Search results for: emergency obstetric care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4413

Search results for: emergency obstetric care

1803 Nutritional Benefits of Soy: An Implication for Health Education

Authors: Mbadugha Esther Ifeoma

Abstract:

Soybeans, like other legumes are rich in nutrients. However, the nutrient profile of soybeans differs in some important ways from most other legumes. Among other nutrients, soy is high in protein, carbohydrates, and fibers, is rich in vitamins, minerals and unsaturated fatty acids and is low in saturated fatty acids. Because of its high nutritional value, it has been rated to be equivalent to meats, eggs and milk. Soy has many health benefits including prevention of coronary heart disease, prevention of cancer growth, improvement of cognitive function, promotion of bone health, prevention of obesity, prevention of type II diabetes and promotion of growth of normal floras in the colon. Soybean consumption is also associated with some side effects which include allergy, flatulence and abdominal discomfort. Nurses/health care providers should therefore, educate clients on the precautionary measures to be taken in preparing soy food products in order to reduce to the barest minimum the side effects, while encouraging them to include soy as part of their daily meals for optimal health and vitality.

Keywords: health benefit, health education, nutritional benefit, soybeans

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1802 Health Advocacy in Medical School: An American Survey on Attitudes and Engagement in Clerkships

Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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1801 Case Report of Angioedema after Application of Botulinum Toxin

Authors: Sokol Isaraj, Lorela Bendo

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Botulinum toxin is the most commonly used treatment to reduce the appearance of dynamic facial wrinkles. It can smooth out wrinkles and restore a more youthful appearance. Although allergic reactions after botox injection are rare, care should be taken by the physician to diagnose the condition and provide suitable treatment in time. The authors report a case of allergic reaction with angioedema to abobotulinumtoxin A. A 50-year-old woman complaining of dynamic wrinkles was injected in a private clinic with Dysport. After two weeks, she returned to the clinic for the touch-up session. Thirty minutes after the completion of the injections in the crow’s feet area, she described the feeling of mild pain and warmth in the injected area, followed by angioedema. The symptoms couldn’t be controlled by IM corticosteroid, and the patient was referred to a hospital center. After adequate systemic treatment for four days, there was a resolution of the symptoms. Despite the reported safety of abobotulinumtoxin A, this case warns practitioners of unpredictably adverse reactions, which require rapid recognition and intravenous support.

Keywords: botulinum toxin, side effects, angioedema, injections

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1800 Rehabilitation of CP Using Pediatric Functional Independent Measure (WeeFIM) as Indicator Instruments Suitable for CP: Saudi's Perspective

Authors: Bara M. Yousef

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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.

Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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1799 Family Satisfaction with Neuro-Linguistic Care for Patients with Alzheimer’s Disease

Authors: Sara Sahraoui

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This research studied the effect of Alzheimer's disease (AD) on language information processing in subjects with Alzheimer’s disease (AD) who were bilingual (French and dialectical Arabic). The results show a disorder of certain semantic aspects of their mother tongue (L1). On the other hand, grammatical levels appeared to be relatively unaffected in oral speech in L1 but were disturbed in the second language (L2). In consequence, we constructed a cognitive-language stimulation protocol for bilingual patients (PSCLAB) to respond to this disorder. The efficacy of this protocol in terms of rehabilitation was assessed in 30 such patients through discourse analysis carried out before and after initiating the protocol. The results show that cognitive/language training using the PSCLAB appears to improve the language behaviour of bilingual patients with AD. However, this survey study aims to verify the satisfaction of patients’ relatives with the results of cognitive language training by PSCLAB. We developed a brief instrument to measure the satisfaction of family members. The results report that the patient's relatives are satisfied with the results of cognitive training by PSCLAB.

Keywords: satisfaction, Alzheimer's disease, rehabilitation, levels language

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1798 Location Uncertainty – A Probablistic Solution for Automatic Train Control

Authors: Monish Sengupta, Benjamin Heydecker, Daniel Woodland

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New train control systems rely mainly on Automatic Train Protection (ATP) and Automatic Train Operation (ATO) dynamically to control the speed and hence performance. The ATP and the ATO form the vital element within the CBTC (Communication Based Train Control) and within the ERTMS (European Rail Traffic Management System) system architectures. Reliable and accurate measurement of train location, speed and acceleration are vital to the operation of train control systems. In the past, all CBTC and ERTMS system have deployed a balise or equivalent to correct the uncertainty element of the train location. Typically a CBTC train is allowed to miss only one balise on the track, after which the Automatic Train Protection (ATP) system applies emergency brake to halt the service. This is because the location uncertainty, which grows within the train control system, cannot tolerate missing more than one balise. Balises contribute a significant amount towards wayside maintenance and studies have shown that balises on the track also forms a constraint for future track layout change and change in speed profile.This paper investigates the causes of the location uncertainty that is currently experienced and considers whether it is possible to identify an effective filter to ascertain, in conjunction with appropriate sensors, more accurate speed, distance and location for a CBTC driven train without the need of any external balises. An appropriate sensor fusion algorithm and intelligent sensor selection methodology will be deployed to ascertain the railway location and speed measurement at its highest precision. Similar techniques are already in use in aviation, satellite, submarine and other navigation systems. Developing a model for the speed control and the use of Kalman filter is a key element in this research. This paper will summarize the research undertaken and its significant findings, highlighting the potential for introducing alternative approaches to train positioning that would enable removal of all trackside location correction balises, leading to huge reduction in maintenances and more flexibility in future track design.

Keywords: ERTMS, CBTC, ATP, ATO

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1797 Disaster Response Training Simulator Based on Augmented Reality, Virtual Reality, and MPEG-DASH

Authors: Sunho Seo, Younghwan Shin, Jong-Hong Park, Sooeun Song, Junsung Kim, Jusik Yun, Yongkyun Kim, Jong-Moon Chung

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In order to effectively cope with large and complex disasters, disaster response training is needed. Recently, disaster response training led by the ROK (Republic of Korea) government is being implemented through a 4 year R&D project, which has several similar functions as the HSEEP (Homeland Security Exercise and Evaluation Program) of the United States, but also has several different features as well. Due to the unpredictiveness and diversity of disasters, existing training methods have many limitations in providing experience in the efficient use of disaster incident response and recovery resources. Always, the challenge is to be as efficient and effective as possible using the limited human and material/physical resources available based on the given time and environmental circumstances. To enable repeated training under diverse scenarios, an AR (Augmented Reality) and VR (Virtual Reality) combined simulator is under development. Unlike existing disaster response training, simulator based training (that allows remote login simultaneous multi-user training) enables freedom from limitations in time and space constraints, and can be repeatedly trained with different combinations of functions and disaster situations. There are related systems such as ADMS (Advanced Disaster Management Simulator) developed by ETC simulation and HLS2 (Homeland Security Simulation System) developed by ELBIT system. However, the ROK government needs a simulator custom made to the country's environment and disaster types, and also combines the latest information and communication technologies, which include AR, VR, and MPEG-DASH (Moving Picture Experts Group - Dynamic Adaptive Streaming over HTTP) technology. In this paper, a new disaster response training simulator is proposed to overcome the limitation of existing training systems, and adapted to actual disaster situations in the ROK, where several technical features are described.

Keywords: augmented reality, emergency response training simulator, MPEG-DASH, virtual reality

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1796 Interventions and Supervision in Mental Health Services: Experiences of a Working Group in Brazil

Authors: Sonia Alberti

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The Regional Conference to Restructure Psychiatric Care in Latin America, convened by the Pan American Health Organization (PAHO) in 1990, oriented the Brazilian Federal Act in 2001 that stipulated the psychiatric reform which requires deinstitutionalization and community-based treatment. Since then, the 15 years’ experience of different working teams in mental health led an academic working group – supervisors from personal practices, professors and researchers – to discuss certain clinical issues, as well as supervisions, and to organize colloquia in different cities as a methodology. These colloquia count on the participation of different working teams from the cities in which they are held, with team members with different levels of educational degrees and prior experiences, in order to increase dialogue right where it does not always appear to be possible. The principal aim of these colloquia is to gain interlocution between practitioners and academics. Working with the theory of case constructions, this methodology revealed itself helpful in unfolding new solutions. The paper also observes that there is not always harmony between what the psychiatric reform demands and clinical ethics.

Keywords: mental health, supervision, clinical cases, Brazilian experience

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1795 The Psychological and Behavioral Problems of Children of the First Years and Their Interest in School Education

Authors: Amina Salem Attia

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This east project consists in studying The child's mental health is the medium through which he expresses his thoughts, so pay attention to it because it is an essential building block in the process of building the child's future personality, where it gives him a balance between feelings and mental thoughts, and since the family is the child's first guardian, it greatly affects his personality and psychological development. As the disturbed environment contributes to behavioral deviations and mental disorders, unlike the stable environment, which plays a major role in developing the child's abilities and forming his psychologically sound attitudes, this should not be forgotten about the role of the school, it is also the second social institution after the family and has a major impact on the child's mental health as it contributes It is important in forming the child's personality and developing his skills and achieving his healthy psychological development, by providing him with psychological care and helping him to solve his problems by using models that are valid for the behavior that is taught to him or that the teachers present in their daily behavior with him.

Keywords: psychological, behavioral problems, children, school education

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1794 Efficient Motion Estimation by Fast Three Step Search Algorithm

Authors: S. M. Kulkarni, D. S. Bormane, S. L. Nalbalwar

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The rapid development in the technology have dramatic impact on the medical health care field. Medical data base obtained with latest machines like CT Machine, MRI scanner requires large amount of memory storage and also it requires large bandwidth for transmission of data in telemedicine applications. Thus, there is need for video compression. As the database of medical images contain number of frames (slices), hence while coding of these images there is need of motion estimation. Motion estimation finds out movement of objects in an image sequence and gets motion vectors which represents estimated motion of object in the frame. In order to reduce temporal redundancy between successive frames of video sequence, motion compensation is preformed. In this paper three step search (TSS) block matching algorithm is implemented on different types of video sequences. It is shown that three step search algorithm produces better quality performance and less computational time compared with exhaustive full search algorithm.

Keywords: block matching, exhaustive search motion estimation, three step search, video compression

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1793 Policy Analysis and Program Evaluation: Need to Designate a Navigable Spatial Identity for Slums Dwellers in India to Maximize Accessibility and Policy Impact

Authors: Resham Badri

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Cities today are unable to justify equitable distribution of theirsocio- economic and infrastructural benefits to the marginalized urban poor, and the emergence of a pressing pandemic like COVID-19 has amplified its impact. Lack of identity, vulnerability, and inaccessibility contribute to exclusion. Owing to systemic gaps in institutional processes, urban development policiesfail to represent and cater to the urban poor. This paper aims to be a roadmap for the Indian Government to understand the significance of the designation of a navigable spatial identity to slum dwellers in the form of a digital address, which can form the fundamental basis of identification to enable accessibility to not only basic servicesbut also other utilities. Capitalizing on such a granular and technology backed approach shall allow to target and reach out to the urban poor strategically andaid effective urban governance. This paper adopts a three-pronged approach;(i) Policy analysis- understanding gaps in existing urban policies of India, such as the Pradhan Mantri Awas Yojana, Swachh Bharat Mission, and Adhaar Card policy, (ii) Program Evaluation- analyzing a case study, where slum dwellers in Kolhapur city in India have been provided with navigable addresses using Google Plus Codes and have gained access to basic services, vaccinations, and other emergency deliveries in COVID-19 times, (iii) Policy recommendation. This designation of a navigable spatial identity has tremendous potential to form the foundation on which policies can further base their data collection and service delivery processes to not only provide basic services but also other infrastructural and social welfare initiatives. Hence, a massive window of opportunity lies in addressing the unaddressed to elevate their living standards and respond to their basic needs.

Keywords: policy analysis, urban poor, navigable spatial identity, accessibility

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1792 Spatial Distribution of Socio-Economic Factors in Kogi State, Nigeria: Development Issues and Implication(s)

Authors: Yahya A. Sadiq, Grace F. Balogun, Olufemi J. Anjorin

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This study analyzed the spatial distribution of socio-economic factors in Kogi state with a view to examining its implications on the development of the state. Consequently, questionnaires were administered on both the selected individual respondents (784) in the state and on the administrative offices (local council offices, 21) to solicit relevant information on the spatial distribution of socio-economic factors in their areas. The collected data were tabulated and analyzed using percentages. The study revealed commerce/trade, education, and health care, etc. as the major socio-economic factors in the state but with marked variation/imbalance in their spatial distribution across the study area. The rural-based local government areas have far less of such important facilities. Conclusively, it was recommended that there is need for socio-economic transformation of living conditions of people in the study area especially by positively redistributing local political power and the resources that are abound in the state will be felt by everybody including the commoners.

Keywords: development, local government areas (LGAs), spatial distribution, socio-economic factors

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1791 A Time Delay Neural Network for Prediction of Human Behavior

Authors: A. Hakimiyan, H. Namazi

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Human behavior is defined as a range of behaviors exhibited by humans who are influenced by different internal or external sources. Human behavior is the subject of much research in different areas of psychology and neuroscience. Despite some advances in studies related to forecasting of human behavior, there are not many researches which consider the effect of the time delay between the presence of stimulus and the related human response. Analysis of EEG signal as a fractal time series is one of the major tools for studying the human behavior. In the other words, the human brain activity is reflected in his EEG signal. Artificial Neural Network has been proved useful in forecasting of different systems’ behavior especially in engineering areas. In this research, a time delay neural network is trained and tested in order to forecast the human EEG signal and subsequently human behavior. This neural network, by introducing a time delay, takes care of the lagging time between the occurrence of the stimulus and the rise of the subsequent action potential. The results of this study are useful not only for the fundamental understanding of human behavior forecasting, but shall be very useful in different areas of brain research such as seizure prediction.

Keywords: human behavior, EEG signal, time delay neural network, prediction, lagging time

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1790 Recycling Biomass of Constructed Wetlands as Precursors of Electrodes for Removing Heavy Metals and Persistent Pollutants

Authors: Álvaro Ramírez Vidal, Martín Muñoz Morales, Francisco Jesús Fernández Morales, Luis Rodríguez Romero, José Villaseñor Camacho, Javier Llanos López

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In recent times, environmental problems have led to the extensive use of biological systems to solve them. Among the different types of biological systems, the use of plants such as aquatic macrophytes in constructed wetlands and terrestrial plant species for treating polluted soils and sludge has gained importance. Though the use of constructed wetlands for wastewater treatment is a well-researched domain, the slowness of pollutant degradation and high biomass production pose some challenges. Plants used in CW participate in different mechanisms for the capture and degradation of pollutants that also can retain some pharmaceutical and personal care products (PPCPs) that are very persistent in the environment. Thus, these systems present advantages in line with the guidelines published for the transition towards friendly and ecological procedures as they are environmentally friendly systems, consume low energy, or capture atmospheric CO₂. However, the use of CW presents some drawbacks, as the slowness of pollutant degradation or the production of important amounts of plant biomass, which need to be harvested and managed periodically. Taking this opportunity in mind, it is important to highlight that this residual biomass (of lignocellulosic nature) could be used as the feedstock for the generation of carbonaceous materials using thermochemical transformations such as slow pyrolysis or hydrothermal carbonization to produce high-value biomass-derived carbons through sustainable processes as adsorbents, catalysts…, thereby improving the circular carbon economy. Thus, this work carried out the analysis of some PPCPs commonly found in urban wastewater, as salicylic acid or ibuprofen, to evaluate the remediation carried out for the Phragmites Australis. Then, after the harvesting, this biomass can be used to synthesize electrodes through hydrothermal carbonization (HTC) and produce high-value biomass-derived carbons with electrocatalytic activity to remove heavy metals and persistent pollutants, promoting circular economy concepts. To do this, it was chosen biomass derived from the natural environment in high environmental risk as the Daimiel Wetlands National Park in the center of Spain, and the rest of the biomass developed in a CW specifically designed to remove pollutants. The research emphasizes the impact of the composition of the biomass waste and the synthetic parameters applied during HTC on the electrocatalytic activity. Additionally, this parameter can be related to the physicochemical properties, as porosity, surface functionalization, conductivity, and mass transfer of the electrodes lytic inks. Data revealed that carbon materials synthesized have good surface properties (good conductivities and high specific surface area) that enhance the electro-oxidants generated and promote the removal of PPCPs and the chemical oxygen demand of polluted waters.

Keywords: constructed wetlands, carbon materials, heavy metals, pharmaceutical and personal care products, hydrothermal carbonization

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1789 Prevalence of Shift Work Disorders among Mongolian Nurses

Authors: Davaakhuu Vandannyam, Amarsaikhan Dashtseren, Oyungoo Badamdorj

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Background: Shift work and extended working hours are increasing in many industries and organization's in the world. Over a 24 hour period, the circadian clock regulates sleep/wake patterns, body temperature, hormone levels, digestion and many other functions. Depending on the time of day or night, the human body is programmed for periods of wakefulness and sleep, high and low body temperature, high and low digestive activity and so on. Shift work is highly prevalent in industrialized societies (>20%) but, when it includes night work, it has pronounced negative effects on sleep, subjective and physiological sleepiness, performance, accident risk, as well as on health outcomes such as cardiovascular disease and certain forms of cancer. Method: In this cross-sectional field study, 634 shift work and day work nurses from a plant were involved, with participation rate of 100% (634 nurses). The general health questionnaire (GHQ-28) and RLS, ESS, ISI, FSS were used to evaluate the level of insomnia, sleepiness, fatigue and restless legs syndrome, respectively. Results: As a result of research on some indicators of health risks caused from work shift, it was proven that prevalence of restless legs syndrome was at 5.5% and 25.9% are in risk of becoming sick, 42.3% are in fatigue, 3.5% in high stage of insomnia and 27.4% are sleepy on duty. Insomnia of nurses mainly affected from long-hour shift, dissatisfaction, workload, lose of focus and use of coffee. There is sleepiness lies in the workplace due to number of shifts, unsatisfactory performance and emergency calls between shifts. It has been determined that risk of sickness influenced by number of shifts in a month and long hour shift, dissatisfaction and use of coffee and divisions are causing restless legs syndrome. Conclusions: Among the nurses, it was found that the prevalence of insomnia is 31.6%, sleepiness 27.4%, fatigue 42.3%, restless legs syndrome 35% and stress 25.9%. These factors of shift work affecting health tend to go up as working hours increase and more common among shift work nurses.

Keywords: shiftwork, insomnia, sleepiness, restless

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1788 Perception of Health Care Providers on the Use of Modern Contraception by Adolescents in Rwanda

Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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1787 Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Laparoscopic Sleeve Gastrectomy (LSG); A Systematic Review and Meta-analysis

Authors: Misbah Nizamani, Saira Malik

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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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1786 Transboundary Pollution after Natural Disasters: Scenario Analyses for Uranium at Kyrgyzstan-Uzbekistan Border

Authors: Fengqing Li, Petra Schneider

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Failure of tailings management facilities (TMF) of radioactive residues is an enormous challenge worldwide and can result in major catastrophes. Particularly in transboundary regions, such failure is most likely to lead to international conflict. This risk occurs in Kyrgyzstan and Uzbekistan, where the current major challenge is the quantification of impacts due to pollution from uranium legacy sites and especially the impact on river basins after natural hazards (i.e., landslides). By means of GoldSim, a probabilistic simulation model, the amount of tailing material that flows into the river networks of Mailuu Suu in Kyrgyzstan after pond failure was simulated for three scenarios, namely 10%, 20%, and 30% of material inputs. Based on Muskingum-Cunge flood routing procedure, the peak value of uranium flood wave along the river network was simulated. Among the 23 TMF, 19 ponds are close to the river networks. The spatiotemporal distributions of uranium along the river networks were then simulated for all the 19 ponds under three scenarios. Taking the TP7 which is 30 km far from the Kyrgyzstan-Uzbekistan border as one example, the uranium concentration decreased continuously along the longitudinal gradient of the river network, the concentration of uranium was observed at the border after 45 min of the pond failure and the highest value was detected after 69 min. The highest concentration of uranium at the border were 16.5, 33, and 47.5 mg/L under scenarios of 10%, 20%, and 30% of material inputs, respectively. In comparison to the guideline value of uranium in drinking water (i.e., 30 µg/L) provided by the World Health Organization, the observed concentrations of uranium at the border were 550‒1583 times higher. In order to mitigate the transboundary impact of a radioactive pollutant release, an integrated framework consisting of three major strategies were proposed. Among, the short-term strategy can be used in case of emergency event, the medium-term strategy allows both countries handling the TMF efficiently based on the benefit-sharing concept, and the long-term strategy intends to rehabilitate the site through the relocation of all TMF.

Keywords: Central Asia, contaminant transport modelling, radioactive residue, transboundary conflict

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1785 Drought Resilient Water Supply for Livelihood: Establishment of Groundwater Treatment Plant at Construction Sites in Taichung City

Authors: Shang-Hsin Ou, Yang-Chun Lin, Ke-Hao Cheng

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The year 2021 marked a historic drought in Taiwan, posing unprecedented challenges due to record-low rainfall and inadequate reservoir storage. The central region experienced water scarcity, leading to the implementation of "Groundwater Utilization at Construction Sites" for drought-resilient livelihood water supply. This study focuses on the establishment process of temporary groundwater treatment plants at construction sites in Taichung City, serving as a reference for future emergency response and the utilization of construction site groundwater. To identify suitable sites for groundwater reuse projects, site selection operations were carried out based on relevant water quality regulations and assessment principles. Subsequently, the planning and design of temporary water treatment plants were conducted, considering the water quality, quantity, and on-site conditions of groundwater wells associated with construction projects. The study consolidates the major water treatment facilities at each site and addresses encountered challenges during the establishment process. Practical insights gained from operating temporary groundwater treatment plants are presented, including improvements related to stable water quality, water quantity, equipment operation, and hydraulic control. In light of possible future droughts, this study provides an outlook and recommendations to expedite and improve the setup of groundwater treatment plants at construction sites. This includes considering on-site water abstraction, treatment, and distribution conditions. The study's results aim to offer practical guidelines for effectively establishing and managing such treatment plants, while offering experiences and recommendations for other regions facing similar emergencies, water shortages, and drought situations. These endeavors contribute to ensuring sustainable water supply for drought-resilient livelihoods and maintaining societal stability.

Keywords: drought resilience, groundwater treatment, construction site, water supply

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1784 Perspectives and Outcomes of a Long and Shorter Community Mental Health Program

Authors: Danielle Klassen, Reiko Yeap, Margo Schmitt-Boshnick, Scott Oddie

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The development of the 7-week Alberta Happiness Basics program was initiated in 2010 in response to the need for community mental health programming. This provincial wide program aims to increase overall happiness and reduce negative thoughts and feelings through a positive psychology intervention. While the 7-week program has proven effective, a shortened 4-week program has additionally been developed to address client needs. In this study, participants were interviewed to determine if the 4- and 7-week programs had similar success of producing lasting behavior change at 3, 6, and 9 months post-program. A health quality of life (HQOL) measure was also used to compare the two programs and examine patient outcomes. Quantitative and qualitative analysis showed significant improvements in HQOL and sustainable behavior change for both programs. Findings indicate that the shorter, patient-centered program was effective in increasing happiness and reducing negative thoughts and feelings.

Keywords: primary care, mental health, depression, short duration

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1783 The Attitude and Willingness to Use Telecare for Arthritis Patients

Authors: Jui-Chen Huang

Abstract:

Nowadays, the population is aging, the number of people who need to be taken care of is increased, but the manpower and funding are insufficient. Therefore, this study aims to explore the attitudes and willingness of arthritis patients to adopt telecare and to take a large medical institution in the central area of Taiwan as a sample hospital. A structured questionnaire (using the Likert five-point scale) was used to collect chronic patients over 20 years old as sample data, and a total of 500 valid questionnaires were effectively collected. The SPSS 18.0 statistical software was used for reliability analysis and independent sample t-test to explore the differences in attitudes and willingness to use telecare for arthritis patients and non-arthritic patients. The Cronbach's alpha value of this study questionnaire was above 0.94, showing good reliability. Arthritis patients and non-arthritic patients had statistically significant differences in attitudes toward telecare, while the willingness to use did not reach statistically significant differences. In addition, the average attitude and intention of arthritis patients for telecare are 3.38 and 3.41, respectively, indicating that arthritis patients have a certain degree of attitude and willingness to adopt telecare, which is worthy of follow-up research and practical industry push.

Keywords: telecare, arthritis patients, attitudes, intention

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1782 Comparison of Parent’s Treatment and Education Priorities between Verbal and Non-Verbal Children with Autism Spectrum Disorder in Iranian Families

Authors: Elanz Alimi, Mehdi Ghanadzade

Abstract:

This current study compared the parents reported treatment and education priorities between verbal and nonverbal children with an autism spectrum disorder (ASD). Participants were 196 parents of 2 to 21-year-old (83 non-verbal and 113 verbal) children and adolescents with an ASD who completed questionnaires measuring parent’s treatment and education priorities, child’s educational and intervention programs and current child’s level of performance according to each skill. Results of this study indicated that parents of verbal children with autism spectrum disorder considered communication skills, community living skills and academic skills correspondingly as their highest intervention and education priorities and parents of non-verbal children with ASD reported communication skills, social relationship skills and self-care skills as the most significant priorities for their children. Findings show that for Iranian parents of both verbal and non-verbal children with ASD, communication skills are the most crucial treatment priority.

Keywords: autism, communication skills, Iran, parent’s priorities

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1781 A Systematic Review in the Impacts of Skilled Parent Migration on Left-Behind Children: Gaps in the Existing Knowledge

Authors: Yassir Mohammed

Abstract:

The study examines the impact of skilled parental migration on left-behind children. It uses the SCOPUS database to evaluate the existing literature from 1972 to 2022 and synthesizes data using the PRISMA framework and bibliometric method of analysis. 49 articles out of 202 papers were involved in the synthesis. International migration, outcome migration, consequence, parental migration, high-skill and left-behind children, and left-behind preschool were all searched. The research found that mental health issues, self-isolation, and physical harm have negative impacts, while sending children to good schools, having good academic records, and better medical care have positive impacts. The study also found that gender gaps increase in some countries while decreasing in others. Further research is needed on child maltreatment, academic performance, subjective well-being, societal effects, behavioral difficulties, and quality of life. The study only included peer-reviewed English publications in the final analysis.

Keywords: parental migration, impact of migration, systematic review, left-behind children

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1780 Designing for Wearable Interactions: Exploring Care Design for Design Anthropology and Participatory Design

Authors: Wei-Chen Chang, Yu-Cheng Pei

Abstract:

This research examines wearable interaction design to mediate the design anthropology and participatory design found in technology and fashion. We will discuss the principles of design anthropology and participatory design using a wearable and fashion product process to transmit the ‘people-situation-reason-object’ method and analyze five sense applied examples that provide new thinking for designers engaged in future industry. Design anthropology and Participatory Design attempt to engage physiological and psychological design through technology-function, meaning-form and fashion aesthetics to achieve cognition between user and environment. The wearable interaction provides technological characteristics and semantic ideas transmitted to craft-cultural, collective, cheerful and creative performance. It is more confident and innovative attempt, that is able to achieve a joyful, fundamental interface. This study takes two directions for cultural thinking as the basis to establish a set of life-craft designs with interactive experience objects by users that assist designers in examining the sensual feelings to initiate a new lifestyle value.

Keywords: design anthropology, wearable design, design communication, participatory design

Procedia PDF Downloads 228
1779 Impact of Overall Teaching Program of Anatomy in Learning: A Students Perspective

Authors: Mamatha Hosapatna, Anne D. Souza, Antony Sylvan Dsouza, Vrinda Hari Ankolekar

Abstract:

Our study intends to know the effect of the overall teaching program of Anatomy on a students learning. The advancement of various teaching methodologies in the present era has led to progressive changes in education. A student should be able to correlate well between the theory and practical knowledge attained even in the early years of their education in medicine and should be able to implement the same in patient care. The present study therefore aims to assess the impact the current anatomy teaching program has on a students learning and to what extent is it successful in making the learning program effective. Specific objectives of our study to assess the impact of overall teaching program of Anatomy in a students’ learning. Description of process proposed: A questionnaire will be constructed and the students will be asked to put forth their views regarding the Anatomy teaching program and its method of assessment. Suggestions, if any will also be encouraged to be put forth. Type of study is cross sectional observations. Target population is the first year MBBS students and sample size is 250. Assessment plan is to obtaining students responses using questionnaire. Calculating percentages of the responses obtained. Tabulation of the results will be done.

Keywords: anatomy, observational study questionnaire, observational study, M.B.B.S students

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1778 A Robust Optimization Method for Service Quality Improvement in Health Care Systems under Budget Uncertainty

Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

Abstract:

With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: allocation, budget uncertainty, healthcare resource, service quality assessment, robust optimization

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1777 Lifetime Assessment for Test Strips of POCT Device through Accelerated Degradation Test

Authors: Jinyoung Choi, Sunmook Lee

Abstract:

In general, single parameter, i.e. temperature, as an accelerating parameter is used to assess the accelerated stability of Point-of-Care Testing (POCT) diagnostic devices. However, humidity also plays an important role in deteriorating the strip performance since major components of test strips are proteins such as enzymes. 4 different Temp./Humi. Conditions were used to assess the lifetime of strips. Degradation of test strips were studied through the accelerated stability test and the lifetime was assessed using commercial POCT products. The life distribution of strips, which were obtained by monitoring the failure time of test strip under each stress condition, revealed that the weibull distribution was the most proper distribution describing the life distribution of strips used in the present study. Equal shape parameters were calculated to be 0.9395 and 0.9132 for low and high concentrations, respectively. The lifetime prediction was made by adopting Peck Eq. Model for Stress-Life relationship, and the B10 life was calculated to be 70.09 and 46.65 hrs for low and high concentrations, respectively.

Keywords: accelerated degradation, diagnostic device, lifetime assessment, POCT

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1776 Synthesis and Characterization of Novel Hollow Silica Particle through DODAB Vesicle Templating

Authors: Eun Ju Park, Wendy Rusli, He Tao, Alexander M. Van Herk, Sanggu Kim

Abstract:

Hollow micro-/nano- structured materials have proven to be promising in wide range of applications, such as catalysis, drug delivery and controlled release, biotechnology, and personal and consumer care. Hollow sphere structures can be obtained through various templating approaches; colloid templates, emulsion templates, multi-surfactant templates, and single crystal templates. Vesicles are generally the self-directed assemblies of amphiphilic molecules including cationic, anionic, and cationic surfactants in aqueous solutions. The directed silica capsule formations were performed at the surface of dioctadecyldimethylammoniumbromide(DODAB) bilayer vesicles as soft template. The size of DODAB bilayer vesicles could be tuned by extrusion of a preheated dispersion of DODAB. The synthesized hollow silica particles were characterized by conventional TEM, cryo-TEM and SEM to determine the morphology and structure of particles and dynamic light scattering (DLS) method to measure the particle size and particle size distribution.

Keywords: characterization, DODAB, hollow silica particle, synthesis, vesicle

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1775 Field Prognostic Factors on Discharge Prediction of Traumatic Brain Injuries

Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

Abstract:

Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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1774 Structuring and Visualizing Healthcare Claims Data Using Systems Architecture Methodology

Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

Abstract:

Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics

Procedia PDF Downloads 344