Search results for: bridge condition assessment
7500 The Microflora Assessment of the Urethra Area of Children with Newly Diagnosed Type 1 Diabetes
Authors: Ewa Rusak, Sebastian Seget, Aleksandra Mroskowiak, Mirosław Partyka, Ewa Samulska, Julia Strózik, Anna Wilk, Przemysława Jarosz-Chobot
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Introduction: Various infections can affect children suffering from Type 1 Diabetes (T1D) because of dysfunctions of the immune system. The urinary tract and urethra of these children can be easily infected areas because of glycosuria. Aim: The microflora assessment of the urethra area of children with newly diagnosed T1D. Methods: The materials of the study were swabs taken prospectively from the urethral area of 63 children at the time of diagnosis of T1D (37 boys), then the results were correlated to the clinical parameters. In the statistical analysis, there were T student, Chi square, and U Mann-Whitney tests used. Results: The mean age was 9.4 years (6 months-17.4 years). The mean HbA1c value was 12.1% (5,6% - 20.1%). The mean value of glycosuria was 4463.2 mg/dl (0 - 9770 mg/dl). Ketoacidosis was diagnosed in 29 children (49%). The following microbial species were isolated in the collected materials: Staphylococcus epidermidis in 18 children (28.6%), Enterococcus faecalis in 17 children (27%), Candida albicans in 15 children (23.8%), coagulase-negative staphylococciin 11 children (17.5%), group B Streptococcus beta-hemolysis in 10 children (15.9%), S. aureus, E. coli, S. anginosus, C. glucuronolyticum, and A. urinae in 7 children each (11.1%), group B Streptococcus beta-hemolysis and S. hominis in 6 children each (9.5%), L. gasseri in 5 children (7.5%), C. dubliniensis in 4 children (6.3) and other, isolated cases. 2 of diagnosed patients were cultured negatively (3.2%). There were statistical correlations between the type of colonisation and patients’ sex and HbA1C value. Conclusions: It is extremely important to examine the urethral area at the time of diagnosis of T1D in order to detect inflammation and to undertake the appropriate and effective intervention.Keywords: diabetology, skin disorders, microbiology, microflora
Procedia PDF Downloads 1467499 From Acute Abdomen to Hormonal Crisis: Case Report on a Long-Delayed Sheehan's Syndrome Diagnosis
Authors: Maham Leeza Adil, Mahrukh Alvi, Muhammad Osman
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Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum hemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries, due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management. Case Presentation: A 40-year-old female presented with acute abdomen symptoms and was initially diagnosed with acalculous cholecystitis. However, a detailed history revealed a history of postpartum hemorrhage 18 years prior, leading to a provisional diagnosis of SS. Further investigations confirmed panhypopituitarism, including hypothyroidism, hypocortisolism, and hypogonadism. Notably, the patient also exhibited pancytopenia, a rarely reported hematological manifestation of SS. Discussion: SS often presents with nonspecific symptoms, leading to delayed or missed diagnoses. In this case, the patient's initial presentation of acute abdomen symptoms was attributed to secondary adrenal insufficiency due to panhypopituitarism. The presence of pancytopenia, along with hyponatremia, further complicated the clinical picture. Hormone replacement therapy led to a remarkable improvement in the patient's condition, emphasizing the importance of early diagnosis and intervention. Conclusion: SS is a common cause of panhypopituitarism in developing countries, but its atypical presentations, such as pancytopenia, are rare and often overlooked. This case highlights the need for increased awareness among clinicians to consider SS in patients with unexplained hematological abnormalities, particularly in regions with high rates of postpartum hemorrhage. Early recognition and appropriate hormone replacement therapy can significantly improve patients' outcomes and prevent long-term complications associated with this underdiagnosed syndrome.Keywords: Sheehan syndrome, panhypopituitarism, pancytopenia, delayed diagnosis
Procedia PDF Downloads 257498 Application of Griddization Management to Construction Hazard Management
Authors: Lingzhi Li, Jiankun Zhang, Tiantian Gu
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Hazard management that can prevent fatal accidents and property losses is a fundamental process during the buildings’ construction stage. However, due to lack of safety supervision resources and operational pressures, the conduction of hazard management is poor and ineffective in China. In order to improve the quality of construction safety management, it is critical to explore the use of information technologies to ensure that the process of hazard management is efficient and effective. After exploring the existing problems of construction hazard management in China, this paper develops the griddization management model for construction hazard management. First, following the knowledge grid infrastructure, the griddization computing infrastructure for construction hazards management is designed which includes five layers: resource entity layer, information management layer, task management layer, knowledge transformation layer and application layer. This infrastructure will be as the technical support for realizing grid management. Second, this study divides the construction hazards into grids through city level, district level and construction site level according to grid principles. Last, a griddization management process including hazard identification, assessment and control is developed. Meanwhile, all stakeholders of construction safety management, such as owners, contractors, supervision organizations and government departments, should take the corresponding responsibilities in this process. Finally, a case study based on actual construction hazard identification, assessment and control is used to validate the effectiveness and efficiency of the proposed griddization management model. The advantage of this designed model is to realize information sharing and cooperative management between various safety management departments.Keywords: construction hazard, griddization computing, grid management, process
Procedia PDF Downloads 2817497 Modeling the Effects of Temperature on Ambient Air Quality Using AERMOD
Authors: Mustapha Babatunde, Bassam Tawabini, Ole John Nielson
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Air dispersion (AD) models such as AERMOD are important tools for estimating the environmental impacts of air pollutant emissions into the atmosphere from anthropogenic sources. The outcome of these models is significantly linked to the climate condition like air temperature, which is expected to differ in the future due to the global warming phenomenon. With projections from scientific sources of impending changes to the future climate of Saudi Arabia, especially anticipated temperature rise, there is a potential direct impact on the dispersion patterns of air pollutants results from AD models. To our knowledge, no similar studies were carried out in Saudi Arabia to investigate such impact. Therefore, this research investigates the effects of climate temperature change on air quality in the Dammam Metropolitan area, Saudi Arabia, using AERMOD coupled with Station data using Sulphur dioxide (SO₂) – as a model air pollutant. The research uses AERMOD model to predict the SO₂ dispersion trends in the surrounding area. Emissions from five (5) industrial stacks on twenty-eight (28) receptors in the study area were considered for the climate period (2010-2019) and future period of mid-century (2040-2060) under different scenarios of elevated temperature profiles (+1ᵒC, + 3ᵒC and + 5ᵒC) across averaging time periods of 1hr, 4hr and 8hr. Results showed that levels of SO₂ at the receiving sites under current and simulated future climactic condition fall within the allowable limit of WHO and KSA air quality standards. Results also revealed that the projected rise in temperature would only have mild increment on the SO₂ concentration levels. The average increase of SO₂ levels was 0.04%, 0.14%, and 0.23% due to the temperature increase of 1, 3, and 5 degrees, respectively. In conclusion, the outcome of this work elucidates the degree of the effects of global warming and climate changes phenomena on air quality and can help the policymakers in their decision-making, given the significant health challenges associated with ambient air pollution in Saudi Arabia.Keywords: air quality, sulfur dioxide, dispersion models, global warming, KSA
Procedia PDF Downloads 857496 Evaluation of 18F Fluorodeoxyglucose Positron Emission Tomography, MRI, and Ultrasound in the Assessment of Axillary Lymph Node Metastases in Patients with Early Stage Breast Cancer
Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park
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Purpose: 18F Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is a noninvasive imaging modality that can identify nodal metastases in women with primary breast cancer. The aim of this study was to compare the accuracy of FDG-PET with MRI and sonography scanning to determine axillary lymph node status in patients with breast cancer undergoing sentinel lymph node biopsy or axillary lymph node dissection. Patients and Methods: Between January and December 2012, ninety-nine patients with breast cancer and clinically negative axillary nodes were evaluated. All patients underwent FDG-PET, MRI, ultrasound followed by sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Results: Using axillary lymph node assessment as the gold standard, the sensitivity and specificity of FDG-PET were 51.4% (95% CI, 41.3% to 65.6%) and 92.2% (95% CI, 82.7% to 97.4%) respectively. The sensitivity and specificity of MRI and ultrasound were 57.1% (95% CI, 39.4% to 73.7%), 67.2% (95% CI, 54.3% to 78.4%) and 42.86% (95% CI, 26.3% to 60.7%), 92.2% (95% CI, 82.7% to 97.4%). Stratification according to hormone receptor status showed an increase in specificity when negative (FDG-PET: 42.3% to 77.8%, MRI 50% to 77.8%, ultrasound 34.6% to 66.7%). Also, positive HER2 status was associated with an increase in specificity (FDG-PET: 42.9% to 85.7%, MRI 50% to 85.7%, ultrasound 35.7% to 71.4%). Conclusions: The sensitivity and specificity of FDG-PET compared with MRI and ultrasound was high. However, FDG-PET is not sufficiently accurate to appropriately identify lymph node metastases. This study suggests that FDG-PET scanning cannot replace histologic staging in early-stage breast cancer, but might have a role in evaluating axillary lymph node status in hormone receptor negative or HER-2 overexpressing subtypes.Keywords: axillary lymph node metastasis, FDG-PET, MRI, ultrasound
Procedia PDF Downloads 3777495 Effects of Forest Therapy on Depression among Healthy Adults
Authors: Insook Lee, Heeseung Choi, Kyung-Sook Bang, Sungjae Kim, Minkyung Song, Buhyun Lee
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Backgrounds: A clearer and comprehensive understanding of the effects of forest therapy on depression is needed for further refinements of forest therapy programs. The purpose of this study was to review the literature on forest therapy programs designed to decrease the level of depression among adults to evaluate current forest therapy programs. Methods: This literature review was conducted using various databases including PubMed, EMBASE, CINAHL, PsycArticle, KISS, RISS, and DBpia to identify relevant studies published up to January 2016. The two authors independently screened the full text articles using the following criteria: 1) intervention studies assessing the effects of forest therapy on depression among healthy adults ages 18 and over; 2) including at least one control group or condition; 3) being peer-reviewed; and 4) being published either in English. The Scottish Intercollegiate Guideline Network (SIGN) measurement tool was used to assess the risk of bias in each trial. Results: After screening current literature, a total of 14 articles (English: 6, Korean: 8) were included in the present review. None of the studies used randomized controlled (RCT) study design and the sample size ranged from 11 to 300. Walking in the forest and experiencing the forest using the five senses was the key component of the forest therapy that was included in all studies. The majority of studies used one-time intervention that usually lasted a few hours or half-day. The most widely used measure for depression was Profile of Mood States (POMS). Most studies used self-reported, paper-and-pencil tests, and only 5 studies used both paper-and-pencil tests and physiological measures. Regarding the quality assessment based on the SIGN criteria, only 3 articles were rated ‘acceptable’ and the rest of the 14 articles were rated ‘low quality.’ Regardless of the diversity in format and contents of forest therapies, most studies showed a significant effect of forest therapy in curing depression. Discussions: This systematic review showed that forest therapy is one of the emerging and effective intervention approaches for decreasing the level of depression among adults. Limitations of the current programs identified from the review were as follows; 1) small sample size; 2) a lack of objective and comprehensive measures for depression; and 3) inadequate information about research process. Futures studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed.Keywords: forest therapy, systematic review, depression, adult
Procedia PDF Downloads 2957494 Political Economy on the Recent Labor Condition in the Philippines: A Literature Review
Authors: Lloyd B. Ranises
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The Philippine labor force has been affected by the pandemic recently. The situation was added by the high inflation rate, which makes matter worse. Since the Philippines has a new government after the 2022 national election, the labor condition under the previous government has been passed on to the new one. To understand the labor challenges the present government faces, this study revisits the labor conditions and responses of the previous government from 2016 to 2022. Thus, this study reviews the labor force of the Philippines within the time frame. It explores the challenges in the labor market and examines government policy. This study uses secondary sources in tracing the labor conditions and government actions that addressed them. The Literatures are consolidated to see its relevance to the new government’s labor policy. This study found that the labor force had a sluggish growth earlier until 2018 and thrived on but was affected by the pandemic. By 2020, the National Capital Region’s labor force dropped, although, after which, it begins to thrive again, showing recovery. However, its composition is much more complex. Cognitive skill is high in demand that requires tertiary education. But the production of goods and services is low in the scientific workforce in addition to the mismatch between position and profession. Moreover, Philippine labor has poor female participation. In addition to these complexities, the agricultural rural areas have high underemployment, which implies surplus labor of low skill. Overseas employment, on the other, is significant to the decrease in domestic production. The major responses of the previous government, by far, have been focused on the minimum wage increase and the social services and health insurance, which are appropriate to the post-pandemic needs. Yet still, some issues are unattended. This study concludes that the previous government’s policy needs to be fleshed out substantially. It necessitates that the new administration shall consider encompassing all aspects of the Philippine labor force to sustain and strengthen the economy of the country.Keywords: cognitive skills, minimum wage, national capital region, underemployment
Procedia PDF Downloads 1167493 The Changes of Chemical Composition of Rice Straw Treated by a Biodecomposer Developed from Rumen Bacterial of Buffalo
Authors: A. Natsir, M. Nadir, S. Syahrir, A. Mujnisa
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In tropical countries such as in Indonesia, rice straw plays an important role in fulfilling the needs of feed for ruminant, especially during the dry season in which the availability of forage is very limited. However, the main problem of using rice straw as a feedstuff is low digestibility due to the existence of the links between lignin and cellulose or hemicellulose, and imbalance of its minerals content. One alternative to solve this problem is by application of biodecomposer (BS) derived from rumen bacterial of the ruminant. This study was designed to assess the effects of BS application on the changes of the chemical composition of rice straw. Four adults local buffalo raised under typical feeding conditions were used as a source of inoculum for BS development. The animal was fed for a month with a diet consisted of rice straw and elephant grass before taking rumen fluid samples. Samples of rumen fluid were inoculated in the carboxymethyl cellulose (CMC) media under anaerobic condition for 48 hours at 37°C. The mixture of CMC media and microbes are ready to be used as a biodecomposer following incubation of the mixture under anaerobic condition for 7 days at 45°C. The effectiveness of BS then assessed by applying the BS on the straw according to completely randomized design consisted of four treatments and three replication. One hundred g of ground coarse rice straw was used as the substrate. The BS was applied to the rice straw substrate with the following composition: Rice straw without BS (P0), rice straw + 5% BS (P1), rice straw +10% BS (P2), and rice straw + 15% BS. The mixture of rice straw and BS then fermented under anaerobic for four weeks. Following the fermentation, the chemical composition of rice straw was evaluated. The results indicated that the crude protein content of rice straw significantly increased (P < 0.05) as the level of BS increased. On the other hand, the concentration of crude fiber of the rice straw was significantly decreased (P < 0.05) as the level of BS increased. Other nutrients such as minerals did not change (P > 0.05) due to the treatments. In conclusion, application of BS developed from rumen bacterial of buffalo has a promising prospect to be used as a biological agent to improve the quality of rice straw as feeding for ruminant.Keywords: biodecomposer, local buffalo, rumen microbial, chemical composition
Procedia PDF Downloads 2157492 Studying the Effect of Heartfulness Meditation on Brain Activity
Authors: Norman Farb, Anirudh Kumar, Abdul Subhan, Pallavi Gupta, Jahnavi Mundluru, Abdul Subhan, Shankar Pathmakanthan
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Long term meditation practice is increasingly recognized for its health benefits. Among a diversity of contemplative traditions, Heartfulness meditation represents a quickly growing set of practices that is largely unstudied. Heartfulness is unique in that it is a meditation practice that focuses on the Heart. It helps individuals to connect to themselves and find inner peace while meditating. In order to deepen ones’ meditation on the heart, the element of Yogic Energy (‘pranahuti’) is used as an aid during meditation. The purpose of this study was to determine whether consistent EEG effects of Heartfulness meditation be observed in sixty experienced Heartfulness meditators, each of whom attended 6 testing sessions. In each session, participants performed three conditions: a set of cognitive tasks, Heartfulness guided relaxation, and Heartfulness Meditation. To measure EEG, the MUSE EEG head band (product of Interaxon Inc) was used. Participants during the cognitive portion were required to answer questions that tested their logical thinking (Cognitive Reflective Test) and creative thinking skills. (Random Associative Test) The order of condition was randomly counter balanced across six sessions. It was hypothesized that Heartfulness meditation would bring increased alpha (8-12Hz) brain activity during meditation and better cognitive task scores in sessions where the tasks followed meditation. Results show that cognitive task scores were higher after meditation in both CRT and RAT, suggesting stronger right brain and left brain activation. Heartfulness meditation produces a significant decrease in brain activity (as indexed by higher levels of alpha) during the early stages of meditation. As the meditation progressed deep meditative state (as indexed by higher levels of delta) were observed until the end of the condition. This lead to the conclusion that Heartfulness Meditation produces a state that is clearly distinguishable from effortful problem solving.Keywords: heartfulness meditation, neuroplasticity, brain activity, relaxation response
Procedia PDF Downloads 3417491 Modeling the Effects of Temperature on Air Pollutant Concentration
Authors: Mustapha Babatunde, Bassam Tawabini, Ole John Nielson
Abstract:
Air dispersion (AD) models such as AERMOD are important tools for estimating the environmental impacts of air pollutant emissions into the atmosphere from anthropogenic sources. The outcome of these models is significantly linked to the climate condition like air temperature, which is expected to differ in the future due to the global warming phenomenon. With projections from scientific sources of impending changes to the future climate of Saudi Arabia, especially anticipated temperature rise, there is a potential direct impact on the dispersion patterns of air pollutants results from AD models. To our knowledge, no similar studies were carried out in Saudi Arabia to investigate such impact. Therefore, this research investigates the effects of climate temperature change on air quality in the Dammam Metropolitan area, Saudi Arabia, using AERMOD coupled with Station data using Sulphur dioxide (SO2) – as a model air pollutant. The research uses AERMOD model to predict the SO2 dispersion trends on the surrounding area. Emissions from five (5) industrial stacks, on twenty-eight (28) receptors in the study area were considered for the climate period (2010-2019) and future period of mid-century (2040-2060) under different scenarios of elevated temperature profiles (+1oC, + 3oC and + 5oC) across averaging time periods of 1hr, 4hr and 8hr. Results showed that levels of SO2 at the receiving sites under current and simulated future climactic condition fall within the allowable limit of WHO and KSA air quality standards. Results also revealed that the projected rise in temperature would only have mild increment on the SO2 concentration levels. The average increase of SO2 levels were 0.04%, 0.14%, and 0.23% due to the temperature increase of 1, 3, and 5 degrees respectively. In conclusion, the outcome of this work elucidates the degree of the effects of global warming and climate changes phenomena on air quality and can help the policymakers in their decision-making, given the significant health challenges associated with ambient air pollution in Saudi Arabia.Keywords: air quality, sulphur dioxide, global warming, air dispersion model
Procedia PDF Downloads 1347490 Vortex Control by a Downstream Splitter Plate in Psudoplastic Fluid Flow
Authors: Sudipto Sarkar, Anamika Paul
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Pseudoplastic (n<1, n is the power index) fluids have great importance in food, pharmaceutical and chemical process industries which require a lot of attention. Unfortunately, due to its complex flow behavior inadequate research works can be found even in laminar flow regime. A practical problem is solved in the present research work by numerical simulation where we tried to control the vortex shedding from a square cylinder using a horizontal splitter plate placed at the downstream flow region. The position of the plate is at the centerline of the cylinder with varying distance from the cylinder to calculate the critical gap-ratio. If the plate is placed inside this critical gap, the vortex shedding from the cylinder suppressed completely. The Reynolds number considered here is in unsteady laminar vortex shedding regime, Re = 100 (Re = U∞a/ν, where U∞ is the free-stream velocity of the flow, a is the side of the cylinder and ν is the maximum value of kinematic viscosity of the fluid). Flow behavior has been studied for three different gap-ratios (G/a = 2, 2.25 and 2.5, where G is the gap between cylinder and plate) and for a fluid with three different flow behavior indices (n =1, 0.8 and 0.5). The flow domain is constructed using Gambit 2.2.30 and this software is also used to generate the mesh and to impose the boundary conditions. For G/a = 2, the domain size is considered as 37.5a × 16a with 316 × 208 grid points in the streamwise and flow-normal directions respectively after a thorough grid independent study. Fine and equal grid spacing is used close to the geometry to capture the vortices shed from the cylinder and the boundary layer developed over the flat plate. Away from the geometry meshes are unequal in size and stretched out. For other gap-ratios, proportionate domain size and total grid points are used with similar kind of mesh distribution. Velocity inlet (u = U∞), pressure outlet (Neumann condition), symmetry (free-slip boundary condition) at upper and lower domain boundary conditions are used for the simulation. Wall boundary condition (u = v = 0) is considered both on the cylinder and the splitter plate surfaces. Discretized forms of fully conservative 2-D unsteady Navier Stokes equations are then solved by Ansys Fluent 14.5. SIMPLE algorithm written in finite volume method is selected for this purpose which is a default solver inculcate in Fluent. The results obtained for Newtonian fluid flow agree well with previous works supporting Fluent’s usefulness in academic research. A thorough analysis of instantaneous and time-averaged flow fields are depicted both for Newtonian and pseudoplastic fluid flow. It has been observed that as the value of n reduces the stretching of shear layers also reduce and these layers try to roll up before the plate. For flow with high pseudoplasticity (n = 0.5) the nature of vortex shedding changes and the value of critical gap-ratio reduces. These are the remarkable findings for laminar periodic vortex shedding regime in pseudoplastic flow environment.Keywords: CFD, pseudoplastic fluid flow, wake-boundary layer interactions, critical gap-ratio
Procedia PDF Downloads 1127489 Deposition of Size Segregated Particulate Matter in Human Respiratory Tract and Their Health Effects in Glass City Residents
Authors: Kalpana Rajouriya, Ajay Taneja
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Particulates are ubiquitous in the air environment and cause serious threats to human beings, such as lung cancer, COPD, and Asthma. Particulates mainly arise from industrial effluent, vehicular emission, and other anthropogenic activities. In the glass industrial city Firozabad, real-time monitoring of size segregated Particulate Matter (PM) and black carbon was done by Aerosol Black Carbon Detector (ABCD) and GRIMM portable aerosol Spectrometer at two different sites in which one site is urban and another is rural. The average mass concentration of size segregated PM during the study period (March & April 2022) was recorded as PM10 (223.73 g/m⁻³), PM5.0 (44.955 g/m⁻³), PM2.5 (59.275 g/m⁻³), PM1.0 (33.02 g/m⁻³), PM0.5 (2.05 g/m⁻³), and PM0.25 (2.99 g/m⁻³). The highest concentration of BC was found in Urban due to the emissions from diesel engines and wood burning, while NO2 was highest at the rural sites. The average concentrations of PM10 (6.08 and 2.73 times) PM2.5 exceeded the NAAQS and WHO guidelines. Particulate Matter deposition and health risk assessment was done by MPPD and USEPA model to know about the particulate matter toxicity in industrial residents. Health risk assessment results showed that Children are most likely to be affected by exposure of PM10 and PM2.5 and may have various non-carcinogenic and carcinogenic diseases. Deposition results inferred that the sensitive exposed population, especially 9 years old children, have high PM deposition as well as visualization and may be at risk of developing health-related problems from exposure to size-segregated PM. They will be discussed during presentation.Keywords: particulate matter, black carbon, NO2, deposition of PM, health risk
Procedia PDF Downloads 707488 Predictors of Malnutrition and Quality of Life among Advanced Cervical Cancer Patients with Cachexia in Uganda
Authors: Innocent Atuhe, Alfred Jatho, Yusuf Mulumba, Babra Nalwadda, Jackson Orem
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Statement of the Problem: Malnutrition and cachexia are common in cancer and often contribute to poor health outcomes. Advanced cervical cancer patients are at an increased risk of malnutrition, chemo-toxicity, poor quality of life (QoL), and higher mortality. It is recommended to assess all cancer patients for malnutrition, risk of malnutrition, and QoL in order to provide targeted care, especially for advanced cancer patients. Objective: The aim of this study was to assess the prevalence of malnutrition or risk of malnutrition and health-related quality of life in advanced cervical cancer patients with cachexia. Methodology: This was a longitudinal study of 212 advanced cervical cancer patients with a confirmed diagnosis of cachexia receiving chemotherapy at the Uganda Cancer Institute between January 2022 and September 2023. We confirmed the diagnosis of cachexia using the international consensus definition. We evaluated each patient for malnutrition using the Mini Nutritional Assessment (MNA) tool and assessed their QoL using the Feeling of well-being (FWB) on the Edmonton Symptom Assessment System (ESAS) questionnaire and the Distress Thermometer (DT) questionnaire. Data was analyzed using Excel and presented using frequencies and percentages. Results: Of the 212 advanced cervical cancer patients with cachexia, 65 (31.7%) of the respondents were malnourished, and 118 (57.6%) were at risk of malnutrition; the average ESAS score was 3, indicating less symptom burden while 115 (54.2%) were extremely distressed with pain as major distress. Conclusion and Significance: The majority of the patients with advanced cervical cancer cachexia were at risk of malnutrition. There is an urgent need to assess all patients with advanced cancer for malnutrition and risk of malnutrition and immediate referral of those with malnutrition to the nutritionist for interventions to improve QoL and overall survival.Keywords: malnutrition, QoL, cachexia, cancer
Procedia PDF Downloads 107487 Sustainable Design for Building Envelope in Hot Climates: A Case Study for the Role of the Dome as a Component of an Envelope in Heat Exchange
Authors: Akeel Noori Almulla Hwaish
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Architectural design is influenced by the actual thermal behaviour of building components, and this in turn depends not only on their steady and periodic thermal characteristics, but also on exposure effects, orientation, surface colour, and climatic fluctuations at the given location. Design data and environmental parameters should be produced in an accurate way for specified locations, so that architects and engineers can confidently apply them in their design calculations that enable precise evaluation of the influence of various parameters relating to each component of the envelope, which indicates overall thermal performance of building. The present paper will be carried out with an objective of thermal behaviour assessment and characteristics of the opaque and transparent parts of one of the very unique components used as a symbolic distinguished element of building envelope, its thermal behaviour under the impact of solar temperatures, and its role in heat exchange related to a specific U-value of specified construction materials alternatives. The research method will consider the specified Hot-Dry weather and new mosque in Baghdad, Iraq as a case study. Also, data will be presented in light of the criteria of indoor thermal comfort in terms of design parameters and thermal assessment for a“model dome”. Design alternatives and considerations of energy conservation, will be discussed as well using comparative computer simulations. Findings will be incorporated to outline the conclusions clarifying the important role of the dome in heat exchange of the whole building envelope for approaching an indoor thermal comfort level and further research in the future.Keywords: building envelope, sustainable design, dome impact, hot-climates, heat exchange
Procedia PDF Downloads 4787486 Assessment of Solid Waste Management in General Mohammed Inuwa Wushishi Housing Estate, Minna, Niger State, Nigeria
Authors: Garba Inuwa Kuta, Mohammed, Adamu, Mohammed Ahmed Emigilati, Ibrahim Ishiaku, Kudu Dangana
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The study sought to identify the problems of solid waste management in General Mohammed InuwaWushishi Housing Estate. The two broad types of data, the secondary and primary data were used in the study. Questionnaires and personal observations were also used to collect some of the data. Factors impeding the effective and efficient solid waste management were identified. The study revealed that sacks disposal method and open dumping are the most commonly used method of disposal, about 30.0% of the respondent use sacks disposal method in the estate while 24.9% dump their refuse on the floor. Wrong attitudes and perceptions of the people about sanitation issues contributed to solid waste management problems of General Mohammed InuwaWushishi Housing Estate. Majority of the households did not educate their members on the need to clean their surroundings and refuse to buy drum for waste disposal from Niger State Environmental Protection Agency (NISEPA) on the basis that the drums are expensive. Virtually, all the people depended on Niger State Environmental Protection Agency (NISEPA) facilities for the disposal of their household refuse. Solid waste management problems were partly the results of NISEPA’s inability to cope with the situation because of lack of equipment. It was recommended that there should be an increase in enlightenment to the people on domestic waste disposal to keep the surroundings clean.Keywords: housing estate, assessment, solid waste, disposal, management
Procedia PDF Downloads 6577485 Relationship between Hepatokines and Insulin Resistance in Childhood Obesity
Authors: Mustafa Metin Donma, Orkide Donma
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Childhood obesity is an important clinical problem because it may lead to chronic diseases during the adulthood period of the individual. Obesity is a metabolic disease associated with low-grade inflammation. The liver occurs at the center of metabolic pathways. Adropin, fibroblast growth factor-21 (FGF-21), and fetuin-A are hepatokines. Due to the immense participation of the liver in glucose metabolism, these liver-derived factors may be associated with insulin resistance (IR), which is a phenomenon discussed within the scope of obesity problems. The aim of this study is to determine the concentrations of adropin, FGF-21, and fetuin-A in childhood obesity, to point out possible differences between the obesity groups, and to investigate possible associations among these three hepatokines in obese and morbidly obese children. A total of one hundred and thirty-two children were included in the study. Two obese groups were constituted. The groups were matched in terms of mean ± SD values of ages. Body mass index values of obese and morbidly obese groups were 25.0 ± 3.5 kg/m² and 29.8 ± 5.7 kg/m², respectively. Anthropometric measurements including waist circumference, hip circumference, head circumference, and neck circumference were recorded. Informed consent forms were taken from the parents of the participants. The ethics committee of the institution approved the study protocol. Blood samples were obtained after overnight fasting. Routine biochemical tests, including glucose- and lipid-related parameters, were performed. Concentrations of the hepatokines (adropin, FGF-21, fetuin A) were determined by enzyme-linked immunosorbent assay. Insulin resistance indices such as homeostasis model assessment for IR (HOMA-IR), alanine transaminase-to aspartate transaminase ratio (ALT/AST), diagnostic obesity notation model assessment laboratory index, diagnostic obesity notation model assessment metabolic syndrome index as well as obesity indices such as diagnostic obesity notation model assessment-II index, and fat mass index were calculated using the previously derived formulas. Statistical evaluation of the study data as well as findings of the study was performed by SPSS for Windows. Statistical difference was accepted significant when p is smaller than 0.05. Statistically significant differences were found for insulin, triglyceride, high-density lipoprotein cholesterol levels of the groups. A significant increase was observed for FGF-21 concentrations in the morbidly obese group. Higher adropin and fetuin-A concentrations were observed in the same group in comparison with the values detected in the obese group (p > 0.05). There was no statistically significant difference between the ALT/AST values of the groups. In all of the remaining IR and obesity indices, significantly increased values were calculated for morbidly obese children. Significant correlations were detected between HOMA-IR and each of the hepatokines. The highest one was the association with fetuin-A (r=0.373, p=0.001). In conclusion, increased levels observed in adropin, FGF-21, and fetuin-A have shown that these hepatokines possess increasing potential going from obese to morbid obese state. Out of the correlations found with the IR index, the most affected hepatokine was fetuin-A, the parameter possibly used as the indicator of the advanced obesity stage.Keywords: adropin, fetuin A, fibroblast growth factor-21, insulin resistance, pediatric obesity
Procedia PDF Downloads 1807484 Genetic Instabilities in Marine Bivalve Following Benzo(α)pyrene Exposure: Utilization of Combined Random Amplified Polymorphic DNA and Comet Assay
Authors: Mengjie Qu, Yi Wang, Jiawei Ding, Siyu Chen, Yanan Di
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Marine ecosystem is facing intensified multiple stresses caused by environmental contaminants from human activities. Xenobiotics, such as benzo(α)pyrene (BaP) have been discharged into marine environment and cause hazardous impacts on both marine organisms and human beings. As a filter-feeder, marine mussels, Mytilus spp., has been extensively used to monitor the marine environment. However, their genomic alterations induced by such xenobiotics are still kept unknown. In the present study, gills, as the first defense barrier in mussels, were selected to evaluate the genetic instability alterations induced by the exposure to BaP both in vivo and in vitro. Both random amplified polymorphic DNA (RAPD) assay and comet assay were applied as the rapid tools to assess the environmental stresses due to their low money- and time-consumption. All mussels were identified to be the single species of Mytilus coruscus before used in BaP exposure at the concentration of 56 μg/l for 1 & 3 days (in vivo exposure) or 1 & 3 hours (in vitro). Both RAPD and comet assay results were showed significantly increased genomic instability with time-specific altering pattern. After the recovery period in 'in vivo' exposure, the genomic status was as same as control condition. However, the relative higher genomic instabilities were still observed in gill cells after the recovery from in vitro exposure condition. Different repair mechanisms or signaling pathway might be involved in the isolated gill cells in the comparison with intact tissues. The study provides the robust and rapid techniques to exam the genomic stability in marine organisms in response to marine environmental changes and provide basic information for further mechanism research in stress responses in marine organisms.Keywords: genotoxic impacts, in vivo/vitro exposure, marine mussels, RAPD and comet assay
Procedia PDF Downloads 2847483 Evaluation of the Safety Status of Beef Meat During Processing at Slaughterhouse in Bouira, Algeria
Authors: A. Ameur Ameur, H. Boukherrouba
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In red meat slaughterhouses a significant number of organs and carcasses were seized because of the presence of lesions of various origins. The objective of this study is to characterize and evaluate the frequency of these lesions in the slaughterhouse of the Wilaya of BOUIRA. On cattle slaughtered in 2646 and inspected 72% of these carcasses have been no seizures against 28% who have undergone at least one entry. 325 lung (44%), 164 livers (22%), 149 hearts (21%) are the main saisis.38 kidneys members (5%), 33 breasts (4%) and 16 whole carcasses (2%) are less seizures parties. The main reasons are the input hydatid cyst for most seized organs such as the lungs (64.5%), livers (51.8%), hearts (23.2%), hydronephrosis for the kidneys (39.4%), and chronic mastitis (54%) for the breasts. Then we recorded second-degree pneumonia (16%) to the lungs, chronic fascioliasis (25%) for livers. A significant difference was observed (p < 0.0001) by sex, race, origin and age of all cattle having been saisie.une a specific input patterns and So pathology was recorded based on race. The local breed presented (75.2%) of hydatid cyst, (95%) and chronic fascioliasis (60%) pyelonephritis, for against the improved breed presented the entire respiratory lesions include pneumonia (64%) the chronic tuberculosis (64%) and mastitis (76%). These results are an important step in the implementation of the concept of risk assessment as the scientific basis of food legislation, by the identification and characterization of macroscopic damage leading withdrawals in meat and to establish the level of inclusion of these injuries within the recommended risk assessment systems (HACCP).Keywords: slaughterhouses, meat safety, seizure patterns, HACCP
Procedia PDF Downloads 4697482 Exploring Coping Mechanisms in Sudanese and Congolese Refugee Women Through Life Story Interviews
Authors: Gwyneth Bernier
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An authoritative literature review of peer-reviewed journals and edited books on East African refugees' coping strategies identifies the four most common coping skills among this group as the following: (1) relying on faith, religion, or another belief system, (2) turning to communities or social supports, (3) cognitive reframing--in other words, finding meaning in one's traumas or hardships--and (4) finding hope for the future, especially through education. However, this review recognizes that there are gaps in knowledge in this field and that the validity of these general findings must be further investigated in East African refugees who are women, have not been resettled in Western countries, and belong to specific nationality groups. This review also suggests studies that build on the current body of research begin to use qualitative methods of data collection and analysis. This paper aims to bridge part of that gap in understanding using a qualitative methodology. Specifically, it provides a more holistic view of East African refugees' psychological coping mechanisms through its analysis of trends observed across life story interviews from two participant groups: Sudanese refugee women in Cairo's informal settlements, Egypt and Congolese refugee women in Rwanda's Mahama camp.Keywords: Congolese refugees, coping mechanisms, refugee women, Sudanese refugees
Procedia PDF Downloads 1877481 Presence and Severity of Language Deficits in Comprehension, Production and Pragmatics in a Group of ALS Patients: Analysis with Demographic and Neuropsychological Data
Authors: M. Testa, L. Peotta, S. Giusiano, B. Lazzolino, U. Manera, A. Canosa, M. Grassano, F. Palumbo, A. Bombaci, S. Cabras, F. Di Pede, L. Solero, E. Matteoni, C. Moglia, A. Calvo, A. Chio
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Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease of adulthood, which primarily affects the central nervous system and is characterized by progressive bilateral degeneration of motor neurons. The degeneration processes in ALS extend far beyond the neurons of the motor system, and affects cognition, behaviour and language. To outline the prevalence of language deficits in an ALS cohort and explore their profile along with demographic and neuropsychological data. A full neuropsychological battery and language assessment was administered to 56 ALS patients. Neuropsychological assessment included tests of executive functioning, verbal fluency, social cognition and memory. Language was assessed using tests for verbal comprehension, production and pragmatics. Patients were cognitively classified following the Revised Consensus Criteria and divided in three groups showing different levels of language deficits: group 1 - no language deficit; group 2 - one language deficit; group 3 - two or more language deficits. Chi-square for independence and non-parametric measures to compare groups were applied. Nearly half of ALS-CN patients (48%) reported one language test under the clinical cut-off, and only 13% of patents classified as ALS-CI showed no language deficits, while the rest 87% of ALS-CI reported two or more language deficits. ALS-BI and ALS-CBI cases all reported two or more language deficits. Deficits in production and in comprehension appeared more frequent in ALS-CI patients (p=0.011, p=0.003 respectively), with a higher percentage of comprehension deficits (83%). Nearly all ALS-CI reported at least one deficit in pragmatic abilities (96%) and all ALS-BI and ALS-CBI patients showed pragmatic deficits. Males showed higher percentage of pragmatic deficits (97%, p=0.007). No significant differences in language deficits have been found between bulbar and spinal onset. Months from onset and level of impairment at testing (ALS-FRS total score) were not significantly different between levels and type of language impairment. Age and education were significantly higher for cases showing no deficits in comprehension and pragmatics and in the group showing no language deficits. Comparing performances at neuropsychological tests among the three levels of language deficits, no significant differences in neuropsychological performances were found between group 1 and 2; compared to group 1, group 3 appeared to decay specifically on executive testing, verbal/visuospatial learning, and social cognition. Compared to group 2, group 3 showed worse performances specifically in tests of working memory and attention. Language deficits have found to be spread in our sample, encompassing verbal comprehension, production and pragmatics. Our study reveals that also cognitive intact patients (ALS-CN) showed at least one language deficit in 48% of cases. Pragmatic domain is the most compromised (84% of the total sample), present in nearly all ALS-CI (96%), likely due to the influence of executive impairment. Lower age and higher education seem to preserve comprehension, pragmatics and presence of language deficits. Finally, executive functions, verbal/visuospatial learning and social cognition differentiate the group with no language deficits from the group with a clinical language impairment (group 3), while attention and working memory differentiate the group with one language deficit from the clinical impaired group.Keywords: amyotrophic lateral sclerosis, language assessment, neuropsychological assessment, language deficit
Procedia PDF Downloads 1697480 Models of Environmental, Crack Propagation of Some Aluminium Alloys (7xxx)
Authors: H. A. Jawan
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This review describes the models of environmental-related crack propagation of aluminum alloys (7xxx) during the last few decades. Acknowledge on effects of different factors on the susceptibility to SCC permits to propose valuable mechanisms on crack advancement. The reliable mechanism of cracking give a possibility to propose the optimum chemical composition and thermal treatment conditions resulting in microstructure the most suitable for real environmental condition and stress state.Keywords: microstructure, environmental, propagation, mechanism
Procedia PDF Downloads 4217479 Construction of a Dynamic Migration Model of Extracellular Fluid in Brain for Future Integrated Control of Brain State
Authors: Tomohiko Utsuki, Kyoka Sato
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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control
Procedia PDF Downloads 1597478 Group Attachment Based Intervention® Reduces Toddlers' Fearfulness
Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner
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The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear
Procedia PDF Downloads 1217477 Inverse Scattering for a Second-Order Discrete System via Transmission Eigenvalues
Authors: Abdon Choque-Rivero
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The Jacobi system with the Dirichlet boundary condition is considered on a half-line lattice when the coefficients are real valued. The inverse problem of recovery of the coefficients from various data sets containing the so-called transmission eigenvalues is analyzed. The Marchenko method is utilized to solve the corresponding inverse problem.Keywords: inverse scattering, discrete system, transmission eigenvalues, Marchenko method
Procedia PDF Downloads 1487476 Anxiety and Depression in Parents of Children with Developmental Disabilities in Early Childhood
Authors: S. Bagur, S. Verger, B. Mut
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Early childhood intervention (ECI) is the set of actions aimed at children aged 0-6 years with special needs, the family, and the environment that aim to improve child development and family well-being. Socio-educational intervention with children with disabilities and their families should be understood through the principles of family-centered practice (FCP). The multidisciplinary team of professionals carries out the intake, assessment, and intervention, understanding that families may experience mental health problems, parental role incompetence, or feelings of exclusion. This study examines the relationship between caregivers' levels of anxiety and depression and child development during the fostering and assessment phase. The design is quantitative, non-experimental, and cross-sectional. The sample consisted of 135 family members (78.5% female, 21.5% male) users of child development services in the Balearic Islands (Spain). Three questionnaires were completed: Anxiety and Depression Scale, Child Behavior Checklist (CBCL 1½-5), and sociodemographic questionnaire. The main results show that parents of children with special needs score higher on anxiety than on depression. It should be noted that professional discipline is a variable to be taken into account in relation to parents' perception of the improvement of their child's development. In addition, there is an association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. In short, we propose a reflection on the application of FCP during the intervention, understanding the lack of professional training as a predictor of quality in early intervention. Likewise, future lines of research are proposed to improve early care practices.Keywords: anxiety, depression, early childhood intervention, family
Procedia PDF Downloads 897475 An Analysis of New Service Interchange Designs
Authors: Joseph E. Hummer
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An efficient freeway system will be essential to the development of Africa, and interchanges are a key to that efficiency. Around the world, many interchanges between freeways and surface streets, called service interchanges, are of the diamond configuration, and interchanges using roundabouts or loop ramps are also popular. However, many diamond interchanges have serious operational problems, interchanges with roundabouts fail at high demand levels, and loops use lots of expensive land. Newer service interchange designs provide other options. The most popular new interchange design in the US at the moment is the double crossover diamond (DCD), also known as the diverging diamond. The DCD has enormous potential, but also has several significant limitations. The objectives of this paper are to review new service interchange options and to highlight some of the main features of those alternatives. The paper tests four conventional and seven unconventional designs using seven measures related to efficiency, cost, and safety. The results show that there is no superior design in all measures investigated. The DCD is better than most designs tested on most measures examined. However, the DCD was only superior to all other designs for bridge width. The DCD performed relatively poorly for capacity and for serving pedestrians. Based on the results, African freeway designers are encouraged to investigate the full range of alternatives that could work at the spot of interest. Diamonds and DCDs have their niches, but some of the other designs investigated could be optimum at some spots.Keywords: interchange, diamond, diverging diamond, capacity, safety, cost
Procedia PDF Downloads 2727474 Exposing the Concealed Impact: Evaluating the Role of Development Projects on Corruption Perception in Afghanistan
Authors: Jawad Taheri
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This paper investigates the impact of foreign aid-funded development projects on corruption perception in Afghanistan, utilizing instrumental variable (IV) approaches in regression analysis setting. Seven sub-categories of development projects are examined in order to have a glance over comparative usefulness of each project. The study incorporates natural disaster indicators as exogenous variables to mitigate endogeneity concerns and control variables. The findings reveal significant associations between certain types of projects and corruption perception. Road and bridge construction, irrigation, and agriculture projects are found to decrease corruption perception, fostering optimism and trust within affected communities. Mosque construction and healthcare initiatives aligned with religious beliefs also contribute to reduced corruption perception. However, drinking water projects are associated with increased corruption perception, highlighting potential challenges in their implementation. The study emphasizes the importance of well-implemented projects, cultural contexts, and effective governance in mitigating corruption and fostering trust within communities. These findings contribute to a refined understanding of the relationship between development projects and corruption perception in Afghanistan.Keywords: foreign aid, development projects, corruption perception, Afghanistan, instrumental variable analysis, survey of Afghan people (SAP), natural disasters, exogenous variation
Procedia PDF Downloads 797473 Improvement of Healthcare Quality and Psychological Stress Relieve for Transition Program in Intensive Care Units
Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang
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Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.Keywords: ICU, critical care transition program, healthcare, transition program
Procedia PDF Downloads 897472 Experimental Pain Study Investigating the Distinction between Pain and Relief Reports
Authors: Abeer F. Almarzouki, Christopher A. Brown, Richard J. Brown, Anthony K. P. Jones
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Although relief is commonly assumed to be a direct reflection of pain reduction, it seems to be driven by complex emotional interactions in which pain reduction is only one component. For example, termination of a painful/aversive event may be relieving and rewarding. Accordingly, in this study, whether terminating an aversive negative prediction of pain would be reflected in a greater relief experience was investigated, with a view to separating apart the effects of the manipulation on pain and relief. We use aversive conditioning paradigm to investigate the perception of relief in an aversive (threat) vs. positive context. Participants received positive predictors of a non-painful outcome which were presented within either a congruent positive (non-painful) context or an incongruent threat (painful) context that had been previously conditioned; trials followed by identical laser stimuli on both conditions. Participants were asked to rate the perceived intensity of pain as well as their perception of relief in response to the cue predicting the outcome. Results demonstrated that participants reported more pain in the aversive context compared to the positive context. Conversely, participants reported more relief in the aversive context compares to the neutral context. The rating of relief in the threat context was not correlated with pain reports. The results suggest that relief is not dependant on pain intensity. Consistent with this, relief in the threat context was greater than that in the positive expectancy condition, while the opposite pattern was obtained for the pain ratings. The value of relief in this study is better appreciated in the context of an impending negative threat, which is apparent in the higher pain ratings in the prior negative expectancy compared to the positive expectancy condition. Moreover, the more threatening the context (as manifested by higher unpleasantness/higher state anxiety scores), the more the relief is appreciated. The importance of the study highlights the importance of exploring relief and pain intensity in monitoring separately or evaluating pain-related suffering. The results also illustrate that the perception of painful input may largely be shaped by the context and not necessarily stimulus-related.Keywords: aversive context, pain, predictions, relief
Procedia PDF Downloads 1437471 Ultrasonic Agglomeration of Protein Matrices and Its Effect on Thermophysical, Macro- and Microstructural Properties
Authors: Daniela Rivera-Tobar Mario Perez-Won, Roberto Lemus-Mondaca, Gipsy Tabilo-Munizaga
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Different dietary trends worldwide seek to consume foods with anti-inflammatory properties, rich in antioxidants, proteins, and unsaturated fatty acids that lead to better metabolic, intestinal, mental, and cardiac health. In this sense, food matrices with high protein content based on macro and microalgae are an excellent alternative to meet the new needs of consumers. An emerging and environmentally friendly technology for producing protein matrices is ultrasonic agglomeration. It consists of the formation of permanent bonds between particles, improving the agglomeration of the matrix compared to conventionally agglomerated products (compression). Among the advantages of this process are the reduction of nutrient loss and the avoidance of binding agents. The objective of this research was to optimize the ultrasonic agglomeration process in matrices composed of Spirulina (Arthrospira platensis) powder and Cochayuyo (Durvillae Antartica) flour, by means of the response variable (Young's modulus) and the independent variables were the process conditions (percentage of ultrasonic amplitude: 70, 80 and 90; ultrasonic agglomeration times and cycles: 20, 25 and 30 seconds, and 3, 4 and 5). It was evaluated using a central composite design and analyzed using response surface methodology. In addition, the effects of agglomeration on thermophysical and microstructural properties were evaluated. It was determined that ultrasonic compression with 80 and 90% amplitude caused conformational changes according to Fourier infrared spectroscopy (FTIR) analysis, the best condition with respect to observed microstructure images (SEM) and differential scanning calorimetry (DSC) analysis, was the condition of 90% amplitude 25 and 30 seconds with 3 and 4 cycles of ultrasound. In conclusion, the agglomerated matrices present good macro and microstructural properties which would allow the design of food systems with better nutritional and functional properties.Keywords: ultrasonic agglomeration, physical properties of food, protein matrices, macro and microalgae
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