Search results for: nutritional intervention
570 Compliance Of Dialysis patients With Nutrition Guidelines: Insights From A Questionnaire
Authors: Zeiler M., Stadler D., Schmaderer C.
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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake
Procedia PDF Downloads 63569 A Rare Case of Synchronous Colon Adenocarcinoma
Authors: Mohamed Shafi Bin Mahboob Ali
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Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.Keywords: synchronous, colon, tumor, adenocarcinoma
Procedia PDF Downloads 102568 Serum Vitamin D and Carboxy-Terminal TelopeptideType I Collagen Levels: As Markers for Bone Health Affection in Patients Treated with Different Antiepileptic Drugs
Authors: Moetazza M. Al-Shafei, Hala Abdel Karim, Eitedal M. Daoud, Hassan Zaki Hassuna
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Epilepsy is a common neurological disorder affecting all age groups. It is one of the world's most prevalent non-communicable diseases. Increased evidence suggesting that long term usage of anti-epileptic drugs can have adverse effects on bone mineralization and bone molding .Aiming to study these effects and to give guide lines to support bone health through early intervention. From Neurology Out-Patient Clinic kaser Elaini University Hospital, 60 Patients were enrolled, 40 patients on antiepileptic drugs for at least two years and 20 controls matched with age and sex, epileptic but before starting treatment both chosen under specific criteria. Patients were divided into four groups, three groups with monotherapy treated with either Phynetoin, Valporic acid or Carbamazipine and fourth group treated with both Valporic acid and Carbamazipine. Estimation of serum Carboxy-Terminal Telopeptide of Type I- Collagen(ICTP) bone resorption marker, serum 25(OH )vit D3, calcium ,magnesium and phosphorus were done .Results showed that all patients on AED had significant low levels of 25(OH) vit D3 (p<0.001) ,with significant elevation of ICTP (P<0.05) versus controls. In group treated with Phynotoin highly significant elevation of (ICTP) marker and decrease of both serum 25(OH) vit D3 (P<0, 0001) and serum calcium(P<0.05)versus control. Double drug group showed significant decrease of serum 25(OH) vit D3 (P<0.0001) and decrease in Phosphorus (P<0.05) versus controls. Serum magnesium showed no significant differences between studied groups. We concluded that Anti- epileptic drugs appears to be an aggravating factor on bone mineralization ,so therapeutically it can be worth wile to supplement calcium and vitamin D even before initiation of antiepileptic therapy. ICTP marker can be used to evaluate change in bone resorption before and during AED therapy.Keywords: antiepileptic drugs, bone minerals, carboxy teminal telopeptidetype-1-collagen bone resorption marker, vitamin D
Procedia PDF Downloads 489567 Fight the Burnout: Phase Two of a NICU Nurse Wellness Bundle
Authors: Megan Weisbart
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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.Keywords: burnout, NICU, nurse, wellness
Procedia PDF Downloads 82566 Women Entrepreneurship: An Era Facing Challenges
Authors: Neetika Mahajan, Awanish Shukla
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Entrepreneurship is key a driver to economic development. It opens opportunities for business startups and has potential to expand employment opportunities for many. Entrepreneurship gives ‘Purpose thriving’ approach towards society with new technologies and zeal to develop and compete in the market. There are many more advantages of entrepreneurship like freedom to scope of work and independence in setting own goals. Women contribute to nearly 50 percent of India’s population, constitute nearly 10 percent of a total number of entrepreneurs in India. Women are found to be better risk calculators, more ambitious and less prone to self-confidence. However, It is a hard fact that life has not been easy for women aspiring professional success. Gender parity is the biggest threat faced by female aspirant seeking new businesses. More challenges like socio-cultural barriers, insufficient financial assistance, etc. have been faced by the women of our country. To uplift the status of women in the society, a number of initiatives have been taken up by the Government of India. Initiatives like National Mission for Empowerment of Women by (Ministry of Women And Child Development) and SKILL INDIA aim to increase the technical skills and knowledge of women for tapping employment opportunities and self-confidence. Trade Related Entrepreneurship Assistance and Development (TREAD) Scheme and Mahila Coir Yojana are proposed by the Ministry of MSMEs aiming to facilitate employment opportunities for women and entrepreneurship development. This paper will aim to bring out the gaps and barriers, which are still resisting the potential women come upfront and start a new business irrespective of a number of initiatives being put by government of India. The aim is also to identify focus areas where further intervention is required and proposing suitable interventions. The methodology to take forward this research will include primary and secondary data collection from on ground survey to track various kind of challenges faced by aspirant women entrepreneurs. Insight will be put towards initiations by the government of India towards women empowerment and assistance to entrepreneurship. Scientific quantitative tools will be used to analyze collected information. The final output of the research shall focus on achieving the respective aims and objectives.Keywords: women entrepreneurship, government programs and schemes, key challenges, economic development
Procedia PDF Downloads 248565 Reducing the Stigma of Homelessness through Community Engagement and Reciprocity
Authors: Jessica Federman
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The current research offers a longitudinal and qualitative study design to examine how reciprocity improves relations between the homeless and various stakeholders within a community. The study examines a homeless shelter that sought to establish a facility within a community of Los Angeles, that was initially met with strong resistance and opposition from a variety of organizations due to deeply entrenched views about the negative impact of having homeless individuals within the community. The project tested an intervention model that targets the reduction of stigmatization of homeless individuals and promotes synergistic exchanges between conflicted organizational entities in communities. Years later, the data show that there has been a remarkable reversal in the perception of the agency by the very forces that initially prevented it from being established. This reversal was achieved by a few key strategic decisions. Community engagement was the first step toward changing people’s minds and demonstrating how the homeless shelter was helping to alleviate the problem of homelessness instead of contributing to it. Central to the non-profit’s success was the agency’s pioneering formulation of a treatment model known as, Reciprocal Community Engagement Model (RCEM). The model works by reintegrating the homeless back into society through relationship building within a network of programs that foster positive human connections. This approach aims to draw the homeless out of the debilitating isolation of their situation, reintegrate them through purposeful roles in the community while simultaneously providing a reciprocal benefit to the community at large. Through multilevel, simultaneous social interaction, RCEM has a direct impact not only on the homeless shelter’s clients but also for the community as well. The agency’s approach of RCEM led to their homeless clients getting out of the shelter and getting to work in the community directly alongside other community volunteers and for the benefit of other city and community organizations. This led to several opportunities for community members and residents to interact in meaningful ways. Through each successive exposure, the resident and community members’ distrust in one another was gradually eased and a mutually supportive relationship restored. In this process, the community member becomes the locus of change as much as the residents of the shelter. Measurements of community trust and resilience increased while negative perceptions of homeless people decreased.Keywords: stigma, homelessness, reciprocity, identity
Procedia PDF Downloads 171564 The ReliVR Project: Feasibility of a Virtual Reality Intervention in the Psychotherapy of Depression
Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann
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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.Keywords: virtual reality therapy, digital health, depression, psychotherapy
Procedia PDF Downloads 57563 Children in Conflict: Institutionalization as a Rehabilitative Mechanism in Jammu and Kashmir
Authors: Moksha Singh
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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation
Procedia PDF Downloads 240562 Reconceptualizing Human Trafficking: Revealings of the Experience of Ethiopian Migrant Returnees
Authors: Waganesh Zeleke, Abebaw Minaye
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This study examined the act, means, and purpose of human trafficking in the case of Ethiopian migrant returnees from the Middle East and South Africa. Using a questionnaire survey data was gathered from 1078 returnees. Twelve focus group discussions were used to solicit detailed experience of returnee about the process of their 'unsafe' immigration. Both quantitative and qualitative analysis results revealed that against the mainstream thinking of human trafficking means such as forcing, coercing, abducting or threatening, traffickers used 'victims’ free will' means by providing false promises to and capitalizing on the vulnerability of migrants. The migrants’ living condition including unemployment, ambitious view to change their life, and low level of risk perception were found to be risk factors which made them vulnerable and target of the brokers and smugglers who served as a catalyst in the process of their 'unsafe' migration. Equal to the traffickers/brokers/agency, the migrants’ family, friends and Ethiopian embassies contributed to the deplorable situation of migrant workers. 64.4% of the returnees reported that their migration is self-initiated, and 20% reported peer pressure and 13.8 percent reported family pressure, and it is only 1.8% who reported having been pushed by brokers. The findings revealed that 69.5% of the returnees do not know about the lifestyle and culture of the host community before their leave. In a similar vein, 50.9% of the returnees reported that they do not know about the nature of the work they are to do and their responsibilities. Further, 81% of the returnees indicated that the pre-migration training they received was not enough in equipping them with the required skill. Despite the returnees experiences of various forms of abuse and exploitation in the journey and at the destination they still have a positive attitude for migration (t=9.7 mean of 18.85 with a test value of 15). The returnees evaluated the support provided by sending agencies and Ethiopian embassies in the destination to be poor. 51.8% of the migrants do not know the details of the contract they signed during migration. Close to 70% of the returnees expressed that they had not got any legal support from stakeholders when they faced problems. What is more is that despite all these 27.9% of the returnees indicated re-immigrating as their plan. Based on these findings on the context and experience of Ethiopian migrant returnees, implications for training, policy, research, and intervention are discussed.Keywords: trafficking, migrant, returnee, Ethiopia, experience, reconceptualizing
Procedia PDF Downloads 305561 The Development of a Cyber Violence Measurement Tool for Youths: A Multi-Reporting of Ecological Factors
Authors: Jong-Hyo Park, Eunyoung Choi, Jae-Yeon Lim, Seon-Suk Lee, Yeong-Rong Koo, Ji-Ung Kwon, Kyung-Sung Kim, Jong-Ik Lee, Juhan Park, Hyun-Kyu Lee, Won-Kyoung Oh, Jisang Lee, Jiwon Choe
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Due to COVID-19, cyber violence among youths has soared as they spend more time online than before. In contrast to the deepening concerns, measurement tools that can assess the vulnerability of cyber violence in individual youths still need to be supplemented. The measurement tools lack consideration of various factors related to cyber violence among youths. Most of the tools are self-report questionnaires, and these adolescents' self-report questionnaire forms can underestimate the harmful behavior and overestimate the damage experience. Therefore, this study aims to develop a multi-report measurement tool for youths that can reliably measure individuals' ecological factors related to cyber violence. The literature review explored factors related to cyber violence, and the questions were constructed. The face validity of the questions was confirmed by conducting focus group interviews. Exploratory and confirmatory factor analyses (N=671) were also conducted for statistical validation. This study developed a multi-report measurement tool for cyber violence with 161 questions, consisting of six domains: online behavior, cyber violence awareness, victimization-perpetration-witness experience, coping efficacy (individuals, peers, teachers, and parents), psychological characteristics, and pro-social capabilities. In addition to self-report from a youth respondent, this measurement tool includes peers, teachers, and parents reporting for the respondent. It is possible to reliably measure the ecological factors of individual youths who are vulnerable or highly resistant to cyber violence. In schools, teachers could refer to the measurement results for guiding students, better understanding their cyber violence conditions, and assessing their pro-social capabilities. With the measurement results, teachers and police officers could detect perpetrators or victims and intervene immediately. In addition, this measurement tool could analyze the effects of the prevention and intervention programs for cyber violence and draw appropriate suggestions.Keywords: adolescents, cyber violence, cyber violence measurement tool, measurement tool, multi-report measurement tool, youths
Procedia PDF Downloads 96560 Efficacy of the Culturally Adapted Stepping Stones Positive Parenting Program on Parents of Children with Autism and down Syndrome
Authors: Afsheen Masood, Sumaira Rashid, Shama Mazahir
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The main aim of this research is to evaluate the efficacy of a culturally adapted management program The Stepping Stones Positive Parenting Program (Tripple P; SSTP) for caregivers of children with autism spectrum disorders and Down syndrome. Positive psychology has catered new dimensions to the traditional perspectives of parenting. The current study was designed to determine the adoptions of positive parenting elements such as parenting styles, parental satisfaction, parental competency, and management of parental stress in alignment with behavioral problems of children with special needs after their parents get trained on Positive Parenting Techniques. This research study was devised in liaison with rehabilitation institute that is extending services for children with Autism Spectrum Disorder and Down syndrome. A Quasi experimental research design was employed with pre-test, post-test control group study in order to evaluate the changes in parenting patterns of parents with children (with Autism and Down syndrome). Caregivers of children diagnosed with Autism and Down syndrome between the age ranges of 25 to 45 years, n=20 from autism group and 20 from Down syndrome group (while their children with special needs in the age ranges of 8 to 14 years) participated in the current research. Parenting scale encompassing areas of parental efficacy, parental satisfaction was used in addition to Parenting Stress Index (SF), indigenously developed Child Behavior Problems Checklist and demographic sheet. Findings revealed statistically significant improvement for caregivers in intervention group from pretest to posttest situation. There was considerable decrease in reported mean behavioral issues of children with Down syndrome when parents in experimental group started practicing Positive Parenting Techniques with their special needs children. This change was somehow not recorded in parents of children with autism. Thus these findings establish the efficacy of culturally adapted parenting program that is evidence based and is established in western empirical research. This carries significant implication for practitioners in special needs domain and for school psychologists in Pakistan.Keywords: Autism and Parenting, Downsyndrome and Parenting , Positive Parenting, Stepping Stone Positive Parenting Program, Mangement of Behavioral Problems with positive parenting
Procedia PDF Downloads 246559 The Importance of Oral Mucosal Biopsy Selection Site in Areas of Field Change: A Case Report
Authors: Timmis W., Simms M., Thomas C.
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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco
Procedia PDF Downloads 107558 Liquid Unloading of Wells with Scaled Perforation via Batch Foamers
Authors: Erwin Chan, Aravind Subramaniyan, Siti Abdullah Fatehah, Steve Lian Kuling
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Foam assisted lift technology is proven across the industry to provide efficient deliquification in gas wells. Such deliquification is typically achieved by delivering the foamer chemical downhole via capillary strings. In highly liquid loaded wells where capillary strings are not readily available, foamer can be delivered via batch injection or bull-heading. The latter techniques differ from the former in that cap strings allow for liquid to be unloaded continuously, whereas foamer batches require that periodic batching be conducted for the liquid to be unloaded. Although batch injection allows for liquid to be unloaded in wells with suitable water to gas (WGR) ratio and condensate to gas (CGR) ratio without well intervention for capillary string installation, this technique comes with its own set of challenges - for foamer to de-liquify liquids, the chemical needs to reach perforation locations where gas bubbling is observed. In highly scaled perforation zones in certain wells, foamer delivered in batches is unable to reach the gas bubbling zone, thus achieving poor lift efficiency. This paper aims to discuss the techniques and challenges for unloading liquid via batch injection in scaled perforation wells X and Y, whose WGR is 6bbl/MMscf, whose scale build-up is observed at the bottom of perforation interval, whose water column is 400 feet, and whose ‘bubbling zone’ is less than 100 feet. Variables such as foamer Z dosage, batching technique, and well flow control valve opening times are manipulated during the duration of the trial to achieve maximum liquid unloading and gas rates. During the field trial, the team has found optimal values between the three aforementioned parameters for best unloading results, in which each cycle’s gas and liquid rates are compared with baselines with similar flowing tubing head pressures (FTHP). It is discovered that amongst other factors, a good agitation technique is a primary determinant for efficient liquid unloading. An average increment of 2MMscf/d against an average production of 4MMscf/d at stable FTHP is recorded during the trial.Keywords: foam, foamer, gas lift, liquid unloading, scale, batch injection
Procedia PDF Downloads 174557 Comparing the SALT and START Triage System in Disaster and Mass Casualty Incidents: A Systematic Review
Authors: Hendri Purwadi, Christine McCloud
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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system
Procedia PDF Downloads 127556 Evaluation to Assess the Impact of Newcastle Infant Partnership Approach
Authors: Samantha Burns, Melissa Brown, Judith Rankin
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Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.Keywords: maternal health, mental health, parent infant relationship, therapy
Procedia PDF Downloads 187555 A Retrospective Study of Vaginal Stenosis Following Treatment of Cervical Cancers and the Effectiveness of Rehabilitation Interventions
Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk
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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis
Procedia PDF Downloads 198554 Improving the Competency of Undergraduate Nursing Students in Addressing a Timely Public Health Issue
Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally
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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.Keywords: lead poisoning, emerging public health issue, community health, nursing edducation
Procedia PDF Downloads 192553 Introducing Gait Function Scale to Quantify the Capacity to Walk Independently from Least Functional to Most Functional
Authors: Mohamed Rizk Abd El Wahab
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The objective of this work is to quantify the independent walking functionality, depending on the use of braces, assistive devices, and walking distance. This study included twenty-one patients suffering from neurological disorders, musculoskeletal injuries, old age, and diabetic foot; their ages ranged from 26 to 77 years old. The patients can walk reciprocally and independently, using braces or assistive devices or not. Individual gait evaluation is done using the Gait Function Scale (GFS) based on three factors: using orthosis, using assistive devices, and distance. The scale doesn't consider the types of pathological gait abnormalities related to neurological conditions such as waddling and hemiplegic gait, and the kinetic gait analysis is based on the force and the moment during the gait cycle. The GFS consists of sixteen levels; the least is zero (0) for no independent reciprocal walking, and the highest level is sixteen (16) when walking twenty meters long without braces and assistive devices. Results: According to the Gait Function Scale, a C5-6 quadriplegic case has a score of zero (0), a paraplegia cauda equine injury has a score minus five (5-), a transverse myelitis has a score minus eight (8-), an elderly with a diabetic foot has a score plus eight (8+), a Parkinson, a hemiparetic and a paraplegic patients have a score minus eleven (11-), a multiple sclerosis female and a postoperative total hip replacement male have a score plus eleven (11+), an old age female has a score twelve (12), a transverse myelitis male has a score plus twelve (12+), a hemiplegia has score plus thirteen (13+), a transverse myelitis male and a hemiplegia have a score minus fifteen (15-), a multiple sclerotic female has a score fifteen (15), a postoperative ACL reconstruction patient and a transverse myelitis male have a score plus fifteen (15+), A Parkinson and a hemiplegic patients have a score of sixteen (16), a sensory ataxic and a postoperative knee replacement patients have a score plus sixteen (16+). Conclusion: It was concluded that the Gait Function Scale provides an objective evaluation that quantifies independent gait functionality. It acts as a road map, aiming to upgrade each level to the next grade. Furthermore, it aids in following up with the patients and evaluating the treatment intervention and rehabilitation program.Keywords: functional, gait, independent, walking
Procedia PDF Downloads 10552 A Retrospective Study - Demographical, Clinical and Pharmacological Correlate of Seclusion, Self-Discharge, Physical Aggression and Use of PRN Psychotropics Within The First 72 Hours Of Admission in The Acute Psychiatric Unit in Saudi Arabia
Authors: Asma AlAmri, Ahmed Hassab Errasoul
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Background & Objectives: Psychiatric disorders are common, affecting approximately one of five adults (17.6%) of the population. While most patients can be successfully treated as outpatients, admission to psychiatric wards is required during relapses or as part of crisis intervention. The first 72h of admission could be particularly critical due to increased risk of physical violence, non-medical discharge and absconding. Many patients requiring interventions such as seclusion, physical restrain, PRN psychotropic medications. This study aims to investigate the relationship between demographical, clinical and pharmacological factors in one hand and certain outcomes (physical aggression, use of PRN medications, need for seclusions and non-medical discharges) within the first 72hours of admission to acute psychiatric wards in KKUH/Riyadh Methods: All admissions to psychiatric wards over a 20 month period, between (May 2015- January 2017) were included. Data was collected on demographics, diagnosis, psychotropic medications prescription, documented physical aggression, and seclusion, self-discharge and absconding. Results: 134 males and 171 females were admitted over the study period. Mean age was 34.2 years (SD 11.96).48.9% (n=149) were single and most patients (n=198) were either unemployed or in educations. Bipolar disorder was the most frequent diagnosis recorded on admission (39.3%, n=120); followed by Schizophrenia and related disorders (34.8%; n=106). Most patients (77.4%, n= 236) received regular psychotropic medications on admission. Vis a vis, 223 patients (73%) received PRN medications. Nominal regression model revealed positive relationship between “no psychotropics prescribed on admission” and self-discharge in women but not in men. No statistically significant relationship was found between age, gender, admission diagnosis and use of regular psychotropic medications on admission and need for seclusion, time spent in seclusion, documented physical aggression and use of PRN medications. Conclusion: Contrary to what is expected, our study does not show association between gender, physical aggression and need for seclusion. This could be due to poor documentation practices by nursing staff in male ward comparing with those in the female ward. Use of PRN psychotropics in the first 72 hours of admission was quite high possibly leading to a “ceiling effect”. A limitation of this study is the retrospective data collection.Keywords: discharge against medical advice, physical aggression, psychotropics, seclusion
Procedia PDF Downloads 124551 Activation-TV® to Reduce Elderly Loneliness and Insecurity
Authors: Hannele Laaksonen, Seija Nyqvist, Kari Nurmes
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Objectives: In the year 2011 the City of Vaasa started to develop know-how in the technology and the introduction of services for aging people in cooperation with the Polytechnic Novia University of Applied Sciences and VAMK, University of Applied Sciences. The project´s targets included: to help elderly people to maintain their ability to function, to provide them social and physical activities, to prevent their social exclusion, to decrease their feelings of loneliness and insecurity and to develop their technical know-how. Methods: The project was built based on open source code, tailor-made service system and user interface for the elderly living at home and their families, based on the users´ expectations and experiences of services. Activation-TV®-project vas carried out 1.4.2011-31.3.2014. A pilot group of eight elderly persons, who were living at home, were selected to the project. All necessary technical means as well as guidance and teaching equipment were provided to the pilot group. The students of University of Applied Sciences (VAMK, Novia) and employees of Center of Ageing were made all programs to the Activation-TV®. The project group were interviewed after and before intervention. The data were evaluated both qualitatively and quantitatively. Results: The built service includes a video library, a group room for interactive programs and a personal room for bilateral meetings and direct shipment. The program is bilingual and produced in both national languages. The Activation TV® reduced elderly peoples´ (n=8) feelings of emptiness, added mental well-being and quality of life with social contacts. Relatives felt, that they were able to get in to older peoples´ everyday life with Activation TV®. Discussion: The built application was tailored to the model that has not been developed elsewhere in Finland. This model can be copied from one server to another and thus transferred to other municipalities but the program requires its own personnel system management and maintenance as well as program production cooperation between the different actors. This service can be used for the elderly who are living at home without dementia.Keywords: mental well-being, quality of life, elderly people, Finland
Procedia PDF Downloads 336550 Peer Group Approach: An Oral Health Intervention from Children for Children at Primary School in Klungkung, Bali, Indonesia
Authors: Regina Tedjasulaksana, Maria Martina Nahak, A. A. Gede Agung, Ni Made Widhiasti
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Strategic effort to realize the empowerment of community in school is through the peer group approach so that it needs to choose the students who are trained as the’ little dentist’ in order to have the cognitive and skills to participate in the school dental health effort (UKGS) program, such as providing oral health education to the other students. Aim: To assessed the effectiveness of peer group approach to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali. Methods: Experimental study using the pre-post test without control group design. The differences of knowledge levels, tooth brushing behavior and oral hygiene status (using PHP-M index) of 10 students before and after trained as the little dentists were analyzed using paired t-test. The correlations between knowledge level and tooth brushing behavior and correlations between tooth brushing behavior and oral hygiene before and after trained as the little dentists were analyzed using Spearman. Furthermore, the trained little dentists provide oral health education to 102 students of grade 1 to 5 at their school once a week for 3 months. The students’ knowledge level scores of each grade were taken every 21 days as many as three times The difference of it was analyzed using Repeated Measured. Result: The mean scores among all little dentists before and after training for each of knowledge level were each 63.05 + 5.62 and 85.00 + 7.81, tooth brushing behavior were each 31.00 + 14.49 and 100.00 + 0.00 and oral hygiene status using PHP-M index were each 32.80 + 10.17 and 11.40 + 8.01. The knowledge level, tooth brushing behavior and oral hygiene status of 10 students before and after trained as the little dentists were different significantly (p<0.05). Before and after trained as the little dentists it showed that significant correlations between knowledge level with tooth brushing behavior (p<0.05) and significant correlations between tooth brushing behavior and oral hygiene (p<0.05). The mean scores of knowledge level among all students before (pre-test) and after (post-test (1),(2),(3)) getting oral health education from little dentists for each, of grade 1 were 40.00 + 17.97; 67.85 + 18.88; 81.72 +26.48 and 70.00 + 22.87, grade 2 were 40.00 + 17.97; 67.85 + 18.88; 81.72 + 26.48 and 70.00 + 22.87, grade 3 were 65.83 + 23.94; 72.50 + 26.08; 80.41 + 24.93 and 83.75 + 19.74, grade 4 were 88.57 + 12.92; 90.71 + 9.97; 92.85 + 10.69 and 93.57 + 6.33 and grade 5 were 86.66 + 13.40; 93.33 + 9.16; 94.16 + 10.17 and 98.33 + 4.81. The students’ knowledge level of grade 1,2 and 3 before and after getting oral health education from little dentists showed significant different (p<0.05), meanwhile there was no significant different on grade 4 and 5 (p<0.05) although mean scores showed an increase. Conclusion: Peer group approach can be used to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali.Keywords: small dentists, oral health, peer group approach, school children
Procedia PDF Downloads 421549 A Rapid and Greener Analysis Approach Based on Carbonfiber Column System and MS Detection for Urine Metabolomic Study After Oral Administration of Food Supplements
Authors: Zakia Fatima, Liu Lu, Donghao Li
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The analysis of biological fluid metabolites holds significant importance in various areas, such as medical research, food science, and public health. Investigating the levels and distribution of nutrients and their metabolites in biological samples allows researchers and healthcare professionals to determine nutritional status, find hypovitaminosis or hypervitaminosis, and monitor the effectiveness of interventions such as dietary supplementation. Moreover, analysis of nutrient metabolites provides insight into their metabolism, bioavailability, and physiological processes, aiding in the clarification of their health roles. Hence, the exploration of a distinct, efficient, eco-friendly, and simpler methodology is of great importance to evaluate the metabolic content of complex biological samples. In this work, a green and rapid analytical method based on an automated online two-dimensional microscale carbon fiber/activated carbon fiber fractionation system and time-of-flight mass spectrometry (2DμCFs-TOF-MS) was used to evaluate metabolites of urine samples after oral administration of food supplements. The automated 2DμCFs instrument consisted of a microcolumn system with bare carbon fibers and modified carbon fiber coatings. Carbon fibers and modified carbon fibers exhibit different surface characteristics and retain different compounds accordingly. Three kinds of mobile-phase solvents were used to elute the compounds of varied chemical heterogeneities. The 2DμCFs separation system has the ability to effectively separate different compounds based on their polarity and solubility characteristics. No complicated sample preparation method was used prior to analysis, which makes the strategy more eco-friendly, practical, and faster than traditional analysis methods. For optimum analysis results, mobile phase composition, flow rate, and sample diluent were optimized. Water-soluble vitamins, fat-soluble vitamins, and amino acids, as well as 22 vitamin metabolites and 11 vitamin metabolic pathway-related metabolites, were found in urine samples. All water-soluble vitamins except vitamin B12 and vitamin B9 were detected in urine samples. However, no fat-soluble vitamin was detected, and only one metabolite of Vitamin A was found. The comparison with a blank urine sample showed a considerable difference in metabolite content. For example, vitamin metabolites and three related metabolites were not detected in blank urine. The complete single-run screening was carried out in 5.5 minutes with the minimum consumption of toxic organic solvent (0.5 ml). The analytical method was evaluated in terms of greenness, with an analytical greenness (AGREE) score of 0.72. The method’s practicality has been investigated using the Blue Applicability Grade Index (BAGI) tool, obtaining a score of 77. The findings in this work illustrated that the 2DµCFs-TOF-MS approach could emerge as a fast, sustainable, practical, high-throughput, and promising analytical tool for screening and accurate detection of various metabolites, pharmaceuticals, and ingredients in dietary supplements as well as biological fluids.Keywords: metabolite analysis, sustainability, carbon fibers, urine.
Procedia PDF Downloads 18548 Method for Improving ICESAT-2 ATL13 Altimetry Data Utility on Rivers
Authors: Yun Chen, Qihang Liu, Catherine Ticehurst, Chandrama Sarker, Fazlul Karim, Dave Penton, Ashmita Sengupta
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The application of ICESAT-2 altimetry data in river hydrology critically depends on the accuracy of the mean water surface elevation (WSE) at a virtual station (VS) where satellite observations intersect with water. The ICESAT-2 track generates multiple VSs as it crosses the different water bodies. The difficulties are particularly pronounced in large river basins where there are many tributaries and meanders often adjacent to each other. One challenge is to split photon segments along a beam to accurately partition them to extract only the true representative water height for individual elements. As far as we can establish, there is no automated procedure to make this distinction. Earlier studies have relied on human intervention or river masks. Both approaches are unsatisfactory solutions where the number of intersections is large, and river width/extent changes over time. We describe here an automated approach called “auto-segmentation”. The accuracy of our method was assessed by comparison with river water level observations at 10 different stations on 37 different dates along the Lower Murray River, Australia. The congruence is very high and without detectable bias. In addition, we compared different outlier removal methods on the mean WSE calculation at VSs post the auto-segmentation process. All four outlier removal methods perform almost equally well with the same R2 value (0.998) and only subtle variations in RMSE (0.181–0.189m) and MAE (0.130–0.142m). Overall, the auto-segmentation method developed here is an effective and efficient approach to deriving accurate mean WSE at river VSs. It provides a much better way of facilitating the application of ICESAT-2 ATL13 altimetry to rivers compared to previously reported studies. Therefore, the findings of our study will make a significant contribution towards the retrieval of hydraulic parameters, such as water surface slope along the river, water depth at cross sections, and river channel bathymetry for calculating flow velocity and discharge from remotely sensed imagery at large spatial scales.Keywords: lidar sensor, virtual station, cross section, mean water surface elevation, beam/track segmentation
Procedia PDF Downloads 55547 Reflecting on Deafblindness: Recommendations for Implementing Effective Strategies
Authors: V. Argyropoulos, M. Nikolaraizi, K. Tanou
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There is little available information concerning the cognitive and communicative abilities of the people who are deaf-blind. This mainly stems from the general inadequacy of existing assessment instruments employed with deafblind individuals. Although considerable variability exists with regard to cognitive capacities of the deaf-blind, careful examination of the literature reveals that the majority of these persons suffer from significant deficits in cognitive and adaptive functioning. The few reports available primarily are case studies, narrative program descriptions, or position papers by workers in the field. Without the objective verification afforded by controlled research, specialists in psychology, education, and other rehabilitation services must rely on personal speculations or biases to guide their decisions in the planning, implementation, and evaluation of services to deaf-blind children and adults. This paper highlights the framework and discusses the results of an action research network. The aim of this study was twofold: a) to describe and analyse the different ways in which a student with deafblindness approached a number of developmental issues such as novel tasks, exploration and manipulation of objects, reactions to social stimuli, motor coordination, and quality of play and b) to map the appropriate functional approach for the specific student that could be used to develop strategies for classroom participation and socialization. The persons involved in this collaborative action research scheme were general teachers, a school counsellor, academic staff and student teachers. Rating scales and checklists were used to gather information in natural activities and settings, and additional data were also obtained through interviews with the educators of the student. The findings of this case study indicated that there is a great need to focus on the development of effective intervention strategies. The results showed that the identification of positive reinforcers for this population might represent an important and challenging aspect of behaviour programmes. Finally, the findings suggest that additional empirical work is needed to increase attention to methodological and social validity issues.Keywords: action research, cognitive and communicative abilities, deafblindness, effective strategies
Procedia PDF Downloads 180546 Rehabilitation of Dilapidated Buildings in Morocco: Turning Urban Challenges into Opportunities
Authors: Derradji A., Ben El Mamoun M., Zakaria E., Charadi I. Anrur
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The issue of dilapidated buildings represents a significant opportunity for constructive and beneficial interventions in Morocco. Faced with challenges associated with aging constructions and rapid urbanization, the country is committed to developing innovative strategies aimed at revitalizing urban areas and enhancing the sustainability of infrastructure, thereby ensuring citizens' safety. Through targeted investments in the renovation and modernization of existing buildings, Morocco aims to stimulate job creation, boost the local economy, and improve the quality of life for residents. Additionally, the integration of sustainable construction standards and the strengthening of regulations will promote resilient and environmentally friendly urban development. In this proactive perspective, LABOTEST has been commissioned by the National Agency for Urban Renewal (ANRUR) to conduct an in-depth study. This study focuses on the technical expertise of 1800 buildings identified as dilapidated in the prefectures of Rabat and Skhirat-Témara following an initial clearance operation. The primary objective of this initiative is to conduct a comprehensive diagnosis of these buildings and define the necessary interventions to eliminate potential risks while ensuring appropriate treatment. The article presents the adopted intervention methodology, taking into account the social dimensions involved, as well as the results of the technical expertise. These results include the classification of buildings according to their degree of urgency and recommendations for appropriate conservatory measures. Additionally, different pathologies are identified and accompanied by specific treatment proposals for each type of building. Since this study, the adopted approach has been generalized to the entire territory of Morocco. LABOTEST has been solicited by other cities such as Casablanca, Chefchaouen, Ouazzane, Azilal, Bejaad, and Demnate. This extension of the initiative demonstrates Morocco's commitment to addressing urban challenges in a proactive and inclusive manner. These efforts also illustrate the endeavors undertaken to transform urban challenges into opportunities for sustainable development and socio-economic progress for the entire population.Keywords: building, dilapidated, rehabilitation, Morocco
Procedia PDF Downloads 57545 Effects of Brewer's Yeast Peptide Extract on the Growth of Probiotics and Gut Microbiota
Authors: Manuela Amorim, Cláudia S. Marques, Maria Conceição Calhau, Hélder J. Pinheiro, Maria Manuela Pintado
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Recently it has been recognized peptides from different food sources with biological activities. However, no relevant study has proven the potential of brewer yeast peptides in the modulation of gut microbiota. The importance of human intestinal microbiota in maintaining host health is well known. Probiotics, prebiotics and the combination of these two components, can contribute to support an adequate balance of the bacterial population in the human large intestine. The survival of many bacterial species inhabiting the large bowel depends essentially on the substrates made available to them, most of which come directly from the diet. Some of these substrates can be selectively considered as prebiotics, which are food ingredients that can stimulate beneficial bacteria such as Lactobacilli or Bifidobacteria growth in the colon. Moreover, conventional food can be used as vehicle to intake bioactive compounds that provide those health benefits and increase people well-being. In this way, the main objective of this work was to study the potential prebiotic activity of brewer yeast peptide extract (BYP) obtained via hydrolysis of yeast proteins by cardosins present in Cynara cardunculus extract for possible use as a functional ingredient. To evaluate the effect of BYP on the modulation of gut microbiota in diet-induced obesity model, Wistar rats were fed either with a standard or a high-fat diet. Quantified via 16S ribosomal RNA (rRNA) expression by quantitative PCR (qPCR), genera of beneficial bacteria (Lactobacillus spp. and Bifidobacterium spp.) and three main phyla (Firmicutes, Bacteroidetes and Actinobacteria) were assessed. Results showed relative abundance of Lactobacillus spp., Bifidobacterium spp. and Bacteroidetes was significantly increased (P < 0.05) by BYP. Consequently, the potential health-promoting effects of WPE through modulation of gut microbiota were demonstrated in vivo. Altogether, these findings highlight the possible intervention of BYP as gut microbiota enhancer, promoting healthy life style, and the incorporation in new food products, leads them bringing associated benefits endorsing a new trend in the improvement of new value-added food products.Keywords: functional ingredients, gut microbiota, prebiotics, brewer yeast peptide extract
Procedia PDF Downloads 490544 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial
Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell
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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI
Procedia PDF Downloads 163543 Effects of Mindfulness Practice on Clinician Burnout: A Scoping Review
Authors: Hani Malik
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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19
Procedia PDF Downloads 149542 Deep Learning-Based Liver 3D Slicer for Image-Guided Therapy: Segmentation and Needle Aspiration
Authors: Ahmedou Moulaye Idriss, Tfeil Yahya, Tamas Ungi, Gabor Fichtinger
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Image-guided therapy (IGT) plays a crucial role in minimally invasive procedures for liver interventions. Accurate segmentation of the liver and precise needle placement is essential for successful interventions such as needle aspiration. In this study, we propose a deep learning-based liver 3D slicer designed to enhance segmentation accuracy and facilitate needle aspiration procedures. The developed 3D slicer leverages state-of-the-art convolutional neural networks (CNNs) for automatic liver segmentation in medical images. The CNN model is trained on a diverse dataset of liver images obtained from various imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI). The trained model demonstrates robust performance in accurately delineating liver boundaries, even in cases with anatomical variations and pathological conditions. Furthermore, the 3D slicer integrates advanced image registration techniques to ensure accurate alignment of preoperative images with real-time interventional imaging. This alignment enhances the precision of needle placement during aspiration procedures, minimizing the risk of complications and improving overall intervention outcomes. To validate the efficacy of the proposed deep learning-based 3D slicer, a comprehensive evaluation is conducted using a dataset of clinical cases. Quantitative metrics, including the Dice similarity coefficient and Hausdorff distance, are employed to assess the accuracy of liver segmentation. Additionally, the performance of the 3D slicer in guiding needle aspiration procedures is evaluated through simulated and clinical interventions. Preliminary results demonstrate the effectiveness of the developed 3D slicer in achieving accurate liver segmentation and guiding needle aspiration procedures with high precision. The integration of deep learning techniques into the IGT workflow shows great promise for enhancing the efficiency and safety of liver interventions, ultimately contributing to improved patient outcomes.Keywords: deep learning, liver segmentation, 3D slicer, image guided therapy, needle aspiration
Procedia PDF Downloads 39541 Structural Health Monitoring-Integrated Structural Reliability Based Decision Making
Authors: Caglayan Hizal, Kutay Yuceturk, Ertugrul Turker Uzun, Hasan Ceylan, Engin Aktas, Gursoy Turan
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Monitoring concepts for structural systems have been investigated by researchers for decades since such tools are quite convenient to determine intervention planning of structures. Despite the considerable development in this regard, the efficient use of monitoring data in reliability assessment, and prediction models are still in need of improvement in their efficiency. More specifically, reliability-based seismic risk assessment of engineering structures may play a crucial role in the post-earthquake decision-making process for the structures. After an earthquake, professionals could identify heavily damaged structures based on visual observations. Among these, it is hard to identify the ones with minimum signs of damages, even if they would experience considerable structural degradation. Besides, visual observations are open to human interpretations, which make the decision process controversial, and thus, less reliable. In this context, when a continuous monitoring system has been previously installed on the corresponding structure, this decision process might be completed rapidly and with higher confidence by means of the observed data. At this stage, the Structural Health Monitoring (SHM) procedure has an important role since it can make it possible to estimate the system reliability based on a recursively updated mathematical model. Therefore, integrating an SHM procedure into the reliability assessment process comes forward as an important challenge due to the arising uncertainties for the updated model in case of the environmental, material and earthquake induced changes. In this context, this study presents a case study on SHM-integrated reliability assessment of the continuously monitored progressively damaged systems. The objective of this study is to get instant feedback on the current state of the structure after an extreme event, such as earthquakes, by involving the observed data rather than the visual inspections. Thus, the decision-making process after such an event can be carried out on a rational basis. In the near future, this can give wing to the design of self-reported structures which can warn about its current situation after an extreme event.Keywords: condition assessment, vibration-based SHM, reliability analysis, seismic risk assessment
Procedia PDF Downloads 138