Search results for: hyper infarction or post stroke region
6906 Animation: A Footpath for Enhanced Awareness Creation on Malaria Prevention in Rural Communities
Authors: Stephen Osei Akyiaw, Divine Kwabena Atta Kyere-Owusu
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Malaria has been a worldwide menace of a health condition to human beings for several decades with majority of people on the African continent with most causalities where Ghana is no exception. Therefore, this study employed the use of animation to enhance awareness creation on the spread and prevention of Malaria in Effutu Communities in the Central Region of Ghana. Working with the interpretivist paradigm, this study adopted Art-Based Research, where the AIDA Model and Cognitive Theory of Multimedia Learning (CTML) served as the theories underpinning the study. Purposive and convenience sampling techniques were employed in selecting sample for the study. The data collection instruments included document review and interviews. Besides, the study developed an animation using the local language of the people as the voice over to foster proper understanding by the rural community folks. Also, indigenous characters were used for the animation for the purpose of familiarization with the local folks. The animation was publicized at Health Town Halls within the communities. The outcomes of the study demonstrated that the use of animation was effective in enhancing the awareness creation for preventing and controlling malaria disease in rural communities in Effutu Communities in the Central Region of Ghana. Health officers and community folks expressed interest and desire to practice the preventive measures outlined in the animation to help reduce the spread of Malaria in their communities. The study, therefore, recommended that animation could be used to curtail the spread and enhanced the prevention of Malaria.Keywords: malaria, animation, prevention, communities
Procedia PDF Downloads 876905 Efficacy of Biofeedback-Assisted Pelvic Floor Muscle Training on Postoperative Stress Urinary Incontinence
Authors: Asmaa M. El-Bandrawy, Afaf M. Botla, Ghada E. El-Refaye, Hassan O. Ghareeb
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Background: Urinary incontinence is a common problem among adults. Its incidence increases with age and it is more frequent in women. Pelvic floor muscle training (PFMT) is the first-line therapy in the treatment of pelvic floor dysfunction (PFD) either alone or combined with biofeedback-assisted PFMT. The aim of the work: The purpose of this study is to evaluate the efficacy of biofeedback-assisted PFMT in postoperative stress urinary incontinence. Settings and Design: A single blind controlled trial design was. Methods and Material: This study was carried out in 30 volunteer patients diagnosed as severe degree of stress urinary incontinence and they were admitted to surgical treatment. They were divided randomly into two equal groups: (Group A) consisted of 15 patients who had been treated with post-operative biofeedback-assisted PFMT and home exercise program (Group B) consisted of 15 patients who had been treated with home exercise program only. Assessment of all patients in both groups (A) and (B) was carried out before and after the treatment program by measuring intra-vaginal pressure in addition to the visual analog scale. Results: At the end of the treatment program, there was a highly statistically significant difference between group (A) and group (B) in the intra-vaginal pressure and the visual analog scale favoring the group (A). Conclusion: biofeedback-assisted PFMT is an effective method for the symptomatic relief of post-operative female stress urinary incontinence.Keywords: stress urinary incontinence, pelvic floor muscles, pelvic floor exercises, biofeedback
Procedia PDF Downloads 3086904 Analysis of Epileptic Electroencephalogram Using Detrended Fluctuation and Recurrence Plots
Authors: Mrinalini Ranjan, Sudheesh Chethil
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Epilepsy is a common neurological disorder characterised by the recurrence of seizures. Electroencephalogram (EEG) signals are complex biomedical signals which exhibit nonlinear and nonstationary behavior. We use two methods 1) Detrended Fluctuation Analysis (DFA) and 2) Recurrence Plots (RP) to capture this complex behavior of EEG signals. DFA considers fluctuation from local linear trends. Scale invariance of these signals is well captured in the multifractal characterisation using detrended fluctuation analysis (DFA). Analysis of long-range correlations is vital for understanding the dynamics of EEG signals. Correlation properties in the EEG signal are quantified by the calculation of a scaling exponent. We report the existence of two scaling behaviours in the epileptic EEG signals which quantify short and long-range correlations. To illustrate this, we perform DFA on extant ictal (seizure) and interictal (seizure free) datasets of different patients in different channels. We compute the short term and long scaling exponents and report a decrease in short range scaling exponent during seizure as compared to pre-seizure and a subsequent increase during post-seizure period, while the long-term scaling exponent shows an increase during seizure activity. Our calculation of long-term scaling exponent yields a value between 0.5 and 1, thus pointing to power law behaviour of long-range temporal correlations (LRTC). We perform this analysis for multiple channels and report similar behaviour. We find an increase in the long-term scaling exponent during seizure in all channels, which we attribute to an increase in persistent LRTC during seizure. The magnitude of the scaling exponent and its distribution in different channels can help in better identification of areas in brain most affected during seizure activity. The nature of epileptic seizures varies from patient-to-patient. To illustrate this, we report an increase in long-term scaling exponent for some patients which is also complemented by the recurrence plots (RP). RP is a graph that shows the time index of recurrence of a dynamical state. We perform Recurrence Quantitative analysis (RQA) and calculate RQA parameters like diagonal length, entropy, recurrence, determinism, etc. for ictal and interictal datasets. We find that the RQA parameters increase during seizure activity, indicating a transition. We observe that RQA parameters are higher during seizure period as compared to post seizure values, whereas for some patients post seizure values exceeded those during seizure. We attribute this to varying nature of seizure in different patients indicating a different route or mechanism during the transition. Our results can help in better understanding of the characterisation of epileptic EEG signals from a nonlinear analysis.Keywords: detrended fluctuation, epilepsy, long range correlations, recurrence plots
Procedia PDF Downloads 1766903 The Effect of Development of Two-Phase Flow Regimes on the Stability of Gas Lift Systems
Authors: Khalid. M. O. Elmabrok, M. L. Burby, G. G. Nasr
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Flow instability during gas lift operation is caused by three major phenomena – the density wave oscillation, the casing heading pressure and the flow perturbation within the two-phase flow region. This paper focuses on the causes and the effect of flow instability during gas lift operation and suggests ways to control it in order to maximise productivity during gas lift operations. A laboratory-scale two-phase flow system to study the effects of flow perturbation was designed and built. The apparatus is comprised of a 2 m long by 66 mm ID transparent PVC pipe with air injection point situated at 0.1 m above the base of the pipe. This is the point where stabilised bubbles were visibly clear after injection. Air is injected into the water filled transparent pipe at different flow rates and pressures. The behavior of the different sizes of the bubbles generated within the two-phase region was captured using a digital camera and the images were analysed using the advanced image processing package. It was observed that the average maximum bubbles sizes increased with the increase in the length of the vertical pipe column from 29.72 to 47 mm. The increase in air injection pressure from 0.5 to 3 bars increased the bubble sizes from 29.72 mm to 44.17 mm and then decreasing when the pressure reaches 4 bars. It was observed that at higher bubble velocity of 6.7 m/s, larger diameter bubbles coalesce and burst due to high agitation and collision with each other. This collapse of the bubbles causes pressure drop and reverse flow within two phase flow and is the main cause of the flow instability phenomena.Keywords: gas lift instability, bubbles forming, bubbles collapsing, image processing
Procedia PDF Downloads 4206902 A Systematic Review of Efficacy and Safety of Radiofrequency Ablation in Patients with Spinal Metastases
Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton
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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review
Procedia PDF Downloads 1736901 To Compare the Visual Outcome, Safety and Efficacy of Phacoemulsification and Small-Incision Cataract Surgery (SICS) at CEITC, Bangladesh
Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam
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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS
Procedia PDF Downloads 3486900 Polycystic Ovary Syndrome: Cervical Cytology Features and Its Association with Endometrial Cancer
Authors: Faezah Shekh Abdullah, Mohd. Azizuddin Mohd. Yussof, Komathy Thiagarajan, Hasnoorina Husin, Noor Azreena Abd Aziz
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Polycystic ovary syndrome has been associated with multiple disorders such as endocrine disorder, metabolic syndrome, infertility, and endometrial cancer. Women with polycystic ovary syndrome (PCOS) are anticipated to develop three times more chances for endometrial cancer than women without PCOS. This study, therefore, was conducted to determine the association between polycystic ovary syndrome and endometrial cancer and to determine the cervical cytology features of PCOS. Patients attending the Subfertility Clinic of the National Population and Family Development Board were recruited and examined physically by medical practitioners. They were categorized into two groups; i) the PCOS group if they met Rotterdam Criteria 2004 and ii) the control group if they did not meet Rotterdam Criteria 2004. Cervical sampling was done on all patients via the Liquid-Based Cytology (LBC) method in the pre-and post-subfertility treatment. A total of 167 patients participated in the study, of which 79 belonged to the PCOS group and 88 to the control group. The findings showed no cervical and endometrial cancer cases in both groups. The Liquid-Based Cytology results in the PCOS group displayed more cases with cellular changes, i.e., benign inflammation, atrophic smear and Candida sp. infection. To conclude, no association was found between polycystic ovary syndrome and endometrial cancer. A more holistic study with a higher number of participants can further determine the association between endometrial cancer and PCOS. Furthermore, a longer duration between LBC pre- and post-subfertility treatment should be implied to observe changes in the cervical cells.Keywords: endometrial cancer, liquid-based cytology, PCOS, polycystic ovary syndrome
Procedia PDF Downloads 1446899 Implementation of Knowledge and Attitude Management Based on Holistic Approach in Andragogy Learning, as an Effort to Solve the Environmental Problems of Post-Coal Mining Activity
Authors: Aloysius Hardoko, Susilo
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The root cause of the problem after the environmental damage due to coal mining activities defined as the province of East Kalimantan corridor masterplan economic activity accelerated the expansion of Indonesia's economic development (MP3EI) is the behavior of adults. Adult behavior can be changed through knowledge management and attitude. Based on the root of the problem, the objective of the research is to apply knowledge management and attitude based on holistic approach in learning andragogy as an effort to solve environmental problems after coal mining activities. Research methods to achieve the objective of using quantitative research with pretest postes group design. Knowledge management and attitudes based on a holistic approach in adult learning are applied through initial learning activities, core and case-based cover of environmental damage. The research instrument is a description of the case of environmental damage. The data analysis uses t-test to see the effect of knowledge management attitude based on holistic approach before and after adult learning. Location and sample of representative research of adults as many as 20 people in Kutai Kertanegara District, one of the districts in East Kalimantan province, which suffered the worst environmental damage. The conclusion of the research result is the application of knowledge management and attitude in adult learning influence to adult knowledge and attitude to overcome environmental problem post-coal mining activity.Keywords: knowledge management and attitude, holistic approach, andragogy learning, environmental Issue
Procedia PDF Downloads 2076898 Management of Caverno-Venous Leakage: A Series of 133 Patients with Symptoms, Hemodynamic Workup, and Results of Surgery
Authors: Allaire Eric, Hauet Pascal, Floresco Jean, Beley Sebastien, Sussman Helene, Virag Ronald
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Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction.Keywords: erectile dysfunction, cavernovenous leakage, surgery, embolization, treatment, result, complications, penile duplex sonography
Procedia PDF Downloads 1506897 The Strategies to Develop Post-Disaster Multi-Mode Transportation System from the Perspective of Traffic Resilience
Authors: Yuxiao Jiang, Lingjun Meng, Mengyu Zhan, Lichunyi Zhang, Yingxia Yun
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On August 8th of 2015, a serious explosion occurred in Binhai New Area of Tianjin. This explosion led to the suspension of Tianjin-Binhai Light Rail Line 9 which was an important transportation mean connecting the old and new urban areas and the suspension causes inconvenience to commuters traveling from Tianjin to Binhai or Binhai to Tianjin and residents living by Line 9. On this regard, this paper intends to give suggestions on how to develop multi-mode transportation system rapidly and effectively after a disaster and tackle with the problems in terms of transportation infrastructure facilities. The paper proposes the idea of traffic resilience which refers to the city’s ability to restore its transportation system and reduce risks when the transportation system is destroyed by a disaster. By doing questionnaire research, on the spot study and collecting data from the internet, a GIS model is established so as to analyze the alternative traffic means used by different types of residents and study the transportation supply and demand. The result shows that along the Line 9, there is a larger demand for alternative traffic means in the place which is nearer to the downtown area. Also, the distribution of bus stations is more reasonable in the place nearer to downtown area, however, the traffic speed in the area is slower. Based on traffic resilience, the paper raises strategies to develop post-disaster multi-mode transportation system such as establishing traffic management mechanism timely and effectively, building multi-mode traffic networks, improving intelligent traffic systems and so on.Keywords: traffic resilience, multi-mode transportation system, public traffic, transportation demand
Procedia PDF Downloads 3486896 Measuring Entrepreneurial Success through Specific Sustainable Development Goals by Linking Entrepreneurship Attitude and Intentions
Authors: Mohit Taneja, Ravi Kiran, S. C. Bose
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Entrepreneurs’ role in achieving Sustainable development goals is crucial as the growth potential of any region depends upon the number and the success rate of entrepreneurial firms. This paper is an effort to examine the relationship between Sustainable growth (SG) with Entrepreneurial attitude (EA) and Entrepreneurial intention (EI) in the context of the Indian economy. The mediation effect of EI between EA and SG has been considered. Partial least square (PLS) –Structural Equation Model (SEM) software was used to design the framework. Students enrolled in entrepreneurship courses of higher educational institutes (HEI) of Punjab, Haryana, and the National Capital Region NCR were contacted for data collection. The National Institutional Ranking Framework (NIRF) framework was used in selecting HEIs and data collected from 589 students was considered for analysis. McGee’s multi-dimensional scale for measuring ESE and the scale of Linan & Chen for measuring EI & ES (SG) was used. Results highlight that EA has a strong impact on EI (p≤ 0.001) and EI has a positive and strong relationship with SG (ES) as β value for the same is 0.683 (p≤ 0.001). The current study also reflects the mediating effect of EI among EA and ES, as the results show that the combined β value of both EA and EI (i.e.0.684*0.683= 0.467) is more than the direct influence of EA on ES (β=0.265). EA, with the mediating effect of EI can enhance the opportunity for achieving SG, which suggests that in order to increase the venture success rate and to attain SG, emphasis should be given to EI along with EA. The study has been investigated in three regions of India. Future studies can be extended to other South Asian countries for generalization.Keywords: entrepreneurship, sustainable growth, entrepreneurship intention, entrepreneurship attitude
Procedia PDF Downloads 956895 An Economic and Technological Analysis of Green Hydrogen Production for the Toulouse-Blagnac Airport
Authors: Badr Eddine Lebrouhi, Melissa Lopez Viveros, Silvia De Los Santos, Kolthoum Missaoui, Pamela Ramirez Vidal
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Since the Paris Climate Agreement, numerous countries, including France, have committed to achieving carbon neutrality by 2050 by enhancing renewable energy capacity and decarbonizing various sectors, including aviation. In this way, the Occitanie region aspires to become a renewable energy pioneer and has focused on Toulouse's Blagnac airport—a prominent hub characterized by high-energy demands. As part of a holistic strategy to reduce the airport's energy dependency, green hydrogen has emerged as a promising alternative fuel, offering the potential to significantly enhance aviation's environmental sustainability. This study assesses the technical and economic aspects of green hydrogen production, particularly its potential to replace fossil kerosene in aviation at Toulouse-Blagnac airport. It analyzes future liquid hydrogen fuel demand, calculates energy requirements for electrolysis and liquefaction, considers diverse renewable energy scenarios, and assesses the Levelized Cost of Hydrogen (LCOH) for economic viability. The research also projects LCOH evolution from 2023 to 2050, offering a comprehensive view of green hydrogen's feasibility as a sustainable aviation fuel, aligning with the region's renewable energy and sustainable aviation objectives.Keywords: Toulouse-Blagnac Airport, green hydrogen, aviation decarbonization, electrolysis, renewable energy, technical-economic feasibility
Procedia PDF Downloads 646894 The History Of Mental Health In The Middle East: Analytical Literature Review
Authors: Mohamad Musa
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The history of mental health practices and services in the Middle East region has been deeply intertwined with its rich cultural, religious, and societal context. Tracing back to ancient times, mental health approaches were heavily influenced by the traditions of major monotheistic religions, with a strong emphasis on spiritual and traditional healing methods. As psychiatric institutions and Western medicine gradually gained a foothold in the region during the 20th century, a notable shift occurred. However, the integration of Western psychiatric practices faced significant challenges due to cultural barriers and deeply rooted beliefs. Families and communities often turned to traditional healers and religious practices as their initial recourse for mental health concerns, viewing Western interventions with skepticism and hesitation. Historically, mental health services in the Middle East have been overshadowed by a focus on physical health and the biomedical model. Mental illness carried substantial stigma, with individuals and families often reluctant to disclose mental health struggles due to fears of societal ostracization and discrimination. This stigma posed a significant barrier to accessing and accepting formal mental health support. Later in the 20th century, governments in the Middle East began recognizing the need for modernizing mental health services and integrating them into the broader healthcare system. However, this process was hindered by several factors, including limited resources, inadequate training for healthcare professionals, and ongoing conflicts and instability in certain regions, which disrupted the delivery of mental health services. As the 21st century progressed, several Middle Eastern nations, particularly those in the Arabian Gulf region, began implementing national mental health strategies and legislative reforms to address the growing need for comprehensive mental health care. These efforts aimed to destigmatize mental illness, protect the rights of individuals with mental health conditions, and promote public awareness and education. Despite these positive developments, the historical legacy of stigma, cultural barriers, and limited resources continues to pose challenges in the provision of accessible and culturally responsive mental health services across the diverse populations of the Middle East.Keywords: mental health, history, middle east, literature review
Procedia PDF Downloads 326893 Psychosocial Determinants of School Violent Behavior and the Efficacy of Covert Sensitization in Combination with Systematic approach Therapy among Male Students in Lagos Metropolis: Implications for Student Counselors
Authors: Fidel O. Okopi, Aminu Kazeem Ibrahim
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The study investigated psychosocial determinants ‘attitudes and self-esteem’ of school violent behaviors and the efficacy of covert sensitization therapy in combination with systematic approach therapy among male students in Lagos metropolis. Ex-post facto experimental research design was adopted for the study. The samples consisted of 39 school violent behavior students identified through the School Disciplinary Record Books and another 39 non-school violent behavior students identified through randomization. The two groups were from four randomly selected Public Senior Secondary Schools. School Violent Behavior Attitudes Scale (SVBAS) and School Violent Behavior Self-Esteem Scale (SVBSES) were used to collect data for the study. Face and Content validity with the Reliability coefficient of 0.772 for SVBAS and 0.813 for SVBSES were obtained. The results showed that the attitude of school violent behavior students do not significantly differ from that of school non-violent behavior students; the self-esteem of school violent behavior students differs significantly from that of school non-violent behavior students and that Covert Sensitization therapy in combination with Systematic Approach therapy were effective in modifying the self-esteem and attitude of school violent behavior students as surf iced in the pre-test and post-test analysis of school violent behavior students’ responses. The School counselors can modify male school violent behaviors that are traced to attitude and self-esteem with Covert Sensitization therapy in combination with Systematic Approach therapy in metropolitan areas.Keywords: psychosocial determinants, violent behavior, covert sensitization therapy, systematic approach therapy
Procedia PDF Downloads 3976892 A Case Study of Building Behavior Damaged during 26th Oct, 2015 Earthquake in Northern Areas of Pakistan
Authors: Rahmat Ali, Amjad Naseer, Abid A. Shah
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This paper is an attempt to presents the performance of building observed during 26th Oct, 2015 earthquake in District Swat and Shangla region. Most of the buildings in the earthquake hit areas were built with Rubble stone masonry, dress Stone Masonry, brick masonry with and without RC column, Brick masonry with RC beams and column, Block Masonry with and without RC column. It was found that most of the buildings were built without proper supervision and without following any codes. A majority of load bearing masonry walls were highly affected during the earthquake. The load bearing walls built with rubble stone masonry were collapsed resulting huge damages and loss of property and life. Load bearing bricks masonry walls were also affected in most of the region. In some residential buildings the bricks were crushed in a single brick walls. Severe cracks were also found in double brick masonry walls. In RC frame structure beams and columns were also seriously affected. A majority of building structures were non-engineered. Some buildings designed by unskilled local consultants were also affected during the earthquake. Several architectural and structural mistakes were also found in various buildings designed by local consultant. It was found that the structures were collapsed prematurely either because of unskillful labor and using substandard materials or avoiding delicate repair, maintenance, and health monitoring activities because of lack of available sophisticated technology in our country.Keywords: cracks, collapse, earthquake, masonry, repair
Procedia PDF Downloads 4926891 Design and Construction of a Device to Facilitate the Stretching of a Plantiflexors Muscles in the Therapy of Rehabilitation for Patients with Spastic Hemiplegia
Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez
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Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching
Procedia PDF Downloads 1666890 Analyzing Growth Trends of the Built Area in the Precincts of Various Types of Tourist Attractions in India: 2D and 3D Analysis
Authors: Yarra Sulina, Nunna Tagore Sai Priya, Ankhi Banerjee
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With the rapid growth in tourist arrivals, there has been a huge demand for the growth of infrastructure in the destinations. With the increasing preference of tourists to stay near attractions, there has been a considerable change in the land use around tourist sites. However, with the inclusion of certain regulations and guidelines provided by the authorities based on the nature of tourism activity and geographical constraints, the pattern of growth of built form is different for various tourist sites. Therefore, this study explores the patterns of growth of built-up for a decade from 2009 to 2019 through two-dimensional and three-dimensional analysis. Land use maps are created through supervised classification of satellite images obtained from LANDSAT 4-5 and LANDSAT 8 for 2009 and 2019, respectively. The overall expansion of the built-up area in the region is analyzed in relation to the distance from the city's geographical center and the tourism-related growth regions are identified which are influenced by the proximity of tourist attractions. The primary tourist sites of various destinations with different geographical characteristics and tourism activities, that have undergone a significant increase in built-up area and are occupied with tourism-related infrastructure are selected for further study. Proximity analysis of the tourism-related growth sites is carried out to delineate the influence zone of the tourist site in a destination. Further, a temporal analysis of volumetric growth of built form is carried out to understand the morphology of the tourist precincts over time. The Digital Surface Model (DSM) and Digital Terrain Model (DTM) are used to extract the building footprints along with building height. Factors such as building height, and building density are evaluated to understand the patterns of three-dimensional growth of the built area in the region. The study also explores the underlying reasons for such changes in built form around various tourist sites and predicts the impact of such growth patterns in the region. The building height and building density around tourist site creates a huge impact on the appeal of the destination. The surroundings that are incompatible with the theme of the tourist site have a negative impact on the attractiveness of the destination that leads to negative feedback by the tourists, which is not a sustainable form of development. Therefore, proper spatial measures are necessary in terms of area and volume of the built environment for a healthy and sustainable environment around the tourist sites in the destination.Keywords: sustainable tourism, growth patterns, land-use changes, 3-dimensional analysis of built-up area
Procedia PDF Downloads 786889 Implementing 3D Printing for 3D Digital Modeling in the Classroom
Authors: Saritdikhun Somasa
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3D printing fabrication has empowered many artists in many fields. Artists who work in stop motion, 3D modeling, toy design, product design, sculpture, and fine arts become one-stop shop operations–where they can design, prototype, and distribute their designs for commercial or fine art purposes. The author has developed a digital sculpting course that fosters digital software, peripheral hardware, and 3D printing with traditional sculpting concept techniques to address the complexities of this multifaceted process, allowing the students to produce complex 3d-printed work. The author will detail the preparation and planning for pre- to post-process 3D printing elements, including software, materials, space, equipment, tools, and schedule consideration for small to medium figurine design statues in a semester-long class. In addition, the author provides insight into teaching challenges in the non-studio space that requires students to work intensively on post-printed models to assemble parts, finish, and refine the 3D printed surface. Even though this paper focuses on the 3D printing processes and techniques for small to medium design statue projects for the Digital Media program, the author hopes the paper will benefit other fields of study such as craft practices, product design, and fine-arts programs. Other schools that might implement 3D printing and fabrication in their programs will find helpful information in this paper, such as a teaching plan, choices of equipment and materials, adaptation for non-studio spaces, and putting together a complete and well-resolved project for students.Keywords: 3D digital modeling, 3D digital sculpting, 3D modeling, 3D printing, 3D digital fabrication
Procedia PDF Downloads 1046888 Analysis study According Some of Physical and Mechanical Variables for Joint Wrist Injury
Authors: Nabeel Abdulkadhim Athab
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The purpose of this research is to conduct a comparative study according analysis of programmed to some of physical and mechanical variables for joint wrist injury. As it can be through this research to distinguish between the amount of variation in the work of the joint after sample underwent rehabilitation program to improve the effectiveness of the joint and naturally restore its effectiveness. Supposed researcher that there is statistically significant differences between the results of the tests pre and post the members research sample, as a result of submission the sample to the program of rehabilitation, which led to the development of muscle activity that are working on wrist joint and this is what led to note the differences between the results of the tests pre and post. The researcher used the descriptive method. The research sample included (6) of injured players in the wrist joint, as the average age (21.68) and standard deviation (1.13) either length average (178cm) and standard deviation (2.08). And the sample as evidenced homogeneous among themselves. And where the data were collected, introduced in program for statistical processing to get to the most important conclusions and recommendations and that the most important: 1-The commitment of the sample program the qualifying process variables studied in the search for the heterogeneity of study activity and effectiveness of wrist joint for injured players. 2-The analysis programmed a high accuracy in the measurement of the research variables, and which led to the possibility of discrimination into account differences in motor ability camel and injured in the wrist joint. To search recommendations including: 1-The use of computer systems in the scientific research for the possibility of obtaining accurate research results. 2-Programming exercises rehabilitation according to an expert system for possible use by patients without reference to the person processor.Keywords: analysis of joint wrist injury, physical and mechanical variables, wrist joint, wrist injury
Procedia PDF Downloads 4316887 Design of a Permanent Magnet Based Focusing Lens for a Miniature Klystron
Authors: Kumud Singh, Janvin Itteera, Priti Ukarde, Sanjay Malhotra, P. PMarathe, Ayan Bandyopadhay, Rakesh Meena, Vikram Rawat, L. M. Joshi
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Application of Permanent magnet technology to high frequency miniature klystron tubes to be utilized for space applications improves the efficiency and operational reliability of these tubes. But nevertheless the task of generating magnetic focusing forces to eliminate beam divergence once the beam crosses the electrostatic focusing regime and enters the drift region in the RF section of the tube throws several challenges. Building a high quality magnet focusing lens to meet beam optics requirement in cathode gun and RF interaction region is considered to be one of the critical issues for these high frequency miniature tubes. In this paper, electromagnetic design and particle trajectory studies in combined electric and magnetic field for optimizing the magnetic circuit using 3D finite element method (FEM) analysis software is presented. A rectangular configuration of the magnet was constructed to accommodate apertures for input and output waveguide sections and facilitate coupling of electromagnetic fields into the input klystron cavity and out from output klystron cavity through coupling loops. Prototype lenses have been built and have been tested after integration with the klystron tube. We discuss the design requirements and challenges, and the results from beam transmission of the prototype lens.Keywords: beam transmission, Brillouin, confined flow, miniature klystron
Procedia PDF Downloads 4466886 Study on Heat Transfer Capacity Limits of Heat Pipe with Working Fluids Ammonia and Water
Authors: M. Heydari, A. Ghanami
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Heat pipe is simple heat transfer device which combines the conduction and phase change phenomena to control the heat transfer without any need for external power source. At hot surface of heat pipe, the liquid phase absorbs heat and changes to vapor phase. The vapor phase flows to condenser region and with the loss of heat changes to liquid phase. Due to gravitational force the liquid phase flows to evaporator section. In HVAC systems the working fluid is chosen based on the operating temperature. The heat pipe has significant capability to reduce the humidity in HVAC systems. Each HVAC system which uses heater, humidifier or dryer is a suitable nominate for the utilization of heat pipes. Generally heat pipes have three main sections: condenser, adiabatic region, and evaporator. Performance investigation and optimization of heat pipes operation in order to increase their efficiency is crucial. In the present article, a parametric study is performed to improve the heat pipe performance. Therefore, the heat capacity of heat pipe with respect to geometrical and confining parameters is investigated. For the better observation of heat pipe operation in HVAC systems, a CFD simulation in Eulerian- Eulerian multiphase approach is also performed. The results show that heat pipe heat transfer capacity is higher for water as working fluid with the operating temperature of 340 K. It is also showed that the vertical orientation of heat pipe enhances it’s heat transfer capacity.used in the abstract.Keywords: heat pipe, HVAC system, grooved heat pipe, heat pipe limits
Procedia PDF Downloads 4006885 Backward-Facing Step Measurements at Different Reynolds Numbers Using Acoustic Doppler Velocimetry
Authors: Maria Amelia V. C. Araujo, Billy J. Araujo, Brian Greenwood
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The flow over a backward-facing step is characterized by the presence of flow separation, recirculation and reattachment, for a simple geometry. This type of fluid behaviour takes place in many practical engineering applications, hence the reason for being investigated. Historically, fluid flows over a backward-facing step have been examined in many experiments using a variety of measuring techniques such as laser Doppler velocimetry (LDV), hot-wire anemometry, particle image velocimetry or hot-film sensors. However, some of these techniques cannot conveniently be used in separated flows or are too complicated and expensive. In this work, the applicability of the acoustic Doppler velocimetry (ADV) technique is investigated to such type of flows, at various Reynolds numbers corresponding to different flow regimes. The use of this measuring technique in separated flows is very difficult to find in literature. Besides, most of the situations where the Reynolds number effect is evaluated in separated flows are in numerical modelling. The ADV technique has the advantage in providing nearly non-invasive measurements, which is important in resolving turbulence. The ADV Nortek Vectrino+ was used to characterize the flow, in a recirculating laboratory flume, at various Reynolds Numbers (Reh = 3738, 5452, 7908 and 17388) based on the step height (h), in order to capture different flow regimes, and the results compared to those obtained using other measuring techniques. To compare results with other researchers, the step height, expansion ratio and the positions upstream and downstream the step were reproduced. The post-processing of the AVD records was performed using a customized numerical code, which implements several filtering techniques. Subsequently, the Vectrino noise level was evaluated by computing the power spectral density for the stream-wise horizontal velocity component. The normalized mean stream-wise velocity profiles, skin-friction coefficients and reattachment lengths were obtained for each Reh. Turbulent kinetic energy, Reynolds shear stresses and normal Reynolds stresses were determined for Reh = 7908. An uncertainty analysis was carried out, for the measured variables, using the moving block bootstrap technique. Low noise levels were obtained after implementing the post-processing techniques, showing their effectiveness. Besides, the errors obtained in the uncertainty analysis were relatively low, in general. For Reh = 7908, the normalized mean stream-wise velocity and turbulence profiles were compared directly with those acquired by other researchers using the LDV technique and a good agreement was found. The ADV technique proved to be able to characterize the flow properly over a backward-facing step, although additional caution should be taken for measurements very close to the bottom. The ADV measurements showed reliable results regarding: a) the stream-wise velocity profiles; b) the turbulent shear stress; c) the reattachment length; d) the identification of the transition from transitional to turbulent flows. Despite being a relatively inexpensive technique, acoustic Doppler velocimetry can be used with confidence in separated flows and thus very useful for numerical model validation. However, it is very important to perform adequate post-processing of the acquired data, to obtain low noise levels, thus decreasing the uncertainty.Keywords: ADV, experimental data, multiple Reynolds number, post-processing
Procedia PDF Downloads 1486884 How to Talk about It without Talking about It: Cognitive Processing Therapy Offers Trauma Symptom Relief without Violating Cultural Norms
Authors: Anne Giles
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Humans naturally wish they could forget traumatic experiences. To help prevent future harm, however, the human brain has evolved to retain data about experiences of threat, alarm, or violation. When given compassionate support and assistance with thinking helpfully and realistically about traumatic events, most people can adjust to experiencing hardships, albeit with residual sad, unfortunate memories. Persistent, recurrent, intrusive memories, difficulty sleeping, emotion dysregulation, and avoidance of reminders, however, may be symptoms of Post-traumatic Stress Disorder (PTSD). Brain scans show that PTSD affects brain functioning. We currently have no physical means of restoring the system of brain structures and functions involved with PTSD. Medications may ease some symptoms but not others. However, forms of "talk therapy" with cognitive components have been found by researchers to reduce, even resolve, a broad spectrum of trauma symptoms. Many cultures have taboos against talking about hardships. Individuals may present themselves to mental health care professionals with severe, disabling trauma symptoms but, because of cultural norms, be unable to speak about them. In China, for example, relationship expectations may include the belief, "Bad things happening in the family should stay in the family (jiāchǒu bùkě wàiyán 家丑不可外扬)." The concept of "family (jiā 家)" may include partnerships, close and extended families, communities, companies, and the nation itself. In contrast to many trauma therapies, Cognitive Processing Therapy (CPT) for Post-traumatic Stress Disorder asks its participants to focus not on "what" happened but on "why" they think the trauma(s) occurred. The question "why" activates and exercises cognitive functioning. Brain scans of individuals with PTSD reveal executive functioning portions of the brain inadequately active, with emotion centers overly active. CPT conceptualizes PTSD as a network of cognitive distortions that keep an individual "stuck" in this under-functioning and over-functioning dynamic. Through asking participants forms of the question "why," plus offering a protocol for examining answers and relinquishing unhelpful beliefs, CPT assists individuals in consciously reactivating the cognitive, executive functions of their brains, thus restoring normal functioning and reducing distressing trauma symptoms. The culturally sensitive components of CPT that allow people to "talk about it without talking about it" may offer the possibility for worldwide relief from symptoms of trauma.Keywords: cognitive processing therapy (CPT), cultural norms, post-traumatic stress disorder (PTSD), trauma recovery
Procedia PDF Downloads 2136883 Application of Alumina-Aerogel in Post-Combustion CO₂ Capture: Optimization by Response Surface Methodology
Authors: S. Toufigh Bararpour, Davood Karami, Nader Mahinpey
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Dependence of global economics on fossil fuels has led to a large growth in the emission of greenhouse gases (GHGs). Among the various GHGs, carbon dioxide is the main contributor to the greenhouse effect due to its huge emission amount. To mitigate the threatening effect of CO₂, carbon capture and sequestration (CCS) technologies have been studied widely in recent years. For the combustion processes, three main CO₂ capture techniques have been proposed such as post-combustion, pre-combustion and oxyfuel combustion. Post-combustion is the most commonly used CO₂ capture process as it can be readily retrofit into the existing power plants. Multiple advantages have been reported for the post-combustion by solid sorbents such as high CO₂ selectivity, high adsorption capacity, and low required regeneration energy. Chemical adsorption of CO₂ over alkali-metal-based solid sorbents such as K₂CO₃ is a promising method for the selective capture of diluted CO₂ from the huge amount of nitrogen existing in the flue gas. To improve the CO₂ capture performance, K₂CO₃ is supported by a stable and porous material. Al₂O₃ has been employed commonly as the support and enhanced the cyclic CO₂ capture efficiency of K₂CO₃. Different phases of alumina can be obtained by setting the calcination temperature of boehmite at 300, 600 (γ-alumina), 950 (δ-alumina) and 1200 °C (α-alumina). By increasing the calcination temperature, the regeneration capacity of alumina increases, while the surface area reduces. However, sorbents with lower surface areas have lower CO₂ capture capacity as well (except for the sorbents prepared by hydrophilic support materials). To resolve this issue, a highly efficient alumina-aerogel support was synthesized with a BET surface area of over 2000 m²/g and then calcined at a high temperature. The synthesized alumina-aerogel was impregnated on K₂CO₃ based on 50 wt% support/K₂CO₃, which resulted in the preparation of a sorbent with remarkable CO₂ capture performance. The effect of synthesis conditions such as types of alcohols, solvent-to-co-solvent ratios, and aging times was investigated on the performance of the support. The best support was synthesized using methanol as the solvent, after five days of aging time, and at a solvent-to-co-solvent (methanol-to-toluene) ratio (v/v) of 1/5. Response surface methodology was used to investigate the effect of operating parameters such as carbonation temperature and H₂O-to-CO₂ flowrate ratio on the CO₂ capture capacity. The maximum CO₂ capture capacity, at the optimum amounts of operating parameters, was 7.2 mmol CO₂ per gram K₂CO₃. Cyclic behavior of the sorbent was examined over 20 carbonation and regenerations cycles. The alumina-aerogel-supported K₂CO₃ showed a great performance compared to unsupported K₂CO₃ and γ-alumina-supported K₂CO₃. Fundamental performance analyses and long-term thermal and chemical stability test will be performed on the sorbent in the future. The applicability of the sorbent for a bench-scale process will be evaluated, and a corresponding process model will be established. The fundamental material knowledge and respective process development will be delivered to industrial partners for the design of a pilot-scale testing unit, thereby facilitating the industrial application of alumina-aerogel.Keywords: alumina-aerogel, CO₂ capture, K₂CO₃, optimization
Procedia PDF Downloads 1166882 Corrosion Behaviour of Al-Mg-Si Alloy Matrix Hybrid Composite Reinforced with Cassava Peel Ash and Silicon Carbide
Authors: B. Oji, O. Olaniran
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The prospect of improving the corrosion property of Al 6063 alloy based hybrid composites reinforced with cassava peel ash (CPA) and silicon carbide (SiC) is the target of this research. It seeks to determine the viability of using locally sourced material (CPA) as a complimentary reinforcement for SiC to produce low cost high performance aluminum matrix composite. The CPA was mixed with the SiC in the ratios 0:1, 1:3, 1:1, 3:1 and 1:0 for 8 wt % reinforcement in the produced composites by double stir-casting method. The microstructures of the composites were studied before and after corrosion using the scanning electron microscopy which reveals the matrix (dark region) and eutectic phase (lamellar region). The corrosion rate was studied in accordance with ASTM G59-97 (2014) using an AutoLab potentiostat (Versa STAT 400) with versaSTUDIO electrochemical software which analyses the results obtained. The result showed that Al 6063 alloy exhibited good corrosion resistance in 0.3M H₂SO₄ and 3.5 wt. % NaCl solutions with sample C containing the 25% wt CPA showing the highest resistance to corrosion with corrosion rate of 0.0046 mmpy as compared to the control sample which has a value of 13.233 mmpy. Sample B, D, E, and F also showed a corrosion rate of 3.9502, 2.6903, 2.1223, and 5.7344 mmpy which indicated a better corrosion rate than the control in the acidic environment. The corrosion rate in the saline medium shows that sample E with 75% wt CPA has the lowest corrosion rate of 0.0422 mmpy as compared to the control sample with 0.0873 mmpy corrosion rate.Keywords: Al-Mg-Si alloy, AutoLab potentiostat, Cassava Peel Ash, CPA, hybrid composite, stir-cast method
Procedia PDF Downloads 1276881 Effectiveness of a Malaysian Workplace Intervention Study on Physical Activity Levels
Authors: M. Z. Bin Mohd Ghazali, N. C. Wilson, A. F. Bin Ahmad Fuad, M. A. H. B. Musa, M. U. Mohamad Sani, F. Zulkifli, M. S. Zainal Abidin
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Physical activity levels are low in Malaysia and this study was undertaken to determine if a four week work-based intervention program would be effective in changing physical activity levels. The study was conducted in a Malaysian Government Department and had three stages: baseline data collection, four-week intervention and two-month post intervention data collection. During the intervention and two-month post intervention phases, physical activity levels (determined by a pedometer) and basic health profiles (BMI, abdominal obesity, blood pressure) were measured. Staff (58 males, 47 females) with an average age of 33 years completed baseline data collection. Pedometer steps averaged 7,102 steps/day at baseline, although male step counts were significantly higher than females (7,861 vs. 6114). Health profiles were poor: over 50% were overweight/obese (males 66%, females 40%); hypertension (males 23%, females 6%); excess waist circumference (males 52%, females 17%). While 86 staff participated in the intervention, only 49 regularly reported their steps. There was a significant increase (17%) in average daily steps from 8,965 (week 1) to 10,436 (week 4). Unfortunately, participation in the intervention program was avoided by the less healthy staff. Two months after the intervention there was no significant difference in average steps/day, despite the fact that 89% of staff reporting they planned to make long-term changes to their lifestyle. An unexpected average increase of 2kg in body weight occurred in participants, although this was less than the 5.6kg in non-participants. A number of recommendations are made for future interventions, including the conclusion that pedometers were a useful tool and popular with participants.Keywords: pedometers, walking, health, intervention
Procedia PDF Downloads 3046880 Evaluation of Prehabilitation Prior to Surgery for an Orthopaedic Pathway
Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett
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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery
Procedia PDF Downloads 1906879 Aerosol Direct Radiative Forcing Over the Indian Subcontinent: A Comparative Analysis from the Satellite Observation and Radiative Transfer Model
Authors: Shreya Srivastava, Sagnik Dey
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Aerosol direct radiative forcing (ADRF) refers to the alteration of the Earth's energy balance from the scattering and absorption of solar radiation by aerosol particles. India experiences substantial ADRF due to high aerosol loading from various sources. These aerosols' radiative impact depends on their physical characteristics (such as size, shape, and composition) and atmospheric distribution. Quantifying ADRF is crucial for understanding aerosols’ impact on the regional climate and the Earth's radiative budget. In this study, we have taken radiation data from Clouds and the Earth’s Radiant Energy System (CERES, spatial resolution=1ox1o) for 22 years (2000-2021) over the Indian subcontinent. Except for a few locations, the short-wave DARF exhibits aerosol cooling at the TOA (values ranging from +2.5 W/m2 to -22.5W/m2). Cooling due to aerosols is more pronounced in the absence of clouds. Being an aerosol hotspot, higher negative ADRF is observed over the Indo-Gangetic Plain (IGP). Aerosol Forcing Efficiency (AFE) shows a decreasing seasonal trend in winter (DJF) over the entire study region while an increasing trend over IGP and western south India during the post-monsoon season (SON) in clear-sky conditions. Analysing atmospheric heating and AOD trends, we found that only the aerosol loading is not governing the change in atmospheric heating but also the aerosol composition and/or their vertical profile. We used a Multi-angle Imaging Spectro-Radiometer (MISR) Level-2 Version 23 aerosol products to look into aerosol composition. MISR incorporates 74 aerosol mixtures in its retrieval algorithm based on size, shape, and absorbing properties. This aerosol mixture information was used for analysing long-term changes in aerosol composition and dominating aerosol species corresponding to the aerosol forcing value. Further, ADRF derived from this method is compared with around 35 studies across India, where a plane parallel Radiative transfer model was used, and the model inputs were taken from the OPAC (Optical Properties of Aerosols and Clouds) utilizing only limited aerosol parameter measurements. The result shows a large overestimation of TOA warming by the latter (i.e., Model-based method).Keywords: aerosol radiative forcing (ARF), aerosol composition, MISR, CERES, SBDART
Procedia PDF Downloads 546878 DNA Barcoding Application in Study of Icthyo- Biodiversity in Rivers of Pakistan
Authors: Asma Karim
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Fish taxonomy plays a fundamental role in the study of biodiversity. However, traditional methods of fish taxonomy rely on morphological features, which can lead to confusion due to great similarities between closely related species. To overcome this limitation, modern taxonomy employs DNA barcoding as a species identification method. This involves using a short standardized mitochondrial DNA region as a barcode, specifically a 658 base pair fragment near the 5′ ends of the mitochondrial cytochrome c oxidase subunit 1 (CO1) gene, to exploit the diversity in this region for identification of species. To test the effectiveness and reliability of DNA barcoding, 25 fish specimens from nine different fish species found in various rivers of Pakistan were identified morphologically using a dichotomous key at the start of the study. Comprising nine freshwater fish species, including Mystus cavasius, Mystus bleekeri, Osteobrama cotio, Labeo rohita, Labeo culbasu, Labeo gonius, Cyprinus carpio, Catla catla and Cirrhinus mrigala from different rivers of Pakistan were used in the present study. DNA was extracted from one of the pectoral fins and a partial sequence of CO1 gene was amplified using the conventional PCR method. Analysis of the barcodes confirmed that genetically identified fishes were the same as those identified morphologically at the beginning of the study. The sequences were also analyzed for biodiversity and phylogenetic studies. Based on the results of the study, it can be concluded that DNA barcoding is an effective and reliable method for studying biodiversity and conducting phylogenetic analysis of different fish species in Pakistan.Keywords: DNA barcoding, fresh water fishes, taxonomy, biodiversity, Pakistan
Procedia PDF Downloads 1086877 Epidemiological Analysis of Measles Outbreak in North-Kazakhstan Region of the Republic of Kazakhstan
Authors: Fatima Meirkhankyzy Shaizadina, Alua Oralovna Omarova, Praskovya Mikhailovna Britskaya, Nessipkul Oryntayevna Alysheva
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In recent years in the Republic of Kazakhstan there have been registered outbreaks of measles among the population. The objective of work was the analysis of outbreak of measles in 2014 among the population of North-Kazakhstan region of the Republic of Kazakhstan. For the analysis of the measles outbreak descriptive and analytical research, techniques were used and threshold levels of morbidity were calculated. The increase of incidence was noted from March to July. The peak was registered in May and made 9.0 per 100000 population. High rates were registered in April – 5.7 per 100000 population, and in June and July they made 5.7 and 3.1 respectively. Duration of the period of increase made 5 months. The analysis of monthly incidence of measles revealed spring and summer seasonality. Across the territory it was established that 69.2% of cases were registered in the city, 29.1% in rural areas and 1.7% of cases were brought in from other regions of Kazakhstan. The registered cases and threshold values of measles during the outbreak revealed that from 12 to 24 week, and also during the 40th week the cases exceeding the threshold levels are registered. Thus, for example, for the analyzed 1 week the number of the revealed patients made 4, which exceeds the calculated threshold value (3) by 33.3%. The data exceeding the threshold values confirm the emergence of a disease outbreak or the beginning of epidemic rise in morbidity. Epidemic rise in incidence of the population of North-Kazakhstan region was observed throughout 2014. The risk group includes 0-4 year-old children, who made 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The analysis of measles cases registration by gender revealed that women are registered 1.1 times more often than men. The ratio of women to men made 1:0.87. In social and professional groups often ill are unorganized children – 23.3% and students – 19.8%. Studying clinical manifestations of measles in the hospitalized patients, the typical beginning of a disease with expressed intoxication symptoms – weakness, sickliness was established. In individual cases expressed intoxication symptoms, hemorrhagic and dyspeptic syndromes, complications in the form of overlay of a secondary bacterial infection, which defined high severity of the illness, were registered both in adults and in children. The average duration of stay of patients in the hospital made 6.9 days. The average duration of time between date of getting the disease and date of delivery of health care made 3.6 days. Thus, the analysis of monthly incidence of measles revealed spring and summer seasonality, the peak of which was registered in May. Urban dwellers are ill more often (69.2%), while in rural areas people are ill more rarely (29.1%). Throughout 2014 an epidemic rise in incidence of the population of North-Kazakhstan region was observed. Risk group includes: children under 4 – 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The ratio of women and men made 1:0.87. The typical beginning of a disease in all hospitalized with the expressed intoxication symptoms – weakness, sickliness was established.Keywords: epidemiological analysis, measles, morbidity, outbreak
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