Search results for: urgent care
Commenced in January 2007
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Edition: International
Paper Count: 4293

Search results for: urgent care

1803 A Comparative Study of Granisetron and Palonosetron in Postoperative Nausea and Vomiting Following Laparoscopic Surgery

Authors: Burra Vijitha

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A prospective randomized comparative study for the prevention of postoperative nausea and vomiting in the patients undergoing general anesthesia ,for elective laparoscopic surgeries with respect to efficacy and side effects of granisetron and palonosetron. Sixty adult patients of class ASA 1,2 of either sex in age group between 20-70 yrs,scheduled for elective laparoscopic surgeries were selected for the study.Patients were randomly divided into two groups 30 each. Group G: Granisetron group (n=30), 40µg/kg; Group P: Palonosetron group (n=30), 0.075 mg. at end of surgery before extubation group G patients 40 µg/kg of inj.granisetron and group P patients received 0.075 mg of inj.palonosetron slow iv over 30 sec.In post anesthesia care unit, episodes of nausea and vomiting experienced by each patient was recorded by direct questioning the patient .study medication was assessed in terms of incidence of nausea and vomiting during periods of 0-4 hrs,4-12 hrs,12-24 hrs,24-48hrs.our study demonstrated that complete response for those patients who received granisetron were 86.66%,80% and 66.66% ,while those received palonosetron were 100%,86.6%,90% between 0-4hrs,4-12hrs,12-24 hrs. It shows no statistically signidficant differences between the baseline values of hemodynamic variables beween two groups during study. Keywords: Granisetron, nausea, palonosetron, vomiting.

Keywords: granisetron, palonosetron, nausea, vomiting

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1802 Reproductive Health Behavior and Nutritional Status of Plain Land Ethnic Women in Bangladesh

Authors: Zainal Abedin

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Introduction: Reproductive health is one of the major priorities of global health and is a fundamental and inalienable part of women’s health due to childbearing, and it is closely associated with nutritional status. Objective: This study was done to assess reproductive health behavior and nutritional status of reproductive-age ethnic women residing in plain land. Method: It was a cross-sectional study conducted among conveniently selected 120 reproductive-aged ethnic women at three Upazila of Rajshahi District. Nutritional status was determined by the WHO cut-off value of BMI for the Asian population. Results: About 88% of respondents noticed that they seek treatment in response to disease, and most of them seek treatment from the pharmacy attendant. Two-thirds of women used contraceptives, and 76% of women received antenatal care visits from Govt health centers, private clinics, and NGO clinics, but 86% of respondents delivered at home. In terms of nutritional status, 70% were normal, 23% underweight, and 7% overweight. Conclusion: Though most of them were normal regarding nutritional status but one-fourth were still underweight. Local pharmacy/quack-dependent treatment should be reduced.

Keywords: reproductive health behavior, nutritional status, plain land, ethnic women

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1801 Mental Health Problems in College Students of India

Authors: Swati Naruka

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"Looking after one’s mind is as important as looking after one’s body". As part of one’s overall health, mental and emotional health or well being is a necessary condition to enable one to manage one’s life successfully. Mental health is the capacity of an individual to form harmonious adjustments to one’s social and physical environments. Universities and colleges are dealing with substantial challenges posed by the changing mental health needs of today’s college students. It is important for administrators, faculty, and staff to understand the profound impact that mental health problems can have on all aspects of campus life, and to treat mental health issues as an institutional responsibility and priority. Counselling centres can respond effectively to the current challenges if they have the support and commitment of the administration; and if they take steps to balance the demand for services with existing resources by reviewing priorities, establishing appropriate limits, employing innovative strategies, and practicing good self-care to minimize stress and burnout. The need for counselling centres has never been greater. They will continue to play an important role in supporting the mission of higher education institutions by providing counselling for students who are experiencing problems and assisting them in achieving their educational and personal goals.

Keywords: mental health, well being, India, college students

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1800 Review of Health Disparities in Migrants Attending the Emergency Department with Acute Mental Health Presentations

Authors: Jacqueline Eleonora Ek, Michael Spiteri, Chris Giordimaina, Pierre Agius

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Background: Malta is known for being a key player as a frontline country with regard to irregular immigration from Africa to Europe. Every year the island experiences an influx of migrants as boat movement across the Mediterranean continues to be a humanitarian challenge. Irregular immigration and applying for asylum is both a lengthy and mentally demanding process. Those doing so are often faced with multiple challenges, which can adversely affect their mental health. Between January and August 2020, Malta disembarked 2 162 people rescued at sea, 463 of them between July & August. Given the small size of the Maltese islands, this regulation places a disproportionately large burden on the country, creating a backlog in the processing of asylum applications resulting in increased time periods of detention. These delays reverberate throughout multiple management pathways resulting in prolonged periods of detention and challenging access to health services. Objectives: To better understand the spatial dimensions of this humanitarian crisis, this study aims to assess disparities in the acute medical management of migrants presenting to the emergency department (ED) with acute mental health presentations as compared to that of local and non-local residents. Method: In this retrospective study, 17795 consecutive ED attendances were reviewed to look for acute mental health presentations. These were further evaluated to assess discrepancies in transportation routes to hospital, nature of presenting complaint, effects of language barriers, use of CT brain, treatment given at ED, availability of psychiatric reviews, and final admission/discharge plans. Results: Of the ED attendances, 92.3% were local residents, and 7.7% were non-locals. Of the non-locals, 13.8% were migrants, and 86.2% were other-non-locals. Acute mental health presentations were seen in 1% of local residents; this increased to 20.6% in migrants. 56.4% of migrants attended with deliberate self-harm; this was lower in local residents, 28.9%. Contrastingly, in local residents, the most common presenting complaint was suicidal thought/ low mood 37.3%, the incidence was similar in migrants at 33.3%. The main differences included 12.8% of migrants presenting with refused oral intake while only 0.6% of local residents presented with the same complaints. 7.7% of migrants presented with a reduced level of consciousness, no local residents presented with this same issue. Physicians documented a language barrier in 74.4% of migrants. 25.6% were noted to be completely uncommunicative. Further investigations included the use of a CT scan in 12% of local residents and in 35.9% of migrants. The most common treatment administered to migrants was supportive fluids 15.4%, the most common in local residents was benzodiazepines 15.1%. Voluntary psychiatric admissions were seen in 33.3% of migrants and 24.7% of locals. Involuntary admissions were seen in 23% of migrants and 13.3% of locals. Conclusion: Results showed multiple disparities in health management. A meeting was held between entities responsible for migrant health in Malta, including the emergency department, primary health care, migrant detention services, and Malta Red Cross. Currently, national quality-improvement initiatives are underway to form new pathways to improve patient-centered care. These include an interpreter unit, centralized handover sheets, and a dedicated migrant health service.

Keywords: emergency department, communication, health, migration

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1799 Benign Recurrent Unilateral Abducens (6th) Nerve Palsy in 14 Months Old Girl: A Case Report

Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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1798 Social and Economic Challenges of Adopting Sustainable Urban Development in Developing Economy: A Stakeholder's Perception

Authors: Raed Fawzi Mohammed Ameen, Haider I. Alyasari, Maryam Altaweel

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Due to rapid urbanization, developing countries faced significant urban challenges that accompanied the population growth such as the inability to provide adequate housing; sustain human and community's health and wellbeing; ensure the safety in urban areas; the prevalence corruption; lack of jobs; and a shortage of investment. The destruction, degradation, and lack of planning are acute in countries such as Iraq that have suffered for more than four decades because of war and international sanctions, resulting in severe damages to the ecology sector, social utilities, housing, infrastructure, as well as the disruption of the economic sector. Many of significant urban development, housing, and regeneration projects are currently underway in different regions in Iraq, labelled as a means to reform the environmental, social, and economic sectors. However, most often with absence of public participation. Hence, there is an urgent need for understanding public perception, especially of urban socio-economic challenges, which represents a crucial concern for many planners, designers, and policy-makers in order to develop effective policies in addition to increasing their participation. The aim of this study is to investigate stakeholder perceptions of the socio-economic challenges of urban development and their priorities in the all Iraqi provinces. A nationwide questionnaire has been conducted (N = 643) across Iraq, using 19- item structured questionnaire where the stakeholder’s perspectives were collected on a 5-point Likert-type scale. The indicators were identified through deep investigation in previous studies. Principal component analysis (PCA) and statistical tests were utilized to the collected responses in order to investigate the linkage between the perceptions of socio- economic challenges and demographic factors. A high value of internal consistency and reliability of the instrument has been achieved (Cronbach’s alpha= 0.867). Five principal components have been identified, namely: economic, cultural aspects, design context, employment, security and housing demands. The item ‘safety of public places' was ranked as the most important, followed by the items 'minimize unplanned housing', and ‘provision of affordable housing’, respectively. Promote high-rise housing from the housing demands group, was ranked the lowest component between all indicators. 'Using sustainable local materials in construction' item had the second lowest mean score. The results also illustrate a link between deficiencies in the social and economic infrastructure because of the destruction and degradation caused by political instability in Iraq in the last few decades.

Keywords: public participation in development, socio-economic challenges, urban development, urban sustainability

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1797 Assessing Autism Spectrum Disorders (ASD) Challenges in Young Children in Dubai: A Qualitative Study, 2016

Authors: Kadhim Alabady

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

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

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1796 Agriculture and Forests: A Perception of Farmers on Sustainable Agro-Ecological Practices

Authors: Kever Gomes, Rosana Martins

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The use of environmental indicators is today an important strategy for analyzing the sustainability of agricultural systems. Despite of the considerable importance of family agriculture for Brazilian economy, sustainable agricultural practices are still weakly known, and the known ones, underused. Currently, economic aspects of the relationship between man and nature lead to the destruction of natural ecosystems, which justifies the urgent need for dissemination and usage of new sustainable production techniques. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture. This study aimed to investigate aspects related to the perception of sustainable agriculture, especially on agroforestry systems in farms of farmers from Distrito Federal-Brazil. Agro-social characteristics of farmers were systematized considering their perceptions about agroforestry systems for the preparation of proposal for a program of Environmental Services Payment, intended for families who are involved in the various activities of home gardens. This study used qualitative methodological approaches of quantitative research, using descriptive exploratory research. To get the necessary elements for the intended analysis, interviews were conducted at 40 heads of households of which 15 were men and 25 women. The results were analyzed using descriptive statistics, having been considered in the analysis the frequency, consistency, coherence and originality of responses. It was found that the lack of financial resources and lack of technical assistance are limiting factors for the dissemination and use of sustainable agricultural practices. Considering the great number of species found for the main categories of use, it can be inferred that the home gardens play important functions for the interviewed families, contributing for the food and medicine production destined for the consumption by the families themselves, and also playing an important esthetic function thanks to the variety of their ornamental plants. The wealth of these home gardens may be related to the rural origin and to the culture of the owners, who still keep a cultivation tradition. It was found that the products obtained from the home gardens contributed for the diet’s variety of the informants, representing a promising potential for the improvement of the population alimentation. The study reached the conclusion over the need to motivate the interest of these farmers to seek information and resources to enable the implementation of Agroforestry projects, including the recovery of areas in their properties, even those distinct from their backyards. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture.

Keywords: agro-biodiversity, natural conservation, silviculture, urban agriculture

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1795 Neurofeedback Applications for Dealing With Depression for Illegitimate Pregnant Teens: A Thesis Proposal

Authors: Mohamad Sharif bin Mustaffa, Maizatul Akmam binti Abu Bakar, Mohd Harriszamani bin Abu Bakar

Abstract:

Most teens who gave birth to an illegitimate child will suffer from depression. This depression issues arising from the incident itself which contains the teen will feel ashamed because labeled as immoral, apart from that most teenagers go through this episode without support from their spouse or family. Teens also face the possibility of a large part with the will be born babies because the issue of too young and needs to go back to school. Teens also can not make a decision on the future of the baby later because they are too immature and no baby care skills other than financial issues, where young people themselves are still dependent on their family. This paper will look at how to apply neurofeedback can be used to see the level of depression experienced by teenagers who get pregnant out of wedlock. Play therapy that will help improve adolescent focus will be used for this purpose. Each level experienced by teenagers going through the phase of easy-to-high difficulty level. Apart from that a recovery module will also be developed as a whole to reduce the level of depression to enable the youth to perform routine healthy activities and can go back to school with cheerful feeling, motivated and active.

Keywords: neurofeedback, depression, pregnant, adolescent, illegitimate

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1794 Food Insecurity and Its Implication for Poverty Alleviation in Nigeria

Authors: Peter Okpamen

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Food security concentrates on the collective efforts of all nations to produce enough food to feed their people. Recently, though the emphasis shifted from food availability to accessibility constraints, which entails the difficulties undernourished people face in gaining access to food even when it is available. Broadly speaking, access to food depends on an individual’s access to resources, markets and food transfers. The opportunities to obtain food through these channels are entitlements, which when denied constitute food insecurity. Evidence shows that a significant percentage of Nigerians are undernourished with adverse implications for the fight against poverty. The greatest danger or consequence of food insecurity is malnutrition. Food insecurity as both an agent and consequence of poverty also increases the economic, political and social tensions in the country. The undernourished in Nigeria are marginalised in several ways to the extent that they are often ill; and because of illness, their work capacity is reduced with attendant reduction in their income. Without adequate income, they cannot save nor invest enough resources to take care of their basic needs. In this paper therefore, we used the political economy approach and statistical analysis to demonstrate that poverty alleviation in Nigeria would be a mirage if food security problems are not adequately resolved.

Keywords: alleviation, demographic, food insecurity, undernourished

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1793 Antiplatelets and Anticoagulants in Rural Emergency General Surgery

Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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1792 Recreational Nitrous Oxide Use: Increasing Risks and Harms

Authors: Julaine Allan, Jacqui Cameron, Helen Simpson, Kenny Kor

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The pleasurable and intoxicating effects of psychoactive substances result in widespread use. However, deaths and injuries from psychoactive substance use, particularly among young people, are a global public health problem. Understanding the benefits and problems associated with different drugs is an important part of creating contextually and physiologically relevant harm reduction strategies. Nitrous oxide use is increasing. A systematic review sought information for harm reduction strategies. The aim of this study was to systematically collate and synthesize the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. A mixed-methods systematic review combined quantitative data such as prevalence and incidence statistics as well as interpretive data on the experience of N₂O use. Thirty-four studies were included in the final analysis. There was minimal information available to inform policy, health care, or individuals using N₂O. The cultural, contextual, and personal reasons for N₂O use are largely unexplored.

Keywords: substance misuse, nitrous oxide, harms, harm reduction, systematic review

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1791 The Use of STIMULAN Resorbable Antibiotic Beads in Conjunction with Autologous Tissue Transfer to Treat Recalcitrant Infections and Osteomyelitis in Diabetic Foot Wounds

Authors: Hayden R Schott, John M Felder III

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Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

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1790 Social and Political Economy of Paid and Unpaid Work: Work of Women Home Based Workers in National Capital Region (NCR), India

Authors: Sudeshna Sengupta

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Women’s work lives weave a complex fabric of myriad work relations and complex structures. Lives, when seen from the lens of work, is a saga of conjugated oppression by intertwined structures that are vertically and horizontally interwoven in a very complex manner. Women interact with multiple institutions through their work. The interactions and interplay of institutions shape their organization of work. They intersperse productive work with reproductive work, unpaid economic activities with unpaid care work, and all kinds of activities with leisure and self-care. The proposed paper intends to understand how women working as home-based workers in the National Capital Region (NCR) of India are organizing their everyday work, and how the organization of work is influenced by the interplay of structures. Situating itself in a multidisciplinary theoretical framework, this paper brings out how the gendering of work is playing out in the political, economic and social domain and shaping the work-life within the family, and in the paid workspace. The paper will use a primary data source, which is qualitative in nature. It will comprise 15 qualitative interviews of women home-based workers from the National Capital Region. The research uses a life history approach. The sampling was purposive using snowballing as a method. The dataset is part of the primary data (qualitative) collected for the ongoing Ph.D. work in Gender Studies at Ambedkar University Delhi. The home-based workers interviewed were in “non-factory” wage relations based on piece rates with flexible working hours. Their workplaces were their own homes with no spatial divide between living spaces and workspaces. Home-based workers were recognized as a group in the domain of labor economics in the 1980s. When menial work was cheaper than machine work, the capital owners preferred to outsource work as home-based work to women. These production spaces are fragmented and the identity of gender is created within labor processes to favor material accumulation. Both the employers and employees acknowledged the material gain of the capital owner when work was subcontracted to women at home. Simultaneously the market reinforced women’s reproductive role by conforming to patriarchal ideology. The contractors played an important role in implementing localized control on workers and also in finding workers for fragmented, gendered production processes. Their presence helped the employers in bringing together multiple forms of oppression that ranged from creating a structure to flout laws by creating shadow employers. It created an intertwined social and economic structure as well as a workspace where the line between productive and reproductive work gets blurred. The state invisibilized itself either by keeping the sector out of the domain of laws or by not implementing its own laws regulating working conditions or social security. It allowed the local hierarchy to function and define localized working conditions. The productive reproductive continuum reveals a labor control that influenced both the productive and reproductive work of women.

Keywords: informal sector, paid work, women workers, labor processes

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1789 Influence of Scalable Energy-Related Sensor Parameters on Acoustic Localization Accuracy in Wireless Sensor Swarms

Authors: Joyraj Chakraborty, Geoffrey Ottoy, Jean-Pierre Goemaere, Lieven De Strycker

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Sensor swarms can be a cost-effectieve and more user-friendly alternative for location based service systems in different application like health-care. To increase the lifetime of such swarm networks, the energy consumption should be scaled to the required localization accuracy. In this paper we have investigated some parameter for energy model that couples localization accuracy to energy-related sensor parameters such as signal length,Bandwidth and sample frequency. The goal is to use the model for the localization of undetermined environmental sounds, by means of wireless acoustic sensors. we first give an overview of TDOA-based localization together with the primary sources of TDOA error (including reverberation effects, Noise). Then we show that in localization, the signal sample rate can be under the Nyquist frequency, provided that enough frequency components remain present in the undersampled signal. The resulting localization error is comparable with that of similar localization systems.

Keywords: sensor swarms, localization, wireless sensor swarms, scalable energy

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1788 Geoecological Problems of Karst Waters in Chiatura Municipality, Georgia

Authors: Liana Khandolishvili, Giorgi Dvalashvili

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Karst waters in the world play an important role in the water supply. Among them, the Vaucluse in Chiatura municipality (Georgia) is used as drinking water and is irreplaceable for the local population. Accordingly, it is important to assess their geo-ecological conditions and take care to maintain sustainability. The aim of the paper is to identify the hazards of pollution of underground waters in the karst environment and to develop a scheme for their protection, which will take into consideration both the hydrogeological characteristics and the role of humans. To achieve this goal, the EPIK method was selected using which an epikarst zone of the study area was studied in detail, as well as the protective cover, infiltration conditions and frequency of karst network development, after which the conditions of karst waters in Chiatura municipality was assessed, their main pollutants were identified and the recommendations were prepared for their protection. The results of the study showed that the karst water pollution rate in Chiatura municipality is highest, where karst-fissured layers are represented and intensive extraction works are underway. The EPIK method is innovative in Georgia and was first introduced on the example of karst waters of Chiatura municipality.

Keywords: cave, EPIK method, pollution, Karst waters, geology, geography, ecology

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1787 Cost Effective Real-Time Image Processing Based Optical Mark Reader

Authors: Amit Kumar, Himanshu Singal, Arnav Bhavsar

Abstract:

In this modern era of automation, most of the academic exams and competitive exams are Multiple Choice Questions (MCQ). The responses of these MCQ based exams are recorded in the Optical Mark Reader (OMR) sheet. Evaluation of the OMR sheet requires separate specialized machines for scanning and marking. The sheets used by these machines are special and costs more than a normal sheet. Available process is non-economical and dependent on paper thickness, scanning quality, paper orientation, special hardware and customized software. This study tries to tackle the problem of evaluating the OMR sheet without any special hardware and making the whole process economical. We propose an image processing based algorithm which can be used to read and evaluate the scanned OMR sheets with no special hardware required. It will eliminate the use of special OMR sheet. Responses recorded in normal sheet is enough for evaluation. The proposed system takes care of color, brightness, rotation, little imperfections in the OMR sheet images.

Keywords: OMR, image processing, hough circle trans-form, interpolation, detection, binary thresholding

Procedia PDF Downloads 173
1786 Health Equity in Hard-to-Reach Rural Communities in Abia State, Nigeria: An Asset-Based Community Development Intervention to Influence Community Norms and Address the Social Determinants of Health in Hard-to-Reach Rural Communities

Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

Abstract:

Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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1785 Harvesting Value-added Products Through Anodic Electrocatalytic Upgrading Intermediate Compounds Utilizing Biomass to Accelerating Hydrogen Evolution

Authors: Mehran Nozari-Asbemarz, Italo Pisano, Simin Arshi, Edmond Magner, James J. Leahy

Abstract:

Integrating electrolytic synthesis with renewable energy makes it feasible to address urgent environmental and energy challenges. Conventional water electrolyzers concurrently produce H₂ and O₂, demanding additional procedures in gas separation to prevent contamination of H₂ with O₂. Moreover, the oxygen evolution reaction (OER), which is sluggish and has a low overall energy conversion efficiency, does not deliver a significant value product on the electrode surface. Compared to conventional water electrolysis, integrating electrolytic hydrogen generation from water with thermodynamically more advantageous aqueous organic oxidation processes can increase energy conversion efficiency and create value-added compounds instead of oxygen at the anode. One strategy is to use renewable and sustainable carbon sources from biomass, which has a large annual production capacity and presents a significant opportunity to supplement carbon sourced from fossil fuels. Numerous catalytic techniques have been researched in order to utilize biomass economically. Because of its safe operating conditions, excellent energy efficiency, and reasonable control over production rate and selectivity using electrochemical parameters, electrocatalytic upgrading stands out as an appealing choice among the numerous biomass refinery technologies. Therefore, we propose a broad framework for coupling H2 generation from water splitting with oxidative biomass upgrading processes. Four representative biomass targets were considered for oxidative upgrading that used a hierarchically porous CoFe-MOF/LDH @ Graphite Paper bifunctional electrocatalyst, including glucose, ethanol, benzyl, furfural, and 5-hydroxymethylfurfural (HMF). The potential required to support 50 mA cm-2 is considerably lower than (~ 380 mV) the potential for OER. All four compounds can be oxidized to yield liquid byproducts with economic benefit. The electrocatalytic oxidation of glucose to the value-added products, gluconic acid, glucuronic acid, and glucaric acid, was examined in detail. The cell potential for combined H₂ production and glucose oxidation was substantially lower than for water splitting (1.44 V(RHE) vs. 1.82 V(RHE) for 50 mA cm-2). In contrast, the oxidation byproduct at the anode was significantly more valuable than O₂, taking advantage of the more favorable glucose oxidation in comparison to the OER. Overall, such a combination of HER and oxidative biomass valorization using electrocatalysts prevents the production of potentially explosive H₂/O₂mixtures and produces high-value products at both electrodes with lower voltage input, thereby increasing the efficiency and activity of electrocatalytic conversion.

Keywords: biomass, electrocatalytic, glucose oxidation, hydrogen evolution

Procedia PDF Downloads 97
1784 Ozonation as an Effective Method to Remove Pharmaceuticals from Biologically Treated Wastewater of Different Origin

Authors: Agne Jucyte Cicine, Vytautas Abromaitis, Zita Rasuole Gasiunaite, I. Vybernaite-Lubiene, D. Overlinge, K. Vilke

Abstract:

Pharmaceutical pollution in aquatic environments has become a growing concern. Various active pharmaceutical ingredient (API) residues, hormones, antibiotics, or/and psychiatric drugs, have already been discovered in different environmental compartments. Due to existing ineffective wastewater treatment technologies to remove APIs, an underestimated amount can enter the ecosystem by discharged treated wastewater. Especially, psychiatric compounds, such as carbamazepine (CBZ) and venlafaxine (VNX), persist in effluent even post-treatment. Therefore, these pharmaceuticals usually exceed safe environmental levels and pose risks to the aquatic environment, particularly to sensitive ecosystems such as the Baltic Sea. CBZ, known for its chemical stability and long biodegradation time, accumulates in the environment, threatening aquatic life and human health through the food chain. As the use of medication rises, there is an urgent need for advanced wastewater treatment to reduce pharmaceutical contamination and meet future regulatory requirements. In this study, we tested advanced oxidation technology using ozone to remove two commonly used psychiatric drugs (carbamazepine and venlafaxine) from biologically treated wastewater effluent. Additionally, general water quality parameters (suspended matter (SPM), dissolved organic carbon (DOC), chemical oxygen demand (COD), and bacterial presence were analyzed. Three wastewater treatment plants (WWTPs) representing different anthropogenic pressures were selected: 1) resort, 2) resort and residential, and 3) residential, industrial, and resort. Wastewater samples for the experiment were collected during the summer season after mechanical and biological treatment and ozonated for 5, 10, and 15 minutes. The initial dissolved ozone concentration of 7,3±0,7 mg/L was held constant during all the experiments. Pharmaceutical levels in this study exceeded the predicted no-effect concentration (PNEC) of 500 and 90 ng L⁻¹ for CBZ and VNX, respectively, in all WWTPs, except CBZ in WWTP 1. Initial CBZ contamination was found to be lower in WWTP 1 (427.4 ng L⁻¹), compared with WWTP 2 (1266.5 ng L⁻¹) and 3 (119.2 ng L⁻¹). VNX followed a similar trend with concentrations of 341.2 ng L⁻¹, 361.4 ng L⁻¹, and 390.0 ng L⁻¹, respectively, for WWTPs 1, 2, and 3. It was determined that CBZ was not detected in the effluent after 5 minutes of ozonation in any of the WWTPs. Contrarily, VNX was still detected after 5, 10, and 15 minutes of treatment with ozone, however, under the limits of quantification (LOD) (<5ng L⁻¹). Additionally, general pollution of SPM, DOC, COD, and bacterial contamination was reduced notably after 5 minutes of treatment with ozone, while no bacterial growth was obtained. Although initial pharmaceutical levels exceeded PNECs, indicating ongoing environmental risks, ozonation demonstrated high efficiency in reducing pharmaceutical and general contamination in wastewater with different pollution matrices.

Keywords: Baltic Sea, ozonation, pharmaceuticals, wastewater treatment plants

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1783 Utilizing Street Medicine to Reduce Communicable Disease Prevalence in a Cost-Effective Way

Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

Abstract:

The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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1782 Assessment of Dose: Area Product of Common Radiographic Examinations in Selected Southern Nigerian Hospitals

Authors: Lateef Bamidele

Abstract:

Over the years, radiographic examinations are the most used diagnostic tools in the Nigerian health care system, but most diagnostic examinations carried out do not have records of patient doses. Lack of adequate information on patient doses has been a major hindrance in quantifying the radiological risk associated with radiographic examinations. This study aimed at estimating dose–area product (DAP) of patient examined in X-Ray units in selected hospitals in Southern Nigeria. The standard projections selected are chest posterior-anterior (PA), abdomen anterior-posterior (AP), pelvis AP, pelvis lateral (LAT), skull AP/PA, skull LAT, lumbar spine AP, lumbar spine, LAT. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDs were converted into DAP using the beam area of patients. The results show that the mean DAP ranged from 0.17 to 18.35 Gycm². The results obtained in this study when compared with those of NRPB-HPE were found to be higher. These are an indication of non optimization of operational conditions.

Keywords: dose–area product, radiographic examinations, patient doses, optimization

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1781 Weight Gain After Total Thyroidectomy

Authors: Yong Seong Kim, Seongbin Hong, So Hun Kim, Moonsuk Nam

Abstract:

Background: Patients who undergo thyroidectomy due to thyroid cancer often complain weight gain, although they are on suppressive thyroid hormone treatment. The aim of this study is to know whether thyroid cancer patients gain the weight after thyroidectomy and weight change is dependent on estrogen state or use of rhTSH. Material and Method: We performed a retrospective chart review of subjects receiving medical care at an academic medical center. Two hundred two patients who underwent total thyroidectomy were included. As a control group, patients with thyroid nodule and euthyroidism were matched for age, gender, menopausal status. The weight changes occurring over first one year and thyroid function were assessed. Results: Mean age was 51±12 years and patients was composed with 38% of premenopausal, 15 % perimenopausal women, 37% of postmenopausal women and 20% of men. Patients with thyroid cancer gained 2.2 kg during the first year. It’ was not significantly different with control. However, weigh change in perimenopausal and post menopausal women gained more weight than control (P <0.05). Age, baseline body weight and weight gain were not correlated. Discussion: Patient who had undergone thyroidectomy gained more weight than their control, especially in peri- and postmenopausal women. Patients in this age should be monitored for their weight carefully.

Keywords: weight gain, thyroidectomy, thyroid cancer, weight chance

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1780 Analyzing the Effectiveness of Elderly Design and the Impact on Sustainable Built Environment

Authors: Tristance Kee

Abstract:

With an unprecedented increase in elderly population around the world, the severe lack of quality housing and health-and-safety provisions to serve this cohort cannot be ignored any longer. Many elderly citizens, especially singletons, live in unsafe housing conditions with poorly executed planning and design. Some suffer from deteriorating mobility, sight and general alertness and their sub-standard living conditions further hinder their daily existence. This research explains how concepts such as Universal Design and Co-Design operate in a high density city such as Hong Kong, China where innovative design can become an alternative solution where government and the private sector fail to provide quality elderly friendly facilities to promote a sustainable urban development. Unlike other elderly research which focuses more on housing policies, nursing care and theories, this research takes a more progressive approach by providing an in-depth impact assessment on how innovative design can be practical solutions for creating a more sustainable built environment. The research objectives are to: 1) explain the relationship between innovative design for elderly and a healthier and sustainable environment; 2) evaluate the impact of human ergonomics with the use of universal design; and 3) explain how innovation can enhance the sustainability of a city in improving citizen’s sight, sound, walkability and safety within the ageing population. The research adopts both qualitative and quantitative methodologies to examine ways to improve elderly population’s relationship to our built environment. In particular, the research utilizes collected data from questionnaire survey and focus group discussions to obtain inputs from various stakeholders, including designers, operators and managers related to public housing, community facilities and overall urban development. In addition to feedbacks from end-users and stakeholders, a thorough analysis on existing elderly housing facilities and Universal Design provisions are examined to evaluate their adequacy. To echo the theme of this conference on Innovation and Sustainable Development, this research examines the effectiveness of innovative design in a risk-benefit factor assessment. To test the hypothesis that innovation can cater for a sustainable development, the research evaluated the health improvement of a sample size of 150 elderly in a period of eight months. Their health performances, including mobility, speech and memory are monitored and recorded on a regular basis to assess if the use of innovation does trigger impact on improving health and home safety for an elderly cohort. This study was supported by district community centers under the auspices of Home Affairs Bureau to provide respondents for questionnaire survey, a standardized evaluation mechanism, and professional health care staff for evaluating the performance impact. The research findings will be integrated to formulate design solutions such as innovative home products to improve elderly daily experience and safety with a particular focus on the enhancement on sight, sound and mobility safety. Some policy recommendations and architectural planning recommendations related to Universal Design will also be incorporated into the research output for future planning of elderly housing and amenity provisions.

Keywords: elderly population, innovative design, sustainable built environment, universal design

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1779 Study on the Work-Life Balance of Selected Working Single Mothers in the Coastal Community of La Huerta, Paranaque

Authors: Idette Sheirina Biyo, Rhodora Lynn C. Lintag

Abstract:

This paper explores how the work-life balance of selected working single mothers situated in a coastal community is affecting their well-being. Working single mothers carry the responsibility of earning for their family while simultaneously exercising their motherhood. This study utilized a purposeful qualitative research through semi-structured interviews among ten working single mothers living in the coastal community of La Huerta, Parañaque in order to identify the following: a) experiences of the working single mothers, b) problems usually encountered, and c) how these problems are affecting their well-being. Dorothy Smith’s Feminist Standpoint theory is used as a theoretical lens in order to explain their work-life balance. Results have shown that despite their dual roles as the main income earners and heads of the households, they are not neglecting to care for their well-being. They consider getting sufficient rest, eating well, and going to church as forms of caring for their well-being. Other factors that affect their work-life balance include living arrangements, work hours, type of work, and income.

Keywords: coastal community, well-being, work-life balance, Working single mother

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1778 Access to Inclusive and Culturally Sensitive Mental Healthcare in Pharmacy Students and Residents

Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

Abstract:

Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

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1777 Surgical Collaboration in Managing Spinal Cord Compression Due to a Pre-Vertebral Chordoma: A Case Report

Authors: Rose Virginy S. Bautista, Ida Marie Tabangay-Lim, Helen Bongalon-Amo, Jose Modesto B. Abellera

Abstract:

Chordomas, particularly those of the spine and the head and neck region, represent a rare and locally aggressive group of malignancies. The complexity of these tumors -given the rarity, location, and involvement of neurovascular structures- imposes a challenge in the diagnosis and management. We herein report a case of spinal cord compression due to a prevertebral cervical chordoma. The patient presented with a gradually enlarging lateral neck mass, with progressive bilateral extremity weakness and urinary incontinence; preoperative biopsy showed chordoma. A multidisciplinary approach for the management of this case was made, involving neurosurgery, head and neck surgery, and radiation oncology services. Surgical collaboration between the two cutting services was done to have a radical excision of the tumor and spinal cord decompression. The patient was then referred for adjuvant radiation therapy. With this collaborative treatment strategy, more comprehensive and quality care could be provided to our patients.

Keywords: chordoma, surgical collaboration, spinal cord compression, neurosurgery, head and neck surgery

Procedia PDF Downloads 69
1776 Assessing Image Quality in Mobile Radiography: A Phantom-Based Evaluation of a New Lightweight Mobile X-Ray Equipment

Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

Abstract:

Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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1775 Impression Evaluation by Design Change of Anthropomorphic Agent

Authors: Kazuko Sakamoto

Abstract:

Anthropomorphic agents have been successful in areas where there are many human interactions, such as education and medical care. The persuasive effect is also expected in e-shopping sites on the web. This indicates that customer service is not necessarily human but can play that role. However, the 'humanity' in anthropomorphism sometimes has a risk of working negatively. In general, as the appearance of anthropomorphic agents approaches humans, it is thought that their affinity with humans increases. However, when the degree of similarity reaches a certain level, it gives the user a weird feeling. This is the 'eerie valley' phenomenon. This is a concept used in the world of robotics, but it seems to be applicable to anthropomorphic agents such as characters. Then what kind of design can you accept as an anthropomorphic agent that gives you a feeling of friendliness or good feeling without causing discomfort or fear to people? This study focused on this point and examined what design and characteristics would be effective for marketing communication. As a result of the investigation, it was found that there is no need for gaze and blinking, the size of the eyes is normal or large, and the impression evaluation is higher when the structure is as simple as possible. Conversely, agents with high eye-gaze and white-eye ratios had low evaluations, and the negative impact on eye-gaze was particularly large.

Keywords: anthropomorphicgents, design evaluation, marketing communication, customer service

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1774 The Role of Quality Management Tools and Knowledge Sharing in Improving the Level of Academic Staff: An Empirical Investigation of the Jordanian Universities

Authors: Tasneem Alfalah, Salsabeel Alfalah, Jannat Alfalah

Abstract:

The quality of higher education as a service is fundamental to a country’s development because universities prepare the professionals who will work as managers in companies and manage public and private resources and care for the health and education of new generations. Knowledge sharing involves the interaction of all activities between individuals. Thus, the higher education institutions are aiming to improve and assist their academics in generating new ideas by encouraging them to work as a team, to simplify the exchange of the new knowledge and to further improve the learning process and achieving institutional aims. Moreover, the sources of competitive advantage in universities derive from intellectual capital and innovations in which innovation comes through knowledge sharing. Using quality tools is to define the exact requirements needed to create the concept of knowledge sharing and what are the barriers to achieve this in universities. The purpose of this research is critically evaluating the role of using quality tools to facilitate the concept of knowledge sharing and improve the academic staff level in the Jordanian universities.

Keywords: higher education, knowledge sharing, quality, management tools

Procedia PDF Downloads 463