Search results for: long term care facility

Authors: Sheng-Che Chen, Keng-Ren Lin, Che-Hsin Lin, Hao-Yuan Tseng, Chih-Han Chang

Abstract:

Teeth play an important role in providing the essential nutrients. The force loading of chewing on the crow is important condition to evaluate long-term success of many dental treatments. However, the quantification of the force regarding forces are distributed over the dental crow is still not well recognized. This study presents an industrial-grade piezoelectric-based multilayer ceramic capacitors (MLCCs) force sensor for measuring the distribution of the force distribute over the first molar. The developed sensor array is based on a flexible polyimide electrode and barium titanate-based MLCCs. MLCCs are commonly used in the electronic industry and it is a typical electric component composed of BaTiO₃, which is used as a capacitive material. The most important is that it also can be used as a force-sensing component by its piezoelectric property. In this study, to increase the sensitivity as well as to reduce the variation of different MLCCs, a treatment process is utilized. The MLCC force sensors are able to measure large forces (above 500 N), making them suitable for measuring the bite forces on the tooth crown. Moreover, the sensors also show good force response and good repeatability.

Keywords: force sensor array, multilayer ceramic capacitors, occlusal force, piezoelectric

Procedia PDF Downloads 415

Authors: Nihayatul Munaa, Nyoman A. Damayanti

Abstract:

This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

Procedia PDF Downloads 198

Authors: Xi Zuo

Abstract:

As a part of the urban population that cannot be ignored, women have long been less involved in urban planning due to socio-economic constraints. Urban planning and development have long been influenced by the mainstream "male standard," paying less attention to women's needs for space in the city. However, with the development of the economy and society and the improvement of women's social status, their participation in urban life is gradually increasing, and their needs for the city are diversifying. Therefore, different scholars, planning designers and governmental departments have explored this field in different degrees and directions. This paper summarizes the research on urban planning from women's perspectives and, discusses its strengths, weaknesses, and methodology with specific case studies, and then further discusses the direction of further research on this topic.

Keywords: urban planning, feminism, methodology, gender

Procedia PDF Downloads 87

Authors: Dana Aljadaa, Hasim Altan

Abstract:

Japan’s strategy is based on improving the current resources and productivity by identifying the environmental challenges to progress further in many areas. For example, it will help in understanding the competitive challenges in the industry, emerging innovation, and other progresses. The present study seeks to examine the characteristics of sustainable practices using materials that will last longer and following environmental policies. There has been a major emphasis since 1990s and onwards about recycling and preserving the environment. Furthermore, the present paper analyses and argues how national interest in policy increases resource productivity. It is a universal law, but these actions may be different based on the unique situation of the country. In addition, the present study explains some of the strategies developed by the Environmental Agency of Japan in the last few years. There are a few resources reviewed involving ‘Strategy for an Environmental Nation in the 21st Century’ from 2001, ‘Clean Asia Initiative’ from 2008, and ‘New Growth Strategy’ from 2010. The present paper also highlights the emphasis on increasing efficiency, as it is an important part of sustainability. We finally conclude by providing reasoning on the impact and positivity of reducing production and consumption on the environment, resulting in a productive and progressive Japan for the near and long term future.

Keywords: eco-system, resource productivity, sound material-cycle, sustainable development

Procedia PDF Downloads 210

Authors: Anupam Purwar

Abstract:

In conventional consumer product industry, stockouts are taken care by carrying buffer stock to check underserving caused by changes in customer demand, incorrect forecast or variability in lead times. But, for food outlets, the alternate of carrying buffer stock is unviable because of indispensable need to serve freshly cooked meals. Besides, the food outlet being the sole provider has no incentives to reduce stockouts, as they have no fear of losing revenue, gross profit, customers and market share. Hence, innovative, easy to implement and practical ways of addressing the twin problem of long queues and poor customer experience needs to be investigated. Current work analyses the demand pattern of 11 different food items across a routine day. Based on this optimum resource allocation for all food items has been carried out by solving a linear programming problem with cost minimization as the objective. Concurrently, recommendations have been devised to address this demand and supply side problem keeping in mind their practicability. Currently, the recommendations are being discussed and implemented at ISB (Indian School of Business) Hyderabad campus.

Keywords: F&B industry, resource allocation, demand management, linear programming, LP, queuing analysis

Procedia PDF Downloads 141

Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

Abstract:

Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

Procedia PDF Downloads 52

Authors: Hidayatul Fitri, Petr Šařec

Abstract:

The use of organic fertilizer is increasing nowadays, and the application must be conducted accurately to provide the right benefits for plants and maintain soil health. Improper application of fertilizers can cause problems for both plants and the environment. This study investigated the liquid organic fertilizer application, particularly digestate, varied into different application doses concerning mitigation of adverse environmental impacts, improving water infiltration ability, and crop yields. The experiment was established into eight variants with different digestate doses, conducted on emission monitoring and soil physical properties. As a result, the digestate application with shallow injection (5 cm in depth) was confirmed as an appropriate technique for applying liquid fertilizer into the soil. Gas emissions resulted in low concentration and declined gradually over time, obviously proved from the experiment conducted under two measurements immediately after application and the next day. Applied various doses of liquid digestate fertilizer affected the emission concentrations of NH3 volatilization, differing significantly and decreasing about 40% from the first to second measurement. In this study, winter wheat crop production significantly increases under digestate application with additional N fertilizer. This study suggested the long-term application of digestate to obtain more alteration of soil properties such as bulk density, penetration resistance, and hydraulic conductivity.

Keywords: liquid organic fertilizer, digestate, application, ammonia, emission

Procedia PDF Downloads 292

Authors: Salima Behdenna, Fatiha Barigou, Ghalem Belalem

Abstract:

Due to the quick increase in the volume of Arabic opinions posted on various social media, Arabic sentiment analysis has become one of the most important areas of research. Compared to English, there is very little works on Arabic sentiment analysis, in particular aspect-based sentiment analysis (ABSA). In ABSA, aspect extraction is the most important task. In this paper, we propose a semantic aspect-based sentiment analysis approach for standard Arabic reviews to extract explicit aspect terms and identify the polarity of the extracted aspects. The proposed approach was evaluated using HAAD datasets. Experiments showed that the proposed approach achieved a good level of performance compared with baseline results. The F-measure was improved by 19% for the aspect term extraction tasks and 55% aspect term polarity task.

Keywords: sentiment analysis, opinion mining, Arabic, aspect level, opinion, polarity

Procedia PDF Downloads 166

Authors: Dua K. S. Y. Klaas, Monzur A. Imteaz, Ika Sudiayem, Elkan M. E. Klaas, Eldav C. M. Klaas

Abstract:

Due to its porous nature, karst terrains – geomorphologically developed from dissolved formations, is vulnerable to water shortage and deteriorated water quality. Therefore, a solid comprehension on sub-surface flow of karst landscape is essential to assess the long-term availability of groundwater resources. In this paper, a single-continuum model using a finite difference model, MODLFOW, was constructed to represent an unconfined carbonate aquifer in a tropical karst island of Rote in Indonesia. The model, spatially discretized in 20 x 20 m grid cells, was calibrated and validated using available groundwater level and atmospheric variables. In the calibration and validation steps, Parameter Estimation (PEST) and geostatistical pilot point methods were employed to estimate hydraulic conductivity and specific yield values. The results show that the model is able to represent the sub-surface flow indicated by good model performances both in calibration and validation steps. The final model can be used as a robust representation of the system for future study on climate and land use scenarios.

Keywords: carbonate aquifer, karst, sub-surface flow, groundwater model

Procedia PDF Downloads 152

Authors: Norasmah Othman, Suzana Mohamed, Salpiah Suradi

Abstract:

Copreneurship is a term used to describe the business pattern of operations run by married couples who share commitment, goals, and responsibilities in handling a business. Research conducted overseas showed that copreneurship business activities grew quickly and played a role in elevating families’ and nations’ socio-economic standards. In Malaysia, copreneurship has long been cultivated by spouses. Thus, this study aimed to explore the factors that motivate married partners to start a copreneurship business, and who is the dominant partner in the management of this business. The study participants are four entrepreneurial couples who are SME business operators selected through purposive sampling. In-depth interviews and direct observation were used as methods of measurement for triangulation of qualitative data in this study. The findings of the interviews were administered using NVivo 8.0 software. The result shows that freedom is a key factor that drives entrepreneurs to set up copreneurship businesses, and that the husband dominates the management aspects of the business. The study gives an overview of the parties involved in entrepreneurship to provide understanding of the copreneurship concept as it is practiced. This study provides academic value by creating understanding of the importance of a harmonious family institution specifically for forming entrepreneurs in the familial environment in Malaysia.

Keywords: copreneurs, copreneurship, business management, enterprise

Procedia PDF Downloads 306

Authors: Bourenane Bouhafs Naziha

Abstract:

ARTEA330EC is a fungicide used to inhibit the growth of many types of fungi on and cereals and rice, it is the single largest selling agrochemical that has been widely detected in surface waters in our area (Northeast Algerian). The studies on long-term genotoxic effects of fugicides in different tissues of fish using genotoxic biomarkers are limited. Therefore, in the present study DNA damage by propiconazole in freshwater fish Gambusia affinis by comet assays was investigated. The LC(50)- 96 h of the fungicide was estimated for the fish in a semi-static system. On this basis of LC(50) value sublethal and nonlethal concentrations were determined (25; 50; 75; and 100 ppm). The DNA damage was measured in erythrocytes as the percentage of DNA in comet tails of fishes exposed to above concentrations the fungicide. In general,non significant effects for both the concentrations and time of exposure were observed in treated fish compared with the controls. However It was found that the highest DNA damage was observed at the highest concentration and the longest time of exposure (day 12). The study indicated comet assay to be sensitive and rapid method to detect genotoxicity of propiconasol and other pesticides in fishes.

Keywords: genotoxicity, fungicide, propiconazole, freshwater, Gambusia affinis, alkaline single-cell gel electrophoresis

Procedia PDF Downloads 300

Authors: Toibayeva Shara, Zainolda Fariza, Abylkhassenova Dina, Zholdybaev Baurzhan, Almassov Nurbek, Aldabergenov Ablay

Abstract:

The article explores the opportunities and challenges associated with the adoption of digital technologies and automation in small and medium-sized businesses (SMEs) in Kazakhstan to achieve the Sustainable Development Goals (SDGs). Key aspects such as improving production efficiency, reducing carbon footprint, and resource efficiency are discussed, as well as the challenges faced by companies, including limited access to finance and lack of knowledge about digital solutions. Based on an analysis of existing practices, recommendations are offered to improve digital infrastructure and create an enabling environment for SMEs to increase their competitiveness and adaptability in the face of global change. The introduction of innovative technologies is seen as an important step towards long-term sustainability and successful business development in Kazakhstan. The study was supported by grants from the Ministry of Science and Higher Education of the Republic of Kazakhstan (grant No. AP23488459) ‘Research and development of scientific and methodological foundations of an intelligent system of management of medium and small businesses in Kazakhstan’.

Keywords: small and medium-sized businesses, digitalization, automation, sustainable development, sustainable development goals, innovation, competitiveness

Procedia PDF Downloads 25

Authors: Jerzy Slowik, Elzbieta Grochowska-Niedworok

Abstract:

The analysis of the market needs and trends in both treatment and prophylaxis shows the growing need to implement comprehensive solutions that would enable safe contact of the beneficiaries with the therapeutic and diagnostic support group. Based on the evaluation of the medical and sports industry services market, projects co-financed by the EFRR in the form of comprehensive care systems using IT tools for patients under treatment in the field of obesity and metabolism using the system were implemented under the Regional Operational Program of the Silesian Voivodeship for 2014-2020. SFAO 1.0 (Support for the Fight Against Obesity) number of the WND-RPSL project. 01.02.00-24-06EA / 16) as well as for competitors in qualified sports SK system (qualified sports) project number WND-RPSL. 01.02.00-24-0630 / 17-002. The service provided in accordance with SFAO 1.0 has shown a wide range of therapy possibilities - from monitoring the body's reactions during sports activities of healthy people to remote care for sick patients. As a result of the introduction of an innovative service, it was possible to increase the effectiveness of the therapy, which was manifested in the reduction of the starting doses of drugs by 10%, improvement of the efficiency of the respiratory and blood circulation system, and a 10% increase in bone density. Innovation in the provision of medical services in the field of qualified sports SK was a response to the needs of the athletes and their parents, coaches, physiotherapists, dieticians, and doctors who take care of people actively practicing qualified sports. The creation of the platform made it possible to constantly monitor the trainers necessary for both the proper training process and the control over the health of patients. Monitoring the patient's health by a specialized team in the field of various specialties allows for the proper targeting of the treatment and training process due to the increase in the availability of medical counseling. Specialists taking care of the patient can provide additional advice and modify the medical treatment of the patient on an ongoing basis, which is why we are dealing with a holistic approach.

Keywords: innovation of medical services, sport, obesity, innovation

Procedia PDF Downloads 134

Authors: L. Krpalkova, N. O' Mahony, A. Carvalho, S. Campbell, S. Harapanahalli, J. Walsh

Abstract:

The objective of this study was to determine the effects of environmental stressors on the performance of lactating dairy cows and discuss some future trends. There exists a relationship between the meteorological data and milk yield prediction accuracy in pasture-based dairy systems. New precision technologies are available and are being developed to improve the sustainability of the dairy industry. Some of these technologies focus on welfare of individual animals on dairy farms. These technologies allow the automatic identification of animal behaviour and health events, greatly increasing overall herd health and yield while reducing animal health inspection demands and long-term animal healthcare costs. The data set consisted of records from 489 dairy cows at two dairy farms and temperature measured from the nearest meteorological weather station in 2018. The effects of temperature on milk production and behaviour of animals were analyzed. The statistical results indicate different effects of temperature on milk yield and behaviour. The “comfort zone” for animals is in the range 10 °C to 20 °C. Dairy cows out of this zone had to decrease or increase their metabolic heat production, and it affected their milk production and behaviour.

Keywords: behavior, milk yield, temperature, precision technologies

Procedia PDF Downloads 112

Authors: Jiayue Zhao, Hongjuan Wu, Guiwen Liu

Abstract:

Old neighborhoods with a large elderly population depend on community-based elderly care facilities (community-based ECFs) for aging-in-place. Yet, due to scarce and scattered land, the facilities face inequitable distribution. This research uses spatial equity theory to measure the spatial equity of community-based ECFs in old neighborhoods. Field surveys gather granular data and methods, including coverage rate, Gini coefficient, Lorenz curve, and G2SFCA. The findings showed that coverage is substantial but does not indicate supply is a match to demand, nor does it imply superior accessibility. The key contributions are that structuring spatial equity framework considering elderly residents’ travel behavior. This study is dedicated to the international literature on spatial equity from the perspective of travel behavior and could provide valuable suggestions for the urban planning of old neighborhoods.

Keywords: community-based ECFs, elderly residents’ travel behavior, old neighborhoods, spatial equity

Procedia PDF Downloads 74

Authors: Gabriela Tutuanu

Abstract:

The economic, social and environmental undesirable impact of the existing development pattern pushes to the adoption and use of a new development paradigm that of sustainable development. This paper intends to substantiate how the marketing can help the sustainable development. It begins with the subjects of sustainable development and sustainable marketing as they are discussed in literature. The sustainable development is a three dimensional concept which embeds the economic dimension, the social dimension and the environmental dimension that ask to have in view the simultaneous pursuit of economic prosperity, social equity and environmental quality. A major challenge to achieve these goals at business level and to integrate all three dimensions of sustainability is the sustainable marketing. The sustainable marketing is a relationship marketing that aims at building lasting relationships with the social and natural environment on a long-term thinking and futurity and this philosophy allows helping all three dimensions of sustainability. As marketing solutions that could contribute to the sustainable development. We advance the stimulation of sustainable demand, the constant innovation and improvement of sustainable products, the design and use of customized communication, a multichannel distribution network and the sale of sustainable products and services at fair prices. Their implementation will increase the economic, social and environmental sustainability at a large extent in the future if they are supported by political, governmental and legal authorities.

Keywords: sustainable development, sustainable marketing, sustainable demand, sustainable product, credible communication, multi-channel distribution network, fair price

Procedia PDF Downloads 478

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

Abstract:

Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

Procedia PDF Downloads 114

Authors: Patsarawadee Paojinda, Waranya Imprasittichai, Sudaratana R. Krungkrai, Nirianne Marie Q. Palacpac, Toshihiro Horii, Jerapan Krungkrai

Abstract:

Fusion of the last two enzymes in the pyrimidine biosynthetic pathway in the inversed order by having COOH-terminal orotate phosphoribosyltransferase (OPRT) and NH2-terminal orotidine 5'-monophosphate decarboxylase (OMPDC), as OMPDC-OPRT, are described in many organisms. Here, we produced gene fusions of Plasmodium falciparum OMPDC-OPRT and expressed the bifunctional protein in Escherichia coli. The enzyme was purified to homogeneity using affinity and anion-exchange chromatography, exhibited enzymatic activities and functioned as a dimer. The activities, although unstable, can be stabilized by its substrate and product during purification and long-term storage. Furthermore, the enzyme expressed a perfect catalytic efficiency (kcat/Km). The kcat was selectively enhanced up to 3 orders of magnitude, while the Km was not much affected and remained at low µM levels when compared to the monofunctional enzymes. The fusion of the two enzymes, creating a “super-enzyme” with perfect catalytic power and more flexibility, reflects cryptic relationship of enzymatic reactivaties and metabolic functions on molecular evolution.

Keywords: bifunctional enzyme, orotate phosphoribosyltransferase, orotidine 5'-monophosphate decarboxylase, plasmodium falciparum

Procedia PDF Downloads 290

Authors: Gauri Shankar Shah

Abstract:

Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

Procedia PDF Downloads 257

Authors: Narupon Kunbootsri, J. Kraipoj, K. Phandech, P. Sirasaporn

Abstract:

Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom before physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on pain score, onset of symptom and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, pain score and obtaining physical modalities were recorded. There was a statistically significant improve in pain score, pretreatment score mean 7.24±1.52 and the last follow up pain score mean 3.88± 1.0 [mean difference 3.18 with 95%CI were [2.45- 3.92]. In addition, the onset of symptoms was 145 days before obtaining physiotherapy program. The physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the retrospective study show physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder in term of pain score. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, physiotherapy, pain score, onset of symptom, physical modality

Procedia PDF Downloads 180

Authors: Honey Bryant, Elvina Chu

Abstract:

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

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

Procedia PDF Downloads 120

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

Procedia PDF Downloads 89

Authors: M. R. Gholizadeh, N. Bhuiyan, M. Salari

Abstract:

In the near future, companies will be increasingly forced to shift their activities along a new road in order to decrease the harmful effects of their design, production and after-life on our environment. Products must meet environmental standards to not only prevent penalties but to consider the sustainability for future generations. However, the most important factor that companies will face is selecting a reasonable strategy to maximize their profit. Thus, companies need to have precise forecast from their profit after design stage through Trade-off analysis. This paper is an attempt to introduce a mathematical model that considers effective factors that impact the total profit when products are designed for resource and energy efficiency or recyclability. The modification is according to different strategies based on a Cost-Volume-Profit model. Here, the cost structure consists of Recycling cost, Development cost, Ramp-up cost, Production cost, and Pollution cost. Also, the model shows the effect of implementation of design for recyclable on revenue structure through revenue of used parts and revenue of recycled materials. A numerical example is used to evaluate the proposed model. Results show that fulfillment of Green Product Development not only can reduce the environmental impact of products but also it will increase profit of company in long term.

Keywords: green product, design for environment, C-V-P model, trade-off analysis

Procedia PDF Downloads 320

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

Abstract:

Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset (Sindh province) on a total of 3133 Married Women of Reproductive Age (MWRA) aged 15-49 years. Source of family planning (public/private sector) was the main exposure variable. Outcome variable was client satisfaction judged by ten different dimensions of client satisfaction. Means and standard deviations were calculated for continuous variable while for categorical variable frequencies and percentages were computed. For univariate analysis, Chi-square/Fisher Exact test was used to find an association between clients’ satisfaction in public and private sectors. Ten different multivariate models were made. Variables were checked for multi-collinearity, confounding, and interaction, and then advanced logistic regression was used to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92,95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care (follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29).

Keywords: client satisfaction, family planning, public private partnership, quality of care

Procedia PDF Downloads 421

Authors: Ahmed D. Balami, Salmiah Md. Said, Nor Afiah Zulkefli, Norsa’adah Bachok, Bala Audu

Abstract:

The World Health Organization prescribes that women living in malaria-endemic regions sleep under an insecticide-treated net (ITN) and comply with intermittent preventive treatment in pregnancy (IPTp). However, compliance with these measures is generally poor in Nigeria, despite the high burden of malaria and its complications in pregnancy, as well as the proven efficacy of these preventive measures. This study aimed to develop, implement, and evaluate the impacts of information-motivation-behavioral skills-based health education modules (IMB-HEMOD) on malaria prevention among pregnant women in Borno state, Nigeria. A parallel-group randomized controlled trial was conducted, enrolling 372 pregnant women (186 participants each in the intervention or control groups) at an antenatal clinic in Borno state, Nigeria. IMB-HEMOD on malaria prevention was delivered to the intervention group. This comprised four sessions and was conducted over four hours. Session one comprised lectures on malaria causative agents, transmission, symptoms, complications, and prevention. Session two was a facilitated interactive session, where participants brainstormed through the potential barriers to compliance with these preventive measures and collectively developed solutions to them. Sessions three and four entailed practical demonstrations of how to use these preventive measures. Participants in the control group received a dummy intervention in the form of health education on breastfeeding, delivered by the same facilitator, for a similar duration, and using a similar approach as the experimental intervention. Validated questionnaires were used to collect baseline and follow-up data (at two months and four months post-intervention) on the dependent variables – malaria prevention knowledge, motivation, behavioral skills, practices, and clinical outcomes. The generalized linear mixed-models analysis was used to test the effects of the intervention on the dependent variables. The total knowledge, motivation, and behavioral skills scores of the intervention group were significantly higher by 12.8% (95% Confidence Interval [CI]: 9.50 - 16.01), 8.6% (95% CI: 6.74 - 10.36), and 6.4% (95% CI: 4.41 – 8.29) respectively over the control group. The results also showed that 32% (95% CI: 6 – 59) and 37% (95% CI: 26 – 47) of participants in the intervention group slept at least one day more frequently under an insecticide-treated net (ITN), and took one dose more of intermittent preventive treatment in pregnancy (IPTp), compared to the control group. The intervention group also achieved 0.8% (95% CI: 0.53 – 1.07) higher hematocrit levels compared to the control group. Overall, the study results revealed the promising potential of the modules for not only boosting compliance with the prescribed malaria preventive measures but also improving clinical outcomes. It is thus recommended to adopt the modules into routine antenatal care health education. Future research evaluating the cost-effectiveness and feasibility of long-term implementation would help inform policy adoption.

Keywords: health education intervention, insecticide-treated net, intermittent preventive treatment, malaria, pregnant women

Procedia PDF Downloads 12

Authors: Syazreen N. Shair, Saiful A. Ishak, Aida Y. Yusof, Azizah Murad

Abstract:

In this paper, we forecast age-specific Malaysian mortality rates and life expectancy at births by gender and ethnic groups including Malay, Chinese and Indian. Two mortality forecasting models are adopted the original Lee-Carter model and its recent modified version, the product ratio coherent model. While the first forecasts the mortality rates for each subpopulation independently, the latter accounts for the relationship between sub-populations. The evaluation of both models is performed using the out-of-sample forecast errors which are mean absolute percentage errors (MAPE) for mortality rates and mean forecast errors (MFE) for life expectancy at births. The best model is then used to perform the long-term forecasts up to the year 2030, the year when Malaysia is expected to become an aged nation. Results suggest that in terms of overall accuracy, the product ratio model performs better than the original Lee-Carter model. The association of lower mortality group (Chinese) in the subpopulation model can improve the forecasts of high mortality groups (Malay and Indian).

Keywords: coherent forecasts, life expectancy at births, Lee-Carter model, product-ratio model, mortality rates

Procedia PDF Downloads 223

Authors: Heli Makkonen, Eini Hyppönen

Abstract:

The ageing of employees, the availability of workforce, and employees’ engagement in work are today’s challenges in the field of health care and social services, and particularly in the care of older people. Therefore, it is important to enhance both the attractiveness of the work in the field of older people’s care and the retention of employees in the field, and also to pay attention to the length of careers. The length of careers can be affected, for example, by developing an age-friendly organisational culture. Changing the organisational culture in a workplace is, however, a slow process which requires engagement from employees and enhanced dialogue between employees. This article presents an example of age-friendly organisational culture in an older people’s care unit and presents the results of the development of this organisational culture to meet the identified development challenges. In this research-based development process, cycles used in action research were applied. Three workshops were arranged for employees in a service home for older people. The workshops worked as interventions, and the employees and their manager were given several consecutive assignments to be completed between them. In addition to workshops, the employees benchmarked two other service homes. In the workshops, data was collected by observing and documenting the conversations. After that, thematic analysis was used to identify the factors connected to an age-friendly organisational culture. By analysing the data and comparing it to previous studies, some dilemmas we recognised that were hindering or enhancing the attractiveness of work and the retention of employees in this nursing home. After each intervention, the process was reflected and evaluated, and the next steps were planned. The areas of development identified in the study were related to, for example, the flexibility of work, holistic ergonomics, the physical environment at the workplace, and the workplace culture. Some of the areas of development were taken over by the work community and carried out in cooperation with e.g. occupational health care. We encouraged the work community, and the employees provided us with information about their progress. In this research project, the focus was on the development of the workplace culture and, in particular, on the development of the culture of interaction. The workshops showed employees’ attitudes and strong opinions, which can be a challenge from the point of view of the attractiveness of work and the retention of employees in the field. On the other hand, the data revealed that the work community has an interest in developing the dialogue in the work community. Enhancing the dialogue gave the employees the opportunity and resources to face even challenging dilemmas related to the attractiveness of work and the retention of employees in the field. The psychological safety was also enhanced at the same time. The results of this study are part of a broader study that aims at building a model for extending older employees’ careers.

Keywords: age-friendliness, attractiveness of work, dialogue, older people, organisational culture, workplace culture

Procedia PDF Downloads 81

Authors: Liliane Clark

Abstract:

Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

Procedia PDF Downloads 193

Authors: Salinee Thumronglaohapun

Abstract:

The proper number and appropriate locations of service centers can save cost, raise revenue and gain more satisfaction from customers. Establishing service centers is high-cost and difficult to relocate. In long-term planning periods, several factors may affect the service. One of the most critical factors is uncertain demand of customers. The opened service centers need to be capable of serving customers and making a profit although the demand in each period is changed. In this work, the capacitated location-allocation problem with stochastic demand is considered. A mathematical model is formulated to determine suitable locations of service centers and their allocation to maximize total profit for multiple planning periods. Two heuristic methods, a local search and genetic algorithm, are used to solve this problem. For the local search, five different chances to choose each type of moves are applied. For the genetic algorithm, three different replacement strategies are considered. The results of applying each method to solve numerical examples are compared. Both methods reach to the same best found solution in most examples but the genetic algorithm provides better solutions in some cases.

Keywords: location-allocation problem, stochastic demand, local search, genetic algorithm

Procedia PDF Downloads 127

Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

Abstract:

Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

Procedia PDF Downloads 94