggregate Column Foundation on Soft Clay Deposit
Authors: Tri Harianto, Lawalenna Samang, St. Hijraini Nur, Arwin
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Recently, a port development is constructed in Makassar city, South Sulawesi Province, Indonesia. Makassar city is located in lowland area that dominated by soft marine clay deposit. A two kilometers causeway construction was built which is situated on the soft clay layer. In order to investigate the behavior of causeway embankment, a full-scale test was conducted of high embankment built on a soft clay deposit. The embankment with 3,5 m high was supported by two types of reinforcement such as raft and raft-aggregate column foundation. Since the ground was undergoing consolidation due to the preload, the raft and raft-aggregate column foundations were monitored in order to analyze the vertical ground movement by inducing the settlement of the foundation. In this study, two types of foundation (raft and raft-aggregate column) were tested to observe the effectiveness of raft-aggregate column compare to raft foundation in reducing the settlement. The settlement monitored during the construction stage by using the settlement plates, which is located in the center and toe of the embankment. Measurements were taken every day for each embankment construction stage (4 months). In addition, an analytical calculation was conducted in this study to compare the full-scale test result. The result shows that the raft-aggregate column foundation significantly reduces the settlement by 30% compared to the raft foundation. A raft-aggregate column foundation also reduced the time period of each loading stage. The Good agreement of analytical calculation compared to the full-scale test result also found in this study.Keywords: full-scale, preloading, raft-aggregate column, soft clay
Procedia PDF Downloads 30110295 Effect of Simulation on Anxiety and Knowledge among Novice Nursing Students
Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram
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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.Keywords: anxiety, knowledge, novice students, simulation
Procedia PDF Downloads 16010294 Sustainable Upgrade of Existing Heritage Infrastructure - Strengthening and Rehabilitation of The LH Ford Bridge
Authors: Vince Scolaro, Lakshman Prasad, Ted Polley, Sanjivan Deshpande
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The LH Ford Bridge, built in the 1960s, comprises 28 spans, is 800m long and crosses the Macquarie River at Dubbo, NSW. The main bridge spans comprise three spans with a 63m center span (25m drop-in section) supported by halving joints from the main cantilevers and back spans of 28m. The main bridge spans were built using complex construction staging (the first of this type in NSW). They comprise twin precast boxes, in-situ reinforced concrete infills, and cantilevered outriggers stressed both longitudinally and transversely. Since construction, this bridge has undergone significantly increased design vehicle loads and showed signs of excessive shrinkage and creep leading to significant sagging of the centre span with evidence of previous failure and remediation of the halving joints. A comprehensive load rating assessment was undertaken taking account of the original complex construction staging. Deficiencies identified included inadequate capacity of the halving joints, failure of the bearings at the halving joints, inadequate shear capacity of the girder webs and inadequate girder flexural capacity to carry B-Double design vehicles. A unique strengthening system comprising two new piers (under each of the halving joints), new bearings and installation of external prestressing to the soffit of both drop-in-span and back spans was adopted. A portion of the dead load had to be transferred from the superstructure to the new piers via innovative soft/stiff bearing combinations to reduce new locked-in stresses resulting from the new pier supports. Significant temporary works comprised a precast concrete shell beam forming the pile cap/pier structure, addition of a temporary suspended scaffold (without overstressing the existing superstructure) and the installation of jacking stays for new bearing top and bottom plates. This paper presents how this existing historic and socially important bridge was strengthened and updated to increase its design life without the need for replacement.Keywords: strengthening, creep, construction, box girder
Procedia PDF Downloads 14110293 Float Glass Manufacture Facility Design: Feasibility Study in Kuwait
Authors: Farah Al-Mutairi, Hadeer Al-Jeeraan, Lima Ali, Raya Al-Dabbous, Sarah Baroun
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Lately, within the middle east, development has taken place in the construction area which increased the demand of a crucial component, where without it; stunning views from skyscrapers cannot been experienced, and natural light would not be able to be viewed from an indoor building. Glass has changed the path of living and building. Float glass is a type of glass that is flat and it is the type used in the construction and automobile sector. Facility design on the other hand is a study that improves the efficiency utilization of people, equipment, material and space. Kuwait's governmental future developing plan bears in mind the need of increase in industries to increase the growth domestic product(GDP) of the country. This project studies the feasibility of two designs of a float glass manufacture in Kuwait. The first Alternative, consists of one production line of capacity 500 tons of glass per day. The second alternative, consists of three production lines, each of capacity 500 tons of glass daily.Keywords: float glass manufacture, Kuwait, feasibility float glass, facility design, float glass production
Procedia PDF Downloads 41410292 The Determination of Self-Esteem, Life Satisfaction, Anxiety and Depression Levels among Patients with Stoma
Authors: Tugba Cinarli, Tugba Kavalali Erdogan, Sevil Masat, Dilek Kiymaz, Nida Kiyici, Zeliha Koc
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This study was conducted in a descriptive and cross-sectional manner, in order to determine the self-esteem, life satisfaction and depression/anxiety levels of the patients with stoma. The study was conducted between June 15, 2016 and June 15, 2017 among 196 oncology patients that were hospitalized in the general surgery clinic of a public hospital in Turkey. The case group consisted of 98 cancer patients with stoma and the control group consisted of 98 cancer patients without stoma. The data were collected through the Coopersmith Self-Esteem Scale, Life Satisfaction Scale, the Hospital Anxiety and Depression Scale, and a 21-question survey that aimed to determine the sociodemographic and clinical properties of the patients. The data were analyzed with percentage analysis, Mann Whitney U-test, Chi-square test and Spearmen’s correlation test. It was determined that for the case group; 44.9% had colon cancer, 29.6% had rectal cancer; 50% underwent temporary colostomia, 15.3% underwent permanent colostomia, 34.7% underwent temporary ileostomy. The experimental group's findings for the Coopersmith Self-Esteem Scale, Life Satisfaction Scale, the Anxiety Subscale and the Depression subscale were 64 (20 - 84), 17 (5 - 38), 10 (1 - 18), and 9 (1 - 19), respectively. The control group's findings for the Coopersmith Self-Esteem Scale, Life Satisfaction Scale, the Anxiety Subscale and the Depression Subscale were 68 (32 - 92), 21 (7 - 31), 8.5 (1 - 18), and 8 (1 - 18), respectively. It was found that the Coopersmith Self-Esteem Scale, Life Satisfaction Scale, and the Anxiety Subscale findings were significantly different for the experimental and control groups (p<0.05). It was determined that the self-esteem levels were positively correlated with life satisfaction and negatively correlated with anxiety and depression; also, the life satisfaction levels were negatively correlated with anxiety and depression. It is suggested that the nursing interventions should be planned in order to improve life-satisfaction and self-esteem levels of the patients, and to decrease depression and anxiety.Keywords: anxiety, cancer, life satisfaction, self-esteem
Procedia PDF Downloads 17510291 Analysis of ZBTB17 Gene rs10927875 Polymorphism in Relation to Dilated Cardiomyopathy in Slovak Population
Authors: I. Boroňová, J. Bernasovská, J. Kmec, E. Petrejčíková
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Dilated cardiomyopathy (DCM) is a primary myocardial disease, it is characterized by progressive systolic dysfunction due to cardiac chamber dilatation and inefficient myocardial contractility with estimated prevalence of 37 in 100 000 people. It is the most frequent cause of heart failure and cardiac transplantation in young adults. About one-third of all patients have a suspected familial disease indicating a genetic basis of DCM. Many candidate gene studies in humans have tested the association of single nucleotide polymorphisms (SNPs) in various genes coding for proteins with a known cardiovascular function. In our study we present the results of ZBTB17 gene rs10927875 polymorphism genotyping in relation to dilated cardiomyopathy in Slovak population. The study included 78 individuals, 39 patients with DCM and 39 healthy control persons. The mean age of patients with DCM was 50.7±11.5 years; the mean age of individuals in control group was 51.3±9.8 years. Risk factors detected at baseline in each group included age, sex, body mass index, smoking status, diabetes and blood pressure. Genomic DNA was extracted from leukocytes by a standard methodology and screened for rs10927875 polymorphism in intron of ZBTB17 gene using Real-time PCR method (Step One Applied Biosystems). The distribution of investigated genotypes for rs10927875 polymorphism in the group of patients with DCM was as follows: CC (89.74%), CT (10.26%), TT (0%), and the distribution in the control group: CC (92.31%), CT (5.13%), and TT (2.56%). Using the chi-square (χ2) test we compared genotype and allele frequencies between patients and controls. There was no difference in genotype or allele frequencies in ZBTB17 gene rs10927875 polymorphism between patients and control group (χ2=3.028, p=0.220; χ2=0.264, p=0.608). Our results represent an initial study, it can be considered as preliminary and first of its kind in Slovak population. Further studies of ZBTB17 gene polymorphisms of more numerous files and additional functional investigations are needed to fully understand the role of genetic associations.Keywords: dilated cardiomyopathy, SNP polymorphism, ZBTB17 gene, bioscience
Procedia PDF Downloads 38510290 The Family as an Agent for Change in Aerobic Activity and Obesity in Grade 2-3 Schoolchildren
Authors: T. Goldstein, E. Serok, J. D. Kark
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Background and Aim: The prevalence of obesity is increasing worldwide and in Israel. To meet this challenge, our study tests a new educational approach through a controlled school-based trial to achieve an improvement in eating habits, aerobic activity, and reduced obesity in Grades 2-3. Methods and Design: A cluster randomized controlled trial allocated 4 elementary schools (3rd and 2nd-grade classes each) to intervention or control groups. This allocation was switched with the next cohort of children. Recruitment was in first grade, randomization at the beginning of second grade, evaluation of results at the end of second grade and the beginning of third grade — intervention: 5 joint parent-children classroom activities on health topics and 5 educational workshops for parents only. Alfred Adler's concepts were guiding principles. Subjects: Of 743 children in 23-second grade classes, parents provided informed consent for 508 (68%). Information of retention health habits continued for third grade. Additional parental approvals were required. Parents provided informed consent for third-grade follow-up for 432. Results: At the end of 2nd grade, the amount of aerobic activity increased in the intervention group in comparison with the control group, the difference being marginally statistically significant (p=0.061). There is a significant difference between the groups in the percentage of "no activity being done" reported at the end of second grade when in the experimental group, the percentage is lower than the control. There are differences between genders in the percentage of aerobic activity at the end of second grade (p=0.044) and in the third grade (p < 0.0001). Height increased significantly (p=0.030 ), and waist circumference declined significantly (p=0.021) in the intervention compared with the control group. There were no significant between-group differences in BMI and weight. Conclusion: There were encouraging changes in aerobic activity and in anthropometric measurements. To maintain changes over longer periods, refreshing these nutrition and activity themes annually in school using the model is required.Keywords: aerobic activity, child obesity, Alfred Adler, schoolchildren
Procedia PDF Downloads 15010289 Monoallelic and Biallelic Deletions of 13q14 in a Group of 36 CLL Patients Investigated by CGH Haematological Cancer and SNP Array (8x60K)
Authors: B. Grygalewicz, R. Woroniecka, J. Rygier, K. Borkowska, A. Labak, B. Nowakowska, B. Pienkowska-Grela
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Introduction: Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the Western world. Hemizygous and or homozygous loss at 13q14 occur in more than half of cases and constitute the most frequent chromosomal abnormality in CLL. It is believed that deletions 13q14 play a role in CLL pathogenesis. Two microRNA genes miR-15a and miR- 16-1 are targets of 13q14 deletions and plays a tumor suppressor role by targeting antiapoptotic BCL2 gene. Deletion size, as a single change detected in FISH analysis, has haprognostic significance. Patients with small deletions, without RB1 gene involvement, have the best prognosis and the longest overall survival time (OS 133 months). In patients with bigger deletion region, containing RB1 gene, prognosis drops to intermediate, like in patients with normal karyotype and without changes in FISH with overall survival 111 months. Aim: Precise delineation of 13q14 deletions regions in two groups of CLL patients, with mono- and biallelic deletions and qualifications of their prognostic significance. Methods: Detection of 13q14 deletions was performed by FISH analysis with CLL probe panel (D13S319, LAMP1, TP53, ATM, CEP-12). Accurate deletion size detection was performed by CGH Haematological Cancer and SNP array (8x60K). Results: Our investigated group of CLL patients with the 13q14 deletion, detected by FISH analysis, comprised two groups: 18 patients with monoallelic deletions and 18 patients with biallelic deletions. In FISH analysis, in the monoallelic group the range of cells with deletion, was 43% to 97%, while in biallelic group deletion was detected in 11% to 94% of cells. Microarray analysis revealed precise deletion regions. In the monoallelic group, the range of size was 348,12 Kb to 34,82 Mb, with median deletion size 7,93 Mb. In biallelic group discrepancy of total deletions, size was 135,27 Kb to 33,33 Mb, with median deletion size 2,52 Mb. The median size of smaller deletion regions on one copy chromosome 13 was 1,08 Mb while the average region of bigger deletion on the second chromosome 13 was 4,04 Mb. In the monoallelic group, in 8/18 deletion region covered RB1 gene. In the biallelic group, in 4/18 cases, revealed deletion on one copy of biallelic deletion and in 2/18 showed deletion of RB1 gene on both deleted 13q14 regions. All minimal deleted regions included miR-15a and miR-16-1 genes. Genetic results will be correlated with clinical data. Conclusions: Application of CGH microarrays technique in CLL allows accurately delineate the size of 13q14 deletion regions, what have a prognostic value. All deleted regions included miR15a and miR-16-1, what confirms the essential role of these genes in CLL pathogenesis. In our investigated groups of CLL patients with mono- and biallelic 13q14 deletions, patients with biallelic deletion presented smaller deletion sizes (2,52 Mb vs 7,93 Mb), what is connected with better prognosis.Keywords: CLL, deletion 13q14, CGH microarrays, SNP array
Procedia PDF Downloads 25710288 Design of the Ice Rink of the Future
Authors: Carine Muster, Prina Howald Erika
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Today's ice rinks are important energy consumers for the production and maintenance of ice. At the same time, users demand that the other rooms should be tempered or heated. The building complex must equally provide cooled and heated zones, which does not translate as carbon-zero ice rinks. The study provides an analysis of how the civil engineering sector can significantly impact minimizing greenhouse gas emissions and optimizing synergies across an entire ice rink complex. The analysis focused on three distinct aspects: the layout, including the volumetric layout of the premises present in an ice rink; the materials chosen that can potentially use the most ecological structural approach; and the construction methods based on innovative solutions to reduce carbon footprint. The first aspect shows that the organization of the interior volumes and defining the shape of the rink play a significant role. Its layout makes the use and operation of the premises as efficient as possible, thanks to the differentiation between heated and cooled volumes while optimising heat loss between the different rooms. The sprayed concrete method, which is still little known, proves that it is possible to achieve the strength of traditional concrete for the structural aspect of the load-bearing and non-load-bearing walls of the ice rink by using materials excavated from the construction site and providing a more ecological and sustainable solution. The installation of an empty sanitary space underneath the ice floor, making it independent of the rest of the structure, provides a natural insulating layer, preventing the transfer of cold to the rest of the structure and reducing energy losses. The addition of active pipes as part of the foundation of the ice floor, coupled with a suitable system, gives warmth in the winter and storage in the summer; this is all possible thanks to the natural heat in the ground. In conclusion, this study provides construction recommendations for future ice rinks with a significantly reduced energy demand, using some simple preliminary design concepts. By optimizing the layout, materials, and construction methods of ice rinks, the civil engineering sector can play a key role in reducing greenhouse gas emissions and promoting sustainability.Keywords: climate change, energy optimization, green building, sustainability
Procedia PDF Downloads 6910287 Comparison of Visual Acuity Outcome and Complication after Phacoemulsification between Diabetic and Non-Diabetic Patients at Burapha University Hospital, Chonburi, Thailand
Authors: Luksanaporn Krungkraipetch
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One hundred cataract patients with phacoemulsification were enrolled in the study to compare of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients at Burapha University Hospital, Chonburi, Thailand. Fifty patients were diabetic (type II) group and 50 patients were non-diabetic group. All cases were operated by one doctor with the same pre-operative care, operation (phacoemulsification), and post-operative care. Visual acuity and complication after surgery were assessed after the operation for two years. There were no significant differences in demographic data between the two groups. The visual outcome values ≥ 2 lines and ≥ 20/40 had no significant differences between two groups after two years of surgery. The complication rate in diabetic group had cystoid macular edema 16%, rupture posterior capsule 8%, posterior capsule opacity 2%, uveitis 2 %, and 2% endophthalmitis. The non-diabetic group had cystoid macular edema 12%, rupture posterior capsule 8%, uveitis 2%, posterior capsule opacity 2%, and 2% wound leak. Comparison of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients had no statistical significant differences between these two groups. It was found that cystoid macular edema was the most common complication in both groups and 10% of retinopathy progression was seen.Keywords: cataract, visual acuity, cataract extraction, phacoemulsification, diabetic retinopathy
Procedia PDF Downloads 35110286 A Case Study on the Long-Term Stability Monitoring of Underground Powerhouse Complex Using Geotechnical Instrumentation
Authors: Sudhakar Kadiyala, Sripad R. Naik
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Large cavern in Bhutan Himalayas is being monitored since the construction period. The behavior of the cavern is being monitored for last 16 years. Instrumentation includes measurement of convergence of high walls by geodetic monitoring, load on the support systems with load cells and instrumented bolts. Analysis of the results of instrumentation showed that during the construction period of the cavern, the convergence of the cavern varied from 181 - 233 mm in the unit bay area with maximum convergence rate of 2.80mm/day. Whereas during the operational period the total convergence observed was in the range of 21 to 45 mm during a period of 11.30 years with convergence rate of 0.005 to 0.011 mm/day. During the last five years, there were no instances of high tensile stress recorded by the instrumented bolts. Load on the rock bolts have shown stabilization trend at most of the locations. This paper discusses in detail the results of long-term monitoring using the geotechnical instruments and how the data is being used in 3D numerical model to confirm the stability of the cavern.Keywords: convergence, displacements, geodetic monitoring, long-term stability
Procedia PDF Downloads 18010285 Complications and Outcomes of Cochlear Implantation in Children Younger than 12 Months: A Multicenter Study
Authors: Alimohamad Asghari, Ahmad Daneshi, Mohammad Farhadi, Arash Bayat, Mohammad Ajalloueyan, Marjan Mirsalehi, Mohsen Rajati, Seyed Basir Hashemi, Nader Saki, Ali Omidvari
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Evidence suggests that Cochlear Implantation (CI) is a beneficial approach for auditory and speech skills improvement in children with severe to profound hearing loss. However, it remains controversial if implantation in children <12 months is safe and effective compared to older children. The present study aimed to determine whether children's ages affect surgical complications and auditory and speech development. The current multicenter study enrolled 86 children who underwent CI surgery at <12 months of age (group A) and 362 children who underwent implantation between 12 and 24 months of age (group B). The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were determined pre-impanation, and "one-year" and "two-year" post-implantation. Four complications (overall rate: 4.65%; three minor) occurred in group A and 12 complications (overall rate: 4.41%; nine minor) occurred in group B. We found no statistically significant difference in the complication rates between the groups (p>0.05). The mean SIR and CAP scores improved over time following CI activation in both groups. However, we did not find significant differences in CAP and SIR scores between the groups across different time points. Cochlear implantation is a safe and efficient procedure in children younger than 12 months, providing substantial auditory and speech benefits comparable to children undergoing implantation at 12 to 24 months of age. Furthermore, surgical complications in younger children are similar to those of children undergoing the CI at an older age.Keywords: cochlear implant, Infant, complications, outcome
Procedia PDF Downloads 11110284 Teacher’s Role in the Process of Identity Construction in Language Learners
Authors: Gaston Bacquet
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The purpose of this research is to explore how language and culture shape a learner’s identity as they immerse themselves in the world of second language learning and how teachers can assist in the process of identity construction within a classroom setting. The study will be conducted as an in-classroom ethnography, using a qualitative methods approach and analyzing students’ experiences as language learners, their degree of investment, inclusion/exclusion, and attitudes, both towards themselves and their social context; the research question the study will attempt to answer is: What kind of pedagogical interventions are needed to help language learners in the process of identity construction so they can offset unequal conditions of power and gain further social inclusion? The following methods will be used for data collection: i) Questionnaires to investigate learners’ attitudes and feelings in different areas divided into four strands: themselves, their classroom, learning English and their social context. ii) Participant observations, conducted in a naturalistic manner. iii) Journals, which will be used in two different ways: on the one hand, learners will keep semi-structured, solicited diaries to record specific events as requested by the researcher (event-contingent). On the other, the researcher will keep his journal to maintain a record of events and situations as they happen to reduce the risk of inaccuracies. iv) Person-centered interviews, which will be conducted at the end of the study to unearth data that might have been occluded or be unclear from the methods above. The interviews will aim at gaining further data on experiences, behaviors, values, opinions, feelings, knowledge and sensory, background and demographic information. This research seeks to understand issues of socio-cultural identities and thus make a significant contribution to knowledge in this area by investigating the type of pedagogical interventions needed to assist language learners in the process of identity construction to achieve further social inclusion. It will also have applied relevance for those working with diverse student groups, especially taking our present social context into consideration: we live in a highly mobile world, with migrants relocating to wealthier, more developed countries that pose their own particular set of challenges for these communities. This point is relevant because an individual’s insight and understanding of their own identity shape their relationship with the world and their ability to continue constructing this relationship. At the same time, because a relationship is influenced by power, the goal of this study is to help learners feel and become more empowered by increasing their linguistic capital, which we hope might result in a greater ability to integrate themselves socially. Exactly how this help will be provided will vary as data is unearthed through questionnaires, focus groups and the actual participant observations being carried out.Keywords: identity construction, second-language learning, investment, second-language culture, social inclusion
Procedia PDF Downloads 10510283 Partial Replacement for Cement and Coarse Aggregate in Concrete by Using Egg Shell Powder and Coconut Shell
Authors: A. K. Jain, M. C. Paliwal
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The production of cement leads to the emission of large amounts of carbon-dioxide gas into the atmosphere which is a major contributor for the greenhouse effect and the global warming; hence it is mandatory either to quest for another material or partly replace it with some other material. According to the practical demonstrations and reports, Egg Shell Powder (ESP) can be used as a binding material for different field applications as it contains some of the properties of lime. It can partially replace the cement and further; it can be used in different proportion for enhancing the performance of cement. It can be used as a first-class alternative, for material reuse and waste recycling practices. Eggshell is calcium rich and analogous to limestone in chemical composition. Therefore, use of eggshell waste for partial replacement of cement in concrete is feasible. Different studies reveal that plasticity index of the soil can be improved by adding eggshell wastes in all the clay soil and it has wider application in construction projects including earth canals and earthen dams. The scarcity of aggregates is also increasing nowadays. Utilization of industrial waste or secondary materials is increasing in different construction applications. Coconut shell was successfully used in the construction industry for partial or full replacement for coarse aggregates. The use of coconut shell gives advantage of using waste material to partially replace the coarse aggregate. Studies carried on coconut shell indicate that it can partially replace the aggregate. It has good strength and modulus properties along with the advantage of high lignin content. It absorbs relatively low moisture due to its low cellulose content. In the paper, study carried out on eggshell powder and coconut shell will be discussed. Optimum proportions of these materials to be used for partial replacement of cement and aggregate will also be discussed.Keywords: greenhouse, egg shell powder, binding material, aggregates, coconut shell, coarse aggregates
Procedia PDF Downloads 25710282 A Soil Stabilization Technique on Apa-Hotamiş Conveyance Channel
Authors: Ali Sinan Soğancı
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Apa-Hotamış conveyance channel is located within in the boundaries of Konya Regional Directorate of Water Works. This channel transfers the water to the fount of Apa Dam with 17 km length of Blue Channel. Then the water is transmitted with Apa- Hotamış conveyance channel to Hotamış Water Storage. In some places along the Apa-Hotamış conveyance canal which will be constructed by Directorate of Water Works of Konya, some swelling soils have been seen. The samples taken from these places have 35-95 kPa swelling pressure. To prevent the swelling pressure arising from the penetration of water to the concrete channel, it was proposed to make 10 cm concrete coating by spreading the geomembrane and geotextile between the soil and concrete. In this way, the pressure (35-95 kPa) caused by the swelling and cracking of concrete failure will be blocked.Keywords: conveyance channel, swelling pressure, geomembrane, geotextile, concrete
Procedia PDF Downloads 41410281 The Influence of Modernity and Globalization upon Language: The Korean Language between Confucianism and Americanization
Authors: Raluca-Ioana Antonescu
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The field research of the paper stands at the intersection between Linguistics and Sociology, while the problem of the research is the importance of language in the modernization process and in a globalized society. The research objective is to prove that language is a stimulant for modernity, while it defines the tradition and the culture of a specific society. In order to examine the linguistic change of the Korean language due to the modernity and globalization, the paper tries to answer one main question, What are the changes the Korean language underwent from a traditional version of Korean, towards one influenced by modernity?, and two secondary questions, How are explored in specialized literature the relations between globalization (and modernity) and culture (focusing on language)? and What influences the Korean language? For the purpose of answering the research questions, the paper has the main premise that due to modernity and globalization, the Korean language changed its discourse construction, and two secondary hypothesis, first is that in literature there are not much explored the relations between culture and modernity focusing on the language discourse construction, but more about identity issue and commodification problems, and the second hypothesis is that the Korean language is influenced by traditional values (like Confucianism) while receiving influence also of globalization process (especially from English language). In terms of methodology, the paper will analyze the two main influences upon the Korean language, referring to traditionalism (being defined as the influence of Confucianism) and modernism (as the influence of other countries’ language and culture), and how the Korean language it was constructed and modified due to these two elements. The paper will analyze at what level (grammatical, lexical, etc.) the traditionalism help at the construction of the Korean language, and what are the changes at each level that modernism brought along. As for the results of this research, the influence of modernism changed both lexically and grammatically the Korean language. In 60 years the increase of English influence is astonishing, and this paper shows the main changes the Korean language underwent, like the loanwords (Konglish), but also the reduction of the speech levels and the ease of the register variation use. Therefore the grammatical influence of modernity and globalization could be seen at the reduction of the speech level and register variation, while the lexical change comes with the influence of English language especially, where about 10% of the Korean vocabulary is considered to be loanwords. Also the paper presents the interrelation between traditionalism and modernity, with the example of Konglish, but not only (we can consider also the Korean greetings which are translated by Koreans when they speak in other languages, bringing their cultural characteristics in English discourse construction), which makes the Koreans global, since they speak in an international language, but still local since they cannot get rid completely of their culture.Keywords: Confucianism, globalization, language and linguistic change, modernism, traditionalism
Procedia PDF Downloads 20410280 Peer Group Approach: An Oral Health Intervention from Children for Children at Primary School in Klungkung, Bali, Indonesia
Authors: Regina Tedjasulaksana, Maria Martina Nahak, A. A. Gede Agung, Ni Made Widhiasti
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Strategic effort to realize the empowerment of community in school is through the peer group approach so that it needs to choose the students who are trained as the’ little dentist’ in order to have the cognitive and skills to participate in the school dental health effort (UKGS) program, such as providing oral health education to the other students. Aim: To assessed the effectiveness of peer group approach to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali. Methods: Experimental study using the pre-post test without control group design. The differences of knowledge levels, tooth brushing behavior and oral hygiene status (using PHP-M index) of 10 students before and after trained as the little dentists were analyzed using paired t-test. The correlations between knowledge level and tooth brushing behavior and correlations between tooth brushing behavior and oral hygiene before and after trained as the little dentists were analyzed using Spearman. Furthermore, the trained little dentists provide oral health education to 102 students of grade 1 to 5 at their school once a week for 3 months. The students’ knowledge level scores of each grade were taken every 21 days as many as three times The difference of it was analyzed using Repeated Measured. Result: The mean scores among all little dentists before and after training for each of knowledge level were each 63.05 + 5.62 and 85.00 + 7.81, tooth brushing behavior were each 31.00 + 14.49 and 100.00 + 0.00 and oral hygiene status using PHP-M index were each 32.80 + 10.17 and 11.40 + 8.01. The knowledge level, tooth brushing behavior and oral hygiene status of 10 students before and after trained as the little dentists were different significantly (p<0.05). Before and after trained as the little dentists it showed that significant correlations between knowledge level with tooth brushing behavior (p<0.05) and significant correlations between tooth brushing behavior and oral hygiene (p<0.05). The mean scores of knowledge level among all students before (pre-test) and after (post-test (1),(2),(3)) getting oral health education from little dentists for each, of grade 1 were 40.00 + 17.97; 67.85 + 18.88; 81.72 +26.48 and 70.00 + 22.87, grade 2 were 40.00 + 17.97; 67.85 + 18.88; 81.72 + 26.48 and 70.00 + 22.87, grade 3 were 65.83 + 23.94; 72.50 + 26.08; 80.41 + 24.93 and 83.75 + 19.74, grade 4 were 88.57 + 12.92; 90.71 + 9.97; 92.85 + 10.69 and 93.57 + 6.33 and grade 5 were 86.66 + 13.40; 93.33 + 9.16; 94.16 + 10.17 and 98.33 + 4.81. The students’ knowledge level of grade 1,2 and 3 before and after getting oral health education from little dentists showed significant different (p<0.05), meanwhile there was no significant different on grade 4 and 5 (p<0.05) although mean scores showed an increase. Conclusion: Peer group approach can be used to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali.Keywords: small dentists, oral health, peer group approach, school children
Procedia PDF Downloads 43110279 Effect of Inspiratory Muscle Training on Diaphragmatic Strength Following Coronary Revascularization
Authors: Abeer Ahmed Abdelhamed
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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange
Procedia PDF Downloads 30310278 Healthy and Smart Building Projects
Authors: Ali A. Karakhan
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Stakeholders in the architecture, engineering, and construction (AEC) industry have been always searching for strategies to develop, design, and construct healthy and smart building projects. Healthy and smart building projects require that the building process including design and construction be altered and carefully implemented in order to bring about sustainable outcomes throughout the facility lifecycle. Healthy and smart building projects are expected to positively influence organizational success and facility performance across the project lifecycle leading to superior outcomes in terms of people, economy, and the environment. The present study aims to identify potential strategies that AEC organizations can implement to achieve healthy and smart building projects. Drivers and barriers for healthy and smart building features are also examined. The study findings indicate that there are three strategies to advance the development of healthy and smart building projects: (1) the incorporation of high-quality products and low chemical-emitting materials, (2) the integration of innovative designs, methods, and practices, and (3) the adoption of smart technology throughout the facility lifecycle. Satisfying external demands, achievement of a third-party certification, obtaining financial incentives, and a desire to fulfill professional duty are identified as the key drivers for developing healthy and smart building features; whereas, lack of knowledge and training, time/cost constrains, preference for/adherence to customary practices, and unclear business case for why healthy buildings are advantageous are recognized as the primary barriers toward a wider diffusion of healthy and smart building projects. The present study grounded in previous engineering, medical, and public health research provides valuable technical and practical recommendations for facility owners and industry professionals interested in pursuing sustainable, yet healthy and smart building projects.Keywords: healthy buildings, smart construction, innovative designs, sustainable projects
Procedia PDF Downloads 16210277 Chinese Acupuncture: A Potential Treatment for Autism Rat Model via Improving Synaptic Function
Authors: Sijie Chen, Xiaofang Chen, Juan Wang, Yingying Zhang, Yu Hong, Wanyu Zhuang, Xinxin Huang, Ping Ou, Longsheng Huang
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Purpose: Autistic symptom improvement can be observed in children treated with acupuncture, but the mechanism is still being explored. In the present study, we used scalp acupuncture to treat autism rat model, and then their improvement in the abnormal behaviors and specific mechanisms behind were revealed by detecting animal behaviors, analyzing the RNA sequencing of the prefrontal cortex(PFC), and observing the ultrastructure of PFC neurons under the transmission electron microscope. Methods: On gestational day 12.5, Wistar rats were given valproic acid (VPA) by intraperitoneal injection, and their offspring were considered to be reliable rat models of autism. They were randomized to VPA or VPA-acupuncture group (n=8). Offspring of Wistar pregnant rats that were simultaneously injected with saline were randomly selected as the wild-type group (WT). VPA_acupuncture group rats received acupuncture intervention at 23 days of age for 4 weeks, and the other two groups followed without intervention. After the intervention, all experimental rats underwent behavioral tests. Immediately afterward, they were euthanized by cervical dislocation, and their prefrontal cortex was isolated for RNA sequencing and transmission electron microscopy. Results: The main results are as follows: 1. Animal behavioural tests: VPA group rats showed more anxiety-like behaviour and repetitive, stereotyped behaviour than WT group rats. While VPA group rats showed less spatial exploration ability, activity level, social interaction, and social novelty preference than WT group rats. It was gratifying to observe that acupuncture indeed improved these abnormal behaviors of autism rat model. 2. RNA-sequencing: The three groups of rats differed in the expression and enrichment pathways of multiple genes related to synaptic function, neural signal transduction, and circadian rhythm regulation. Our experiments indicated that acupuncture can alleviate the major symptoms of ASD by improving these neurological abnormalities. 3. Under the transmission electron microscopy, several lysosomes and mitochondrial structural abnormalities were observed in the prefrontal neurons of VPA group rats, which were manifested as atrophy of the mitochondrial membran, blurring or disappearance of the mitochondrial cristae, and even vacuolization. Moreover, the number of synapses and synaptic vesicles was relatively small. Conversely, the mitochondrial structure of rats in the WT group and VPA_acupuncture was normal, and the number of synapses and synaptic vesicles was relatively large. Conclusion: Acupuncture effectively improved the abnormal behaviors of autism rat model and the ultrastructure of the PFC neurons, which might worked by improving their abnormal synaptic function, synaptic plasticity and promoting neuronal signal transduction.Keywords: autism spectrum disorder, acupuncture, animal behavior, RNA sequencing, transmission electron microscope
Procedia PDF Downloads 4810276 Discerning of Antimicrobial Potential of Phenylpropanoic Acid Derived Oxadiazoles
Authors: Neeraj Kumar Fuloria, Shivkanya Fuloria, Amit Singh
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2-Phenyl propionic acid and oxadiazoles possess antimicrobial potential. 2-Phenyl propane hydrazide (1), on cyclization with aromatic acids offered 2-aryl-5-(1-phenylethyl)-1,3,4-oxadiazole derivatives (1A-E). The PPA derived oxadiazoles were characterized by elemental analysis and spectral studies. The compounds were screened for antimicrobial potential. The compound 1D bearing strong electron withdrawing group showed maximum antimicrobial potential. Other compounds also displayed antimicrobial potential to a certain extent. The SAR of newer oxadiazoles indicated that substitution of strong electronegative group in the PPA derived oxadiazoles enhanced their antimicrobial potential.Keywords: antimicrobial, imines, oxadiazoles, PPA
Procedia PDF Downloads 34310275 Effect of Family-Based DOTS Support Program on Adherence to Health Behaviors among Patients with Pulmonary Tuberculosis in Bandung, Indonesia
Authors: D. I. Yani, S. Isaramalai, C. Kritpracha
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Adherence to health behaviors is essential to achieve successful TB treatment. This study aimed to examine the effect of a family-based DOTS support program on adherence to health behaviors in patients with pulmonary TB. Sixty TB patients and their families were selected using cluster randomization of community health centers. The subjects were assigned into a control group, who received the routine care, and an experimental group, who received both routine care and care from the family-based DOTS support program. Paired t-test and the independent t-test were applied. The total score of adherence to health behaviors in the experimental group was significantly higher after receiving care from the family-based DOTS support program than the pretest score (t = -10.34, p < .001). Suggestions were made to expand the application of this program in various contexts and to extend knowledge for nursing practices and research.Keywords: self-care deficit nursing theory, family-based DOTS program, pulmonary tuberculosis, adherence, health behaviors
Procedia PDF Downloads 46510274 Detection of Bcl2 Polymorphism in Patient with Hepatocellular carcinoma
Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud
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Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis
Procedia PDF Downloads 50910273 Entropy Analysis in a Bubble Column Based on Ultrafast X-Ray Tomography Data
Authors: Stoyan Nedeltchev, Markus Schubert
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By means of the ultrafast X-ray tomography facility, data were obtained at different superficial gas velocities UG in a bubble column (0.1 m in ID) operated with an air-deionized water system at ambient conditions. Raw reconstructed images were treated by both the information entropy (IE) and the reconstruction entropy (RE) algorithms in order to identify the main transition velocities in a bubble column. The IE values exhibited two well-pronounced minima at UG=0.025 m/s and UG=0.085 m/s identifying the boundaries of the homogeneous, transition and heterogeneous regimes. The RE extracted from the central region of the column’s cross-section exhibited only one characteristic peak at UG=0.03 m/s, which was attributed to the transition from the homogeneous to the heterogeneous flow regime. This result implies that the transition regime is non-existent in the core of the column.Keywords: bubble column, ultrafast X-ray tomography, information entropy, reconstruction entropy
Procedia PDF Downloads 39510272 Role-Governed Categorization and Category Learning as a Result from Structural Alignment: The RoleMap Model
Authors: Yolina A. Petrova, Georgi I. Petkov
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The paper presents a symbolic model for category learning and categorization (called RoleMap). Unlike the other models which implement learning in a separate working mode, role-governed category learning and categorization emerge in RoleMap while it does its usual reasoning. The model is based on several basic mechanisms known as reflecting the sub-processes of analogy-making. It steps on the assumption that in their everyday life people constantly compare what they experience and what they know. Various commonalities between the incoming information (current experience) and the stored one (long-term memory) emerge from those comparisons. Some of those commonalities are considered to be highly important, and they are transformed into concepts for further use. This process denotes the category learning. When there is missing knowledge in the incoming information (i.e. the perceived object is still not recognized), the model makes anticipations about what is missing, based on the similar episodes from its long-term memory. Various such anticipations may emerge for different reasons. However, with time only one of them wins and is transformed into a category member. This process denotes the act of categorization.Keywords: analogy-making, categorization, category learning, cognitive modeling, role-governed categories
Procedia PDF Downloads 14410271 Development of Highly Repellent Silica Nanoparticles Treatment for Protection of Bio-Based Insulation Composite Material
Authors: Nadia Sid, Alan Taylor, Marion Bourebrab
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The construction sector is on the critical path to decarbonise the European economy by 2050. In order to achieve this objective it must enable reducing its CO2 emission by 90% and its energy consumption by as much as 50%. For this reason, a new class of low environmental impact construction materials named “eco-material” are becoming increasingly important in the struggle against climate change. A European funded collaborative project ISOBIO coordinated by TWI is aimed at taking a radical approach to the use of bio-based aggregates to create novel construction materials that are usable in high volume in using traditional methods, as well as developing markets such as exterior insulation of existing house stocks. The approach taken for this project is to use finely chopped material protected from bio-degradation through the use of functionalized silica nanoparticles. TWI is exploring the development of novel inorganic-organic hybrid nano-materials, to be applied as a surface treatment onto bio-based aggregates. These nanoparticles are synthesized by sol-gel processing and then functionalised with silanes to impart multifunctionality e.g. hydrophobicity, fire resistance and chemical bonding between the silica nanoparticles and the bio-based aggregates. This talk will illustrate the approach taken by TWI to design the functionalized silica nanoparticles by using a material-by-design approach. The formulation and synthesize process will be presented together with the challenges addressed by those hybrid nano-materials. The results obtained with regards to the water repellence and fire resistance will be displayed together with preliminary public results of the ISOBIO project. (This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 641927).Keywords: bio-sourced material, composite material, durable insulation panel, water repellent material
Procedia PDF Downloads 23810270 Static Balance in the Elderly: Comparison Between Elderly Performing Physical Activity and Fine Motor Coordination Activity
Authors: Andreia Guimaraes Farnese, Mateus Fernandes Reu Urban, Leandro Procopio, Renato Zangaro, Regiane Albertini
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Senescence changes include postural balance, inferring the risk of falls, and can lead to fractures, bedridden, and the risk of death. Physical activity, e.g., cardiovascular exercises, is notable for improving balance due to brain cell stimulations, but fine coordination exercises also elevate cell brain metabolism. This study aimed to verify whether the elderly person who performs fine motor activity has a balance similar to that of those who practice physical activity. The subjects were divided into three groups according to the activity practice: control group (CG) with seven participants for the sedentary individuals, motor coordination group (MCG) with six participants, and activity practitioner group (PAG) with eight participants. Data comparisons were from the Berg balance scale, Time up and Go test, and stabilometric analysis. Descriptive statistical and ANOVA analyses were performed for data analysis. The results reveal that including fine motor activities can improve the balance of the elderly and indirectly decrease the risk of falls.Keywords: balance, barapodometer, coordination, elderly
Procedia PDF Downloads 17210269 Efficiency of Nutritional Support Treatments in Children With Failure to Thrive
Authors: Mehves Isiklar Ekici, Ceyda Tuna Kirsaclioglu, Zarife Kuloglu, Aydan Kansu
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Malnutrition is an important cause of morbidity and mortality as it accounts for 45% of child deaths under the age of 5 worldwide. Therefore, early recognition and effective treatment of failure to thrive and malnutrition are important. In this study, it was aimed to retrospectively evaluate the nutritional support treatment approaches (nutrition education and diet enrichment / use of enteral nutrition products) applied in children followed up with growth failure without underlying organic causes, and to compare the efficacy of nutritional support treatments. In this study, children aged 1 month to 18 years diagnosed with growth failure who were followed up for at least 12 months between January 2011 and February 2020, were included. Anthropometric measurements at baseline and during follow-up, type of nutritional support therapy and treatment compliance were evaluated based on the retrospective records. 119 children (median age:3.2, 69 girls) were included in the study. Nutrition education and dietary enrichment were provided to 28% of the patients (Group 1). In addition to dietary education and recommendations, enteral nutrition supplements was given in 78% of them (Group 2). Compliance to the treatment rates of the patients in Group 1 and Group 2 were not significantly different at both 6th and 12th month controls. At the end of the follow up children who comply with the treatment in Group 1 had significant increase in weight for age z scores (-1.74 vs 0.05, respectively, p=0.019) and body mass index z scores (-1.47 vs -0.53, respectively, p=0.034) compared with baseline measurements. Similar to Group 1, in Group 2 children with treatment compliance, had a significant increase in weight for age z scores (-2.24 vs. -0.54, respectively, p=0.00) and body mass index z scores (-2.27 vs. -1.06, respectively, p=0.00) compared with baseline measurements. The rate of patients with severe malnutrition decreased from 15% to 12%, for moderate malnutrition decreased from 54% to 33%. Moreover, it was observed that this decrease in the rate of patients with both severe and moderate malnutrition was more prominent in patients under 3 years of age. Although there was a significant increase in anthropometric measurements with treatment in both groups, there was no significant difference in between two groups terms of change in anthropometric measurements (p>0.05), therefore effectiveness. Failure to thrive and malnutrition in infancy and childhood cause health problems that can affect adult life. To conclude, nutritional education - dietary enrichment. recommendations and use of enteral nutrition supplements were both proven beneficial in this study. Researchers are willing to underline that the most important part of the treatment is to include the family to the process to ensure the treatment compliance.Keywords: enteral nutrition supplements, failure to thrive, malnutrition, nutritional education
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