Search results for: diagnosis and treatment

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: Arnab Majumdar, Sanjoy Sadhukhan

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Although gun barrel steels are an important variety from defense view point, available literatures are very limited. In the present work, an IF grade Ni-Cr-Mo-V high strength low alloy steel is produced in Electric Earth Furnace-ESR Route. Ingot was hot forged to desired dimension with a reduction ratio of 70-75% followed by homogenization, hardening and tempering treatment. Sample chemistry, NMIR, macro and micro structural analyses were done. Mechanical properties which include tensile, impact, and fracture toughness were studied. Ultrasonic testing was done to identify internal flaws. The existing high strength low alloy Ni-Cr-Mo-V steel shows improved properties in modified processing route and heat treatment schedule in comparison to properties noted earlier for manufacturing of gun barrels. The improvement in properties seems to withstand higher explosive loads with the same amount of steel in gun barrel application.

Keywords: gun barrel steels, IF grade, chemistry, physical properties, thermal and mechanical processing, mechanical properties, ultrasonic testing

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Authors: Mariola Głowacka

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Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.

Keywords: cancer, shortness of breath, anxiety, senior, hospice

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Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.

Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression

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Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta

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Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.

Keywords: chronic periodontitis, atherosclerosis, risk factor, inflammatory markers

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Authors: Khosro Mohammadi

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In order to study the effect of different resources of farmyard manure, compost and biofertilizers on grain yield and quality of canola (Talaieh cultivar), an experiment was conducted at Kurdistan region. Experimental units were arranged in split-split plots design based on randomized complete blocks with three replications. Main plots consisted of two locations with difference in soil texture (L1): Agricultural Research Center of Sanandaj and (L2): Islamic Azad University of Sanandaj, as location levels. Also, five strategies for obtaining the base fertilizer requirement including (N1): farmyard manure; (N2): compost; (N3): chemical fertilizers; (N4): farm yard manure + compost and (N5): farm yard manure + compost + chemical fertilizers were considered in split plots. Four levels of biofertilizers were (B1): Bacillus lentus and Pseudomonas putida; (B2): Trichoderma harzianum; (B3): Bacillus lentus and Pseudomonas putida & Trichoderma harzianum; and (B4): control. Results showed that location, different resources of fertilizer and interactions of them have a significant effect on grain yield. The highest grain yield (4660 kg/ha) was obtained from treatment, that farmyard manure, compost and biofertilizers were co application in clay loam soil (Gerizeh station). Different methods of fertilization have a significant effect on leaf chlorophyll. Highest amount of chlorophyll (38 Spad) was obtained from co application of farmyard manure, chemical fertilizers and compost (N5 treatment). Location, basal fertilizers and biofertilizers have a significant effect on N, S and N/S of canola seed. Oil content was decreased in Gerizeh station, but oil yield had a significant increasing than Azad University station. Co application of compost and farmyard manure produced highest percent of oleic acid (61.5 %) and linoleic acid (22.9 %). Co application of compost and farmyard manure has a significant increase in oleic acid and linoleic acid. Finally, L1N5B3 treatment, that compost, farmyard manure and biofertilizers were co application in Gerizeh station in compare to other treatments, selected as a best treatment of experiment.

Keywords: soil texture, organic fertilizer, chemical fertilizer, oil, Canola

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Authors: Z. Hormozi Moghaddam, M. Mokhtari-Dizaji, M. Movahedin, M. E. Ravari

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Mechanical index (MI) is used for quantifying acoustic cavitation and the relationship between acoustic pressure and the frequency. In this study, modeling of the MI was applied to provide treatment protocol and to understand the effective physical processes on reproducibility of stem cells. The acoustic pressure and MI equations are modeled and solved to estimate optimal MI for 28, 40, 150 kHz and 1 MHz frequencies. Radial and axial acoustic pressure distribution was extracted. To validate the results of the modeling, the acoustic pressure in the water and near field depth was measured by a piston hydrophone. Results of modeling and experiments show that the model is consistent well to experimental results with 0.91 and 0.90 correlation of coefficient (p<0.05) for 1 MHz and 40 kHz. Low intensity ultrasound with 0.40 MI is more effective on the proliferation rate of the spermatogonial stem cells during the seven days of culture, in contrast, high MI has a harmful effect on the spermatogonial stem cells. This model provides proper treatment planning in vitro and in vivo by estimating the cavitation phenomenon.

Keywords: ultrasound, mechanical index, modeling, stem cell

Procedia PDF Downloads 321

Authors: Željka Rogač, Dejan Stevanović, Sara Bečanović, Ljubica Božić, Aleksandar Dimitrijević, Dragana Bogićević, Dimitrije Nikolić

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Children with epilepsy face changes in cognitive functioning, the appearance of symptoms of psychopathology and a decline in their quality of life. Factors related to epileptic seizures and the side effects of AEDs are considered to be potential causes of these changes.These changes can be prevented by prompt action, replacement of AEDs, psychological and psychiatric treatment, and social support. However, a review of literature has not yielded a conclusion as to when it is best to react, i.e., when changes in the functioning of children with newly-diagnosed epilepsy appears. The primary goal of this study was to investigate the impact of the most commonly used AEDs on cognitive status, behavior, anxiety and depression, as well as quality of life of children with newly-diagnosed epilepsy, during the first six months of treatment. This is a non-interventional, prospective study involving six-month monitoring of cognitive status, internalizing and externalizing symptoms, as well as quality of life of children with newly-diagnosed epilepsy, and the impact of antiepileptic drugs on these domains. Children with new-onset epilepsy and their parents, immediately after the introduction of antiepileptic drugs as well as six months later, filled out appropriate questionnaires (RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP). At the same time, a psychologist performed the psychological testing of the child (REVISK). At the very beginning of REVISK treatment, a reduced VIQ was established, while after six months there was a significant decrease in IQ, VIQ and especially PIQ, under the influence of primary cognitive potentials and the development of depressive symptoms. All scores of the RCADS and NCBFR questionnaires were significantly elevated after six months while internalizing and externalizing symptoms affected each other. The development of depressive symptoms was significantly influenced by AED. The scores of the CHEQOL25 and KIDSCREEN10 questionnaires were significantly reduced, influenced by the adverse effects of AED and quality of life at the start of treatment. Side effects of AEDs, were significantly associated with depressive symptoms and reduced quality of life and did not significantly affect cognitive decline, anxiety, ADHD, and behavioral disorders during the first six months.

Keywords: epilepsy, children, AEDs, cognition, behavior, ADHD, anxiety, depression, QOL

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Authors: C. A Osunla, A. I. Okoh

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Treated wastewater effluent has been found to encompass high levels of pollutants, including disease-causing bacteria such as Vibrio pathogens. The current study was designed to evaluate the physicochemical qualities and prevalence of Vibrio pathogens in treated effluents of two wastewater treatment plants (WWTP) in Eastern Cape Province, South Africa over the period of six months. Parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), and free chlorine; and these parameters were simultaneously monitored in the treated final effluents of the two wastewater treatment plants using standard methods. The ranges of values for the physicochemical are: pH (7.0–8.6), total dissolved solids (286.3–916.5 mg/L), electrical conductivity (572.57–1704.5 mS/m), temperature (10.3–28.6 °C), turbidity (4.02–43.20 NTU), free chlorine (0.00–0.19 mg/L), dissolve oxygen (2.06–6.32 mg/L) and biochemical oxygen demand (0.1–9.0 mg/L). The microbiological assessment for both WWTPs revealed the presence of Vibrio counts ranging between 0 and 8.76×104 CFU/100 mL. The obtained values of the measured parameters and Vibrio loads of the treated wastewater effluents were found outside the compliance levels of the South African guidelines and World Health Organization tolerance limits for effluents intended to be discharged into receiving waterbodies. Hence, we conclude that these WWTPs are important point sources of pollution in surface water with potential public health and ecological risks.

Keywords: effluents, public health, South Africa, Vibrio, wastewater

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Authors: Dolores Hidalgo, Jesús M. Martín-Marroquín, Francisco Corona

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Municipal waste consist of a variety of items that are everyday discarded by the population. They are usually collected by municipalities and include waste generated by households, commercial activities (local shops) and public buildings. The composition of municipal waste varies greatly from place to place, being mostly related to levels and patterns of consumption, rates of urbanization, lifestyles, and local or national waste management practices. Each year, a huge amount of resources is consumed in the EU, and according to that, also a huge amount of waste is produced. The environmental problems derived from the management and processing of these waste streams are well known, and include impacts on land, water and air. The situation in remote areas is even worst. Difficult access when climatic conditions are adverse, remoteness of centralized municipal treatment systems or dispersion of the population, are all factors that make remote areas a real municipal waste treatment challenge. Furthermore, the scope of the problem increases significantly because the total lack of awareness of the existing risks in this area together with the poor implementation of advanced culture on waste minimization and recycling responsibly. The aim of this work is to analyze the existing situation in remote areas in reference to the production of municipal waste and evaluate the efficiency of different management alternatives. Ideas for improving waste management in remote areas include, for example: the implementation of self-management systems for the organic fraction; establish door-to-door collection models; promote small-scale treatment facilities or adjust the rates of waste generation thereof.

Keywords: door to door collection, islands, isolated areas, municipal waste, remote areas, rural communities

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Tong-Chien Wu, Ching-Liang Hsieh, Yi-Wen Lin

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There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). Local EA can reliably attenuate inflammatory pain in mouse with unclear mechanisms. However, the effect of EA on distal and contralateral acupoint for pain control has been rarely studied and the result was controversial. Here in our study, we found that inflammatory hindpaw pain in mouth, which was induced by injecting the complete Freund’s adjuvant (CFA) 2 days ago can be alleviated immediately after 2Hz 15mins EA treatment at contralateral forefoot acupoint LI4 through both mechanic and thermal behavior test, while sham acupoint group is not. The efficacy was observed to be more obvious after the second round of EA treatment on the following day. This analgesic effect is produced by applying EA to a site remote from the painful area. The present study provides a powerful experimental animal model that can be used for investigating the unique physiological mechanisms involved in acupuncture analgesia.

Keywords: remote electroacupuncture, distal EA, pain control, anti-inflammation

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Authors: Laila Almulla, Narayana Bhat, Majda Suleiman, Sheena Jacob

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Biodiversity conservation has become one of the challenging priorities to combat species extinction for many countries, including the state of Kuwait. Since native plants are better adapted to the local environment, can endure long spells of drought, withstand high soil salinity levels and provide a more natural effect to landscape projects, their use will both conserve natural resources and produce sustainable greenery. When native plants are properly blended with naturalized exotic ornamental plants in a landscape, they can improve social and cultural benefits. Screening of exotic and native plants in Kuwait during the past two decades has led to the selection of some very promising plants. Continuation of evaluation of additional native and exotic plants is essential to increase diversity of plant resources for greenery projects. Therefore, an effort was made to evaluate further native plants for their suitability for greenery applications. In the present study, various treatments were used to mass multiply selected plants using seeds to secure maximum germination. Seeds were subjected to nine treatments, and each treatment was replicated five times with ten seeds per treatment unit. After the treatment, the seeds of Zygophyllum qatarense were incubated at 30 °C, three lights for 12 h, at 40% humidity; where as the seeds of Haloxylon salicornicum were incubated at 22 °C with continuous light, at 40% humidity. Soaking in 250-ppm GA3 resulted in highest germination percentage of 20% in Zygophyllum qatarense and, Soaking in 500-ppm GA3 resulted in 6% germination in Haloxylon salicornicum. Germination of the viable seeds is influenced by various external and internal factors, seed must not be in a state of dormancy and the environmental requirements for germination of that seed must be met, before germination can occur.

Keywords: landscape, native plants, revegetation, seed germination

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Authors: Mwenya Mubanga, Sula Mazimba

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Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

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Authors: Muhammad Al Rizqi Dharma Fauzi, Dwi Yulian Fahruddin Shah, Andre Pratama, Ari Hasna Widyapuspa, Ganden Supriyanto

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Diabetes mellitus is still known as one of diseases which give a big amount of death in the world. From 2012 to 2014, diabetes is estimated to have resulted in 1.5 to 4.9 million deaths each year. In this paper, we present our research in the analysis and dose determination of Tenebrio molitor (Mealworm) extract as an anti-diabetic agent which is believed by Indonesian people as a traditional treatment to prevent and treat diabetes. We found that Tenebrio molitor extract has a potential as an anti-diabetic agent by in vitro test to Mus musculus which were divided into six group of treatment. Our dose determination analysis gave a conclusion that at 2,5 g/mL of concentration of the extract would give the optimal result in healing a wound given to Mus musculus which were induced by aloxane monohydrate. These results show that Tenebrio molitor extract is potential to be used as an Anti-Diabetic agent.

Keywords: diabetes, extraction, Tenebrio molitor, traditional medicine

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Authors: Yann Jean Tan, Hui Meng Er, Choy Sin Lee, Shew Fung Wong, Wen Huei Lim

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Griseofulvin is a long standing fungistatic agent against dermatophytosis. Nevertheless, it has several drawbacks such as poor and highly variable bio availability, long duration of treatment, systemic side effects and drug interactions. Targeted treatment for the superficial skin infection, dermatophytosis via topical route could be beneficial. Nevertheless, griseofulvin is only available in the form of oral preparation. Hence, it generates interest in developing a topical formulation for griseofulvin, by using lipid nano particle as the vehicle. Lipid nanoparticle is a submicron colloidal carrier with a core that is solid in nature (lipid). It has combined advantages of various traditional carriers and is a promising vehicle for topical delivery. The griseofulvin loaded lipid nano particles produced using high pressure homogenization method were characterized and investigated for its skin targeting effect in vitro. It has a mean particle size of 179.8±4.9 nm with polydispersity index of 0.306±0.011. Besides, it showed higher skin permeation and better skin targeting effect compared to the griseofulvin suspension.

Keywords: lipid nanoparticles, griseofulvin, topical, dermatophytosis

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Niloofar Bahramian, Mohammad Atai, Mohammad Reza Naimi-Jamal

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Rule of mixtures is the simple analytical model is used to predict various properties of composites before design. The aim of this study was to demonstrate the benefits and limitations of the Rule-of-Mixtures (ROM) for predicting bending modulus of a continuous and unidirectional fiber reinforced composites using in dental applications. The Composites were fabricated from light curing resin (with and without silica nanoparticles) and modified and non-modified fibers. Composite samples were divided into eight groups with ten specimens for each group. The bending modulus (flexural modulus) of samples was determined from the slope of the initial linear region of stress-strain curve on 2mm×2mm×25mm specimens with different designs: fibers corona treatment time (0s, 5s, 7s), fibers silane treatment (0%wt, 2%wt), fibers volume fraction (41%, 33%, 25%) and nanoparticles incorporation in resin (0%wt, 10%wt, 15%wt). To study the fiber and matrix interface after fracture, single edge notch beam (SENB) method and scanning electron microscope (SEM) were used. SEM also was used to show the nanoparticles dispersion in resin. Experimental results of bending modulus for composites made of both physical (corona) and chemical (silane) treated fibers were in reasonable agreement with linear ROM estimates, but untreated fibers or non-optimized treated fibers and poor nanoparticles dispersion did not correlate as well with ROM results. This study shows that the ROM is useful to predict the mechanical behavior of unidirectional dental composites but fiber-resin interface and quality of nanoparticles dispersion play important role in ROM accurate predictions.

Keywords: bending modulus, fiber reinforced composite, fiber treatment, rule-of-mixtures

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Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka

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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.

Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman

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Authors: Rifda Naufalin, Nurul Latifasari, Siti Nuryanti, Muna Ridha Hanifah

Abstract:

Kecombrang is a Zingiberaceae plant which has antioxidant properties. The high antioxidant content in kecombrang flowers has the potential to be processed as a functional beverage raw material so that it can be used as an ingredient in making herbal teas. The purpose of this study was to determine the chemical components, physicochemistry, antioxidant activity and sensory characteristics of kecombrang tea. The research methodology was carried out by using a completely randomized design with processing factors of kecombrang tea namely blanching and non-blanching, fermentation and non-fermentation, and the optimal time for drying kecombrang tea. The best treatment combination based on the effective index method is the treatment of the blanching process followed by drying at a temperature of 50ᵒC until the 2% moisture content can produce kecombrang tea with a total phenol content of 5.95 mg Tannic Acid Equivalent (TAE) / gram db, total flavonoid 3%, pH 4.5, and antioxidant activity 82.95%, red color, distinctive aroma of tea, fresh taste, and preferred by panelists.

Keywords: kecombrang tea, blanching, fermentation, total phenol, and antioxidant activity

Procedia PDF Downloads 129

Authors: B. Bergström, A. Ladd, A. Jones, L. Rosso, P. Michael

Abstract:

Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.

Keywords: exposure therapy, evidence based practice, manualized treatments, student attitudes

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Authors: Preeti Makkar, R. C. Agarwala, Vijaya Agarwala

Abstract:

The present study focuses on the preparation of Al2O3 nanoparticles by top down approach i.e. mechanical milling using high energy planetary ball mill at 250 rpm for 40h. The milled Al2O3 nanoparticles are then used as the second phase to develop electroless (EL) Ni-P- Al2O3 nanocomposite coatings on mild steel substrate. An alkaline bath was used with a suspension of Al2O3 particles (4 g/L) for the synthesis of Ni-P-Al2O3 nanocomposite coating. The surface morphology, size range and phase analysis of as-prepared Al2O3 particles and the coatings were characterized using X-ray diffraction (XRD) and field emission scanning electron microscopy (FESEM). The coatings were heat treated at 400°C for 1h in argon atmosphere and the hardness of the nanocomposite coatings was investigated with respect to Ni-P before and after heat treatment. The results showed that as milled Al2O3 nanoparticles exhibit irregular shaped and size ranges around 40-45 nm. The Al2O3 particles are uniformly distributed in Ni-P matrix. The microhardness of the coatings is found to be significantly improved after heat treatment (1126 VHN).

Keywords: Electroless (EL), Ni-P-Al2O3, nanocomposite, mechanical milling, microhardness

Procedia PDF Downloads 269

Authors: Lakshmi Sujeesh, Aaron Ramzeen, Ricky Ziming Guo, Abhishek Agrawal

Abstract:

Introduction: Range of motion (ROM) is often measured by physiotherapists using hand-held goniometer as part of mobility assessment for diagnosis. Due to the nature of hand-held goniometer measurement procedure, readings often tend to have some variations depending on the physical therapist taking the measurements (Riddle et al.). This study aims to validate computer vision software readings against goniometric measurements for quick and consistent ROM measurements to be taken by clinicians. The use of this computer vision software hopes to improve the future of musculoskeletal space with more efficient diagnosis from recording of patient’s ROM with minimal human error across different physical therapists. Methods: Using the hand-held long arm goniometer measurements as the “gold-standard”, healthy study participants (n = 20) were made to perform 4 exercises: Front elevation, Abduction, Internal Rotation, and External Rotation, using both arms. Assessment of active ROM using computer vision software at different angles set by goniometer for each exercise was done. Interclass Correlation Coefficient (ICC) using 2-way random effects model, Box-Whisker plots, and Root Mean Square error (RMSE) were used to find the degree of correlation and absolute error measured between set and recorded angles across the repeated trials by the same rater. Results: ICC (2,1) values for all 4 exercises are above 0.9, indicating excellent reliability. Lowest overall RMSE was for external rotation (5.67°) and highest for front elevation (8.00°). Box-whisker plots showed have showed that there is a potential zero error in the measurements done by the computer vision software for abduction, where absolute error for measurements taken at 0 degree are shifted away from the ideal 0 line, with its lowest recorded error being 8°. Conclusion: Our results indicate that the use of computer vision software is valid and reliable to use in clinical settings by physiotherapists for measuring shoulder ROM. Overall, computer vision helps improve accessibility to quality care provided for individual patients, with the ability to assess ROM for their condition at home throughout a full cycle of musculoskeletal care (American Academy of Orthopaedic Surgeons) without the need for a trained therapist.

Keywords: physiotherapy, frozen shoulder, joint range of motion, computer vision

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Authors: Igna Brajevic-Gizdic, Magda Pletikosa Pavić

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Introduction: Research in opiate addiction is increasingly indicating the importance of substitution therapy in opiate addicts. Opiate addiction is a chronic relapsing disease that includes craving as a criterion. Craving has been considered a predictor of a relapse, which is defined as a strong desire with an excessive need to take a substance. The study aimed to measure the intensity of craving using the VAS (visual analog scale) in opioid addicts taking Opioid Substitution Therapy (OST). Method: The total sample compromised of 30 participants in outpatient treatment. Two groups of opiate addicts were considered: Methadone-maintenance and buprenorphine-maintenance addicts. The participants completed the survey questionnaire during the outpatient treatment. Results: The results indicated high levels of cravings in patients during the treatment of OST, which is considered an important destabilization factor in abstinence. Thus, the use of methadone/buprenorphine dose should be considered. Conclusion: These findings provided an objective measurement of methadone /buprenorphine dosage and therapy options. The underdoes of OST can put patients at high risk of relapse, resulting in high levels of craving. Thus, when determining the therapeutic dose of OST, it is crucial to consider patients' cravings. This would achieve stabilization more quickly and avoid relapse in abstinence. Subjective physician assessment and patients' statement are the main criteria to determine OST dosage. Future studies should use larger sample sizes and focus on the importance of intensity craving measurement on OST to objectify methadone /buprenorphine dosage.

Keywords: buprenorphine, craving, heroin addicts, methadone, OST

Procedia PDF Downloads 74

Authors: Miraz Hafiz Rossy

Abstract:

As part of planning to address shortfalls in fresh water supply for the world, Sea water can be a huge source of fresh water. But Desalinating sea water to get fresh water could require a lots of fossil fuels. To save the fossil fuel in terms of save the green world but meet the up growing need for fresh water, a very useful but energy efficient method needs to be introduced. Vacuum desalination of sea water using only the Renewable energy can be an effective solution to this issue. Taking advantage of sensitivity of water's boiling point to air pressure a vacuum desalination water treatment plant can be designed which would only use sea water as feed water and solar energy as fuel to produce fresh drinking water. The study indicates that reducing the air pressure to a certain value water can be boiled at very low temperature. Using solar energy to provide the condensation and the vacuum creation would be very useful and efficient. Compared to existing resources, desalination is considered to be expensive, but using only renewable energy the cost can be reduced significantly. Despite its very few drawbacks, it can be considered a possible solution to the world's fresh water shortages.

Keywords: desalination, scarcity of fresh water, water purification, water treatment

Procedia PDF Downloads 371

Authors: Olusola Omolola Olafuyi, Michael Coleman, Raj Kumar Singh Badhan

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Introduction: Malaria in pregnancy has morbidity and mortality implication on both mother and unborn child. Piperaquine (PQ) based antimalarial treatment is emerging as a choice antimalarial for pregnant women in the face of resistance to current antimalarial treatment recommendation in pregnancy. Physiological and biochemical changes in pregnant women may affect the pharmacokinetics of the antimalarial drug in these. In malaria endemic regions other infectious diseases like HIV/AIDs are prevalent. Pregnant women who are co-infected with malaria and HIV/AID are at even more greater risk of death not only due to complications of the diseases but also due to drug-drug interactions (DDIs) between antimalarials (AMT) and antiretroviral (ARVs). In this study, physiologically based pharmacokinetic (PBPK) modelling was used to investigate the effect of physiological and biochemical changes on the impact of ARV mediated DDIs in pregnant women in three countries. Method: A PBPK model for PQ was developed on SimCYP® using published physicochemical and pharmacokinetic data of PQ from literature, this was validated in three customized population groups from Thailand, Sudan and Papua New Guinea with clinical data. Validation of PQ model was also done in presence of interaction with efavirenz (pre-validated on SimCYP®). Different albumin levels and pregnancy stages was simulated in the presence of interaction with standard doses of efavirenz and ritonavir. PQ day 7 concentration of 30ng/ml was used as the efficacy endpoint for PQ treatment.. Results: The median day 7 concentration of PQ remained virtually consistent throughout pregnancy and were satisfactory across the three population groups ranging from 26-34.1ng/ml; this implied the efficacy of PQ throughout pregnancy. DDI interaction with ritonavir and efavirenz resulted in modest effect on the day 7 concentrations of PQ with AUCratio ranging from 0.56-0.8 and 1.64-1.79 for efavirenz and ritonavir respectively over 10-40 gestational weeks, however, a reduction in human serum albumin level reflective of severe malaria resulted in significantly reduced the number of subjects attaining the PQ day 7 concentration in the presence of both DDIs. The model demonstrated that the DDI between PQ and ARV in pregnant women with different malaria severities can alter the pharmacokinetic of PQ.

Keywords: antiretroviral, malaria, piperaquine, pregnancy, physiologically-based pharmacokinetics

Procedia PDF Downloads 168

Authors: Tella Toluwani, Adegbegi Ademuyiwa, Musei Chiedu, Adekunle Odola, Ayangbenro Ayansina, Adaramoye Oluwatosin

Abstract:

Dithiocarbamates are very useful biological agents with antioxidant properties. Diclofenac (DIC) is a non-steroidal analgesic, anti-inflammatory, and antipyretic agent. The use of diclofenac has been linked with reproductive toxicity/damage. The purpose of this study is (i) To investigate the therapeutic potential of diisopropyldithiocarbamate sodium salt (Na(i-Pr₂dtc)) and vitamin E (VIT E) against diclofenac induced toxicity in the testes of male Wistar rats. (ii) To investigate the effect of (Na(i-Pr₂dtc)) and vitamin E on ameliorating damage done to the testes through histological analysis of the testes. Thirty-six (36) male Wistar rats were used for the experiment, they were divided into six (6) groups, the animals in group 1 served as control, animals in groups 2, 3, 4, 5 and 6 received DIC only, DIC and (Na(i-Pr₂dtc)), DIC and VIT E, (Na(i-Pr₂dtc) only and VIT E only respectively. A single dose of 100 mg/kg body weight of DIC was administered to male Wistar rats, while 30 mg/kg body weight of (Na(i-Pr₂dtc)) was used to treat both normal and DIC treated animals, control animals were treated with the vehicle, after 24 hrs of treatment the animals were euthanized and the testes were removed for analysis. The treatment of rats with Na(i-Pr₂dtc) significantly restored catalase (CAT) activity depressed by diclofenac. (Na(i-Pr₂dtc)) also restored glutathione levels reduced by DIC treatment and this was also accompanied by reduced lipid peroxidation (LPO) level. VIT E significantly restored superoxide dismutase (SOD) activity when compared with DIC only treated animals. Photomicrographs of testes from (Na(i-Pr₂dtc)) treated rats showed seminiferous epithelium with no lesions. We conclude that (Na(i-Pr₂dtc)) has an antioxidant effect, which might be related to the dose and duration of administration.

Keywords: diisopropyldithiocarbamate sodium salt, diclofenac, vitamin E, testes

Procedia PDF Downloads 173

Authors: D. P. Rahardja, M. Rahman Hakim, V. Sri Lestari

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An experiment was conducted to elucidate the effects of turmeric powder supplementation on egg production performance of old laying hens (104 weeks of age). There were 40 hens of Hysex Brown strain used in the study. They were caged individually, and randomly divided into 4 treatment groups of diet containing 0 (control), 1, 2 and 4 % oven dried turmeric powder for 3 periods of 4 weeks; Egg production (% hen day) and feed intake of the 4 treatment groups at the commencement of the experiment were not significantly different. In addition to egg production performance (%HD and egg weight), feed and water intakes were measured daily. The results indicated that feed intakes of the hen were significantly lowered when 4% turmeric powder supplemented, while there were no significant changes in water intakes. Egg production (%HD) were significantly increased and maintained at a higher level by turmeric powder supplementation up to 4% compared with the control, while the weight of eggs were not significantly affected. The research markedly demonstrated that supplementation of turmeric powder up to 4% could improve and maintain egg production performance of the old laying hen.

Keywords: curcumin, feed and water intake, old laying hen, egg production

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Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

Procedia PDF Downloads 105

Authors: Kaarthik K., Harshini S., Karthika M., Kripanandhini T.

Abstract:

Water is an essential part of living organisms. Major water pollution is caused due to contamination of industrial wastewater in the river. The most important step in bringing wastewater contaminants down to levels that are safe for nature is wastewater treatment. The contamination of river water harms both humans who consume it and the aquatic life that lives there. We introduce a new cloud-based industrial IoT paradigm in this work for real-time control and monitoring of wastewater. The proposed system prevents prohibited entry of industrial wastewater into the plant by monitoring temperature, hydrogen power (pH), CO₂ and turbidity factors from the wastewater input that the wastewater treatment facility will process. Real-time sensor values are collected and uploaded to the cloud by the system using an IoT Wi-Fi Module. By doing so, we can prevent the contamination of industrial wastewater entering the river earlier, and the necessary actions will be taken by the users. The proposed system's results are 90% efficient, preventing water pollution due to industry and protecting human lives.

Keywords: sensors, pH, CO₂, temperature, turbidity

Procedia PDF Downloads 96