Search results for: husbands approval
119 The Effect of Reminiscence Therapy with Ethernet-Based Videos on Cognition and Apathy in Elderly with Mild Dementia
Authors: Ayse Inel Manav, Nuray Simsek
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The number of people with dementia and the problems that are experienced by these people are increasing along with aging world population. This study was carried out to assess the effects of reminiscence therapy using internet videos on the cognitive condition and apathy levels of elderly people who had mild dementia and lived in nursing homes. This randomly controlled experimental study was conducted between 25 May-25 August 2016 in the nursing home, elderly care and rehabilitation centers in Adana and Seyhan, Turkey. A total of 32 individuals participated in this study, 16 in the experimental group and 16 in the control group. Data were collected using a personal information form developed on the basis of the published literature, the Standardized Mini Mental Test (SMMT) and the Apathy Rating Scale (ARS). The Clinical Research Ethics Committee's approval, written institutional permission, and the written consent of the participants were obtained before data collection. The individuals in the experimental group received reminiscence therapy using internet videos for 60 minutes one day a week for three months. During the same period, 25-30 minutes of unstructured interviews on subjects unrelated to reminiscence were carried out with individuals in the control group. The SMMT and ARS were administered before the applications in the experimental group and at the end of the third month. The collected data were analyzed using descriptive statistics (means, standard deviations, and frequencies) as well as Student's t-test, the Mann-Whitney U-test, and Wilcoxon's signed ranks test. In this study, the total SMMT post-test scores of the experimental group were higher than those of the control group (p = 0.001; p < 0.01). There was a difference between experimental and control groups' total SMMT post-test scores (p = 0.001; p < 0.01). The experimental group's ARS total post-test scores were higher than those of the control group (p = 0.001; p < 0.01). This study found that group reminiscence therapy using internet videos improved the cognitive functions and apathy levels of elderly individuals with mild dementia.Keywords: apaty, cognitive testing, dementia, elderly, reminisence threapy
Procedia PDF Downloads 196118 Religion and Politeness: An Exploratory Study for the Integration of Religious Expressions with Politeness Strategies in Iraqi Computer-Mediated Communication
Authors: Rasha Alsabbah
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This study explores the relationship between polite language use and religion in the Iraqi culture in computer mediated communication. It tackles the speech acts where these expressions are employed, the frequency of their occurrence and the aims behind them. It also investigates if they have equivalent expressions in English and the possibility of translating them in intercultural communication. Despite the wide assumption that language is a reflection of culture and religion, it started to grant the attention sociologists during the recent 40 years when scholars have questioned the possible interconnection between religion and language in which religion is used as a mean of producing language and performing pragmatic functions. It is presumed that Arabs in general, and Iraqis in particular, have an inclination to use religious vocabulary in showing politeness in their greeting and other speech acts. Due to Islamic religion and culture’s influences, it is observed that Iraqis are very much concerned of maintaining social solidarity and harmonious relationships which make religion a politeness strategy that operates as the key point of their social behaviours. In addition, religion has found to influence almost all their interactions in which they have a tendency of invoking religious expressions, the lexicon of Allah (God), and Qur’anic verses in their daily politeness discourse. This aspect of Islamic culture may look strange, especially to people who come from individualist societies, such as England. Data collection in this study is based on messaging applications like Viber, WhatsApp, and Facebook. After gaining the approval of the participants, there was an investigation for the different aims behind these expressions and the pragmatic function that they perform. It is found that Iraqis tend to incorporate the lexicon of Allah in most of their communication. Such employment is not only by religious people but also by individuals who do not show strong commitment to religion. Furthermore, the social distance and social power between people do not play a significant role in increasing or reducing the rate of using these expressions. A number of these expressions, though can be translated into English, do not have one to one counterpart or reflect religious feeling. In addition, they might sound odd upon being translated or transliterated in oral and written communication in intercultural communication.Keywords: computer mediated communication (CMC), intercultural communication, politeness, religion, situation bound utterances rituals, speech acts
Procedia PDF Downloads 402117 Kidney Stones in Individuals Living with Diabetes Mellitus at King Abdul-Aziz Medical City - Tertiary Care Center, Jeddah, Saudi Arabia: A Retrospective Cohort Study
Authors: Suhaib Radi, Ibrahim Basem Nafadi, Abdullah Ahmed Alsulami, Nawaf Faisal Halabi, Abdulrhman Abdullah Alsubhi, Sami Wesam Maghrabi, Waleed Saad Alshehri
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Background: Kidney stones greatly affect individuals. The range of these effects regarding multiple kidney stone factors (size, presence of obstruction, and modality of treatment) in stone formers with and without diabetes has not been well explored in the literature to the best of the author's knowledge. Our goal is to investigate this unexplored correlation between diabetes and kidney stones by conducting a Cohort retrospective study to precisely evaluate the effects of this condition and the existence of complications in adult individuals with diabetes in Saudi Arabia in comparison to a non-diabetic control group. Methodology: This is a retrospective cohort study aiming to evaluate the range of effects of kidney stones in stone formers in a group of adults diagnosed with type 2 diabetes mellitus and adults without diabetes between 2017 and 2019 in Jeddah, Saudi Arabia. An IRB approval has been granted for this study. The data was analyzed using SPSS. The data was collected from the 1st of December 2022 until the 1st of March 2023. Results: A total of 254 individuals diagnosed with kidney stones were included, 127 of whom were adult individuals with type 2 diabetes, and 127 were non-diabetics. Our study shows that the individuals affected with diabetes were more likely to have larger kidney stones in comparison to individuals without diabetes (13.12 mm vs. 10.53 mm, p-value = 0.03). Moreover, individuals with hypertension and dyslipidemia also had significantly larger stones. On the other hand, no significant difference was found in the presence of obstruction and modality of treatment between the two groups. Conclusion: This study done in Saudi Arabia found that individuals with kidney stones who concurrently had diabetes formed larger kidney stones, and they were also found to have other comorbidities such as HTN, dyslipidemia, obesity, and renal disease. The significance of these findings could assist in the future of primary and secondary prevention of renal stones.Keywords: kidney stone, type 2 DM, metabolic syndrome, lithotripsy
Procedia PDF Downloads 111116 The Effect of Values on Social Innovativeness in Nursing and Medical Faculty Students
Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım
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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students
Procedia PDF Downloads 321115 Maternal Perception of Using Epidural Anesthesia and the Childbirth Outcomes
Authors: Jiyoung Kim, Chae Weon Chung
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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.Keywords: epidural anesthesia, delivery outcomes, labor pain, perception
Procedia PDF Downloads 153114 Providing Support for Minority LGBTQ Students: Developing a Queer Studies Course
Authors: Karen Butler
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The LGBTQ youth of color face stigma related to both race and gender identity. Effectively dealing with racial/ethnic discrimination requires strong connections to family and one’s racial/ethnic group. However, LGBTQ youth of color seldom receive support from family, peer groups or church groups. Moreover, ethnic communities often perceive LGBTQ identities as a rejection of ethnic heritage. Thus, stigma places these young people at greater risk for substance use, violence, risky sexual behaviors, suicide, and homelessness. Offering a Queer Studies (QS) class is one way to facilitate a safer and more inclusive environment for LGBTQ students, faculty and staff. The discipline of Queer Studies encompasses theories and thinkers from numerous fields: cultural studies, gay and lesbian studies, race studies, women's studies, media, postmodernism, post-colonialism, psychoanalysis and more. We began our course development by researching existing programs and classes. Several course syllabi were examined and course materials such as readings, videos, and guest speakers were assessed for possible inclusion. We also employed informal survey methods with students and faculty in order to gauge interest in the course. We then developed a sample course syllabus and began the process of new course approval. Feedback thus far indicates that students of various sexual orientations and gender identities are interested in the course and understand the need to offer it; faculty in Psychology, Social Work, and Interdisciplinary Studies are interested in cross-listing the course; library staff is willing to assist with course material acquisition, and the administration is supportive. The purpose of this session is to 1) explore the various health and wellness issues facing LGBTQ students of color and 2) share our experience of developing a QS course in health education in order to address these needs. This process, from initial recognition of the need to a course offering, will be described and discussed in the hopes that participants will increase their awareness of the issues. A QS course would be an appropriate requirement for any number of majors as well as an elective for any major.Keywords: black colleges, health education, LGBTQ, queer studies
Procedia PDF Downloads 144113 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning
Authors: Umamaheswari Shanmugam, Silvia Ronchi
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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems
Procedia PDF Downloads 88112 Clinical Evidence of the Efficacy of ArtiCovid (Artemisia Annua Extract) on Covid-19 Patients in DRC
Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome
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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.Keywords: artiCovid, DRC, Covid-19, SARS_COV_2
Procedia PDF Downloads 120111 Flourishing in Marriage among Arab Couples in Israel: The Impact of Capitalization Support and Accommodation on Positive and Negative Affect
Authors: Niveen Hassan-Abbas, Tammie Ronen-Rosenbaum
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Background and purpose: 'Flourishing in marriage' is a concept refers to married individuals’ high positivity ratio regarding their marriage, namely greater reported positive than negative emotions. The study proposes a different approach to marriage which emphasizes the place of the individual himself as largely responsible for his personal flourishing within marriage. Accordingly, the individual's desire to preserve and strengthen his marriage largely determines the marital behavior in a way that will contribute to his marriage success (Actor Effect), regardless the contribution of his or her partner to his marriage success (Partner Effect). Another assumption was that flourishing in marriage could be achieved by two separate processes, where capitalization support increases the positive marriage's evaluations and accommodation decreases the negative one. A theoretical model was constructed, whereby individuals who were committed to their marriage were hypothesized as employing self-control skills by way of two dynamic processes. First, individual’s higher degree of 'capitalization supportive responses' - supportive responses to the partner's sharing of positive personal experiences - was hypothesized as increasing one’s positive evaluations of marriage and thereby one’s positivity ratio. Second, individual’s higher degree of 'accommodation' responses - the ability during conflict situations to control the impulse to respond destructively and instead to respond constructively - was hypothesized as decreasing one’s negative evaluations of marriage and thereby increasing one’s positivity ratio. Methods: Participants were 156 heterosexual Arab couples from different regions of Israel. The mean period of marriage was 10.19 (SD=7.83), ages were 31.53 years for women (SD=8.12) and 36.80 years for men (SD=8.07). Years of education were 13.87 for women (SD=2.84) and 13.23 years for men (SD=3.45). Each participant completed seven questionnaires: socio-demographic, self-control skills, commitment, capitalization support, accommodation, marital quality, positive and negative affect. Using statistical analyses adapted to dyadic research design, firstly descriptive statistics were calculated and preliminary tests were performed. Next, dyadic model based on the Actor-Partner Interdependence Model (APIM) were tested using structural equation modeling (SEM). Results: The assumption according to which flourishing in marriage can be achieved by two processes was confirmed. All of the Actor Effect hypotheses were confirmed. Participants with higher self-control used more capitalization support and accommodation responses. Among husbands, unlike wives, these correlations were stronger when the individual's commitment level was higher. More capitalization supportive responses were found to increase positive evaluations of marriage, and greater spousal accommodation was found to decrease negative evaluations of marriage. High positive evaluations and low negative evaluations were found to increase positivity ratio. Not according to expectation, four partner effect paths were found significant. Conclusions and Implications: The present findings coincide with the positive psychology approach that emphasizes human strengths. The uniqueness of this study is its proposal that individuals are largely responsible for their personal flourishing in marriage. This study demonstrated that marital flourishing can be achieved by two processes, where capitalization increases the positive and accommodation decreases the negative. Practical implications include the need to construct interventions that enhance self-control skills for employment of capitalizing responsiveness and accommodation processes.Keywords: accommodation, capitalization support, commitment, flourishing in marriage, positivity ratio, self-control skills
Procedia PDF Downloads 159110 Adequate Dietary Intake to Improve Outcome of Urine: Urea Nitrogen with Balance Nitrogen and Total Lymphocyte Count
Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari
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The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen
Procedia PDF Downloads 124109 Comparison of Propofol versus Ketamine-Propofol Combination as an Anesthetic Agent in Supratentorial Tumors: A Randomized Controlled Study
Authors: Jakkireddy Sravani
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Introduction: The maintenance of hemodynamic stability is of pivotal importance in supratentorial surgeries. Anesthesia for supratentorial tumors requires an understanding of localized or generalized rising ICP, regulation, and maintenance of intracerebral perfusion, and avoidance of secondary systemic ischemic insults. We aimed to compare the effects of the combination of ketamine and propofol with propofol alone when used as an induction and maintenance anesthetic agent during supratentorial tumors. Methodology: This prospective, randomized, double-blinded controlled study was conducted at AIIMS Raipur after obtaining the institute Ethics Committee approval (1212/IEC-AIIMSRPR/2022 dated 15/10/2022), CTRI/2023/01/049298 registration and written informed consent. Fifty-two supratentorial tumor patients posted for craniotomy and excision were included in the study. The patients were randomized into two groups. One group received a combination of ketamine and propofol, and the other group received propofol for induction and maintenance of anesthesia. Intraoperative hemodynamic stability and quality of brain relaxation were studied in both groups. Statistical analysis and technique: An MS Excel spreadsheet program was used to code and record the data. Data analysis was done using IBM Corp SPSS v23. The independent sample "t" test was applied for continuously dispersed data when two groups were compared, the chi-square test for categorical data, and the Wilcoxon test for not normally distributed data. Results: The patients were comparable in terms of demographic profile, duration of the surgery, and intraoperative input-output status. The trends in BIS over time were similar between the two groups (p-value = 1.00). Intraoperative hemodynamics (SBP, DBP, MAP) were better maintained in the ketamine and propofol combination group during induction and maintenance (p-value < 0.01). The quality of brain relaxation was comparable between the two groups (p-value = 0.364). Conclusion: Ketamine and propofol combination for the induction and maintenance of anesthesia was associated with superior hemodynamic stability, required fewer vasopressors during excision of supratentorial tumors, provided adequate brain relaxation, and some degree of neuroprotection compared to propofol alone.Keywords: supratentorial tumors, hemodynamic stability, brain relaxation, ketamine, propofol
Procedia PDF Downloads 25108 The Effect of Empathy Training Given to Midwives on Mothers’ Satisfaction with Midwives and Their Birth Perception
Authors: Songul Aktas, Turkan Pasinlioglu, Kiymet Yesilcicek Calik
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Introduction: Emphatic approach during labor increases both quality of care and birth satisfaction of mothers. Besides; maternal satisfaction statements and expressions about midwives who assist labor contribute to a positive birth perception and wish to give vaginal delivery again. Aim: The study aimed at investigating the effect of empathy training given to midwives on mothers’ satisfaction with midwives and their birth perception. Material/Method: This experimental study was undertaken between February 2013 and January 2014 at a public hospital in Trabzon Province. The population of the study was composed of mothers who gave vaginal delivery and the sample was composed of 222 mothers determined with power analyzes. Ethical approval and written informed consents were obtained. Mothers who were assisted by midwives during 1st, 2nd and 3rd phases of delivery and first two postpartum hours were included. Empathy training given to midwives included didactic narration, creative drama, psychodrama techniques and lasted 32 hours. The data were collected before the empathy training (BET), right after empathy training (RAET) and 8 weeks later after birth (8WLAB). Mothers were homogenous in terms of socio-demographic, obstetric characteristics. Data were collected with a questionnaire and were analyzed with Chi-square tests. Findings: Rate of mother’s satisfaction with midwives was 36.5% in BET, 81.1% in RAET and 75.7% in 8WLAB. Key mother’s satisfaction with midwives were as follows: 27.6% of mothers told that midwives were “smiling-kind” in BET, 39.6% of them in RAET and 33.7% of them in 8WLAB; 31% of mothers told that midwives were “understanding” in BET, 38.2% of them in RAET and 33.7% of them in 8WLAB; 15.7% of mothers told that midwives were “reassuring” in BET, 44.9% of them in RAET and 39.3% of them in 8WLAB;19.5% of mothers told that midwives were “encouraging and motivating” in BET, 39.8% of them in RAET and 19.8% of mothers told that midwives were “informative” in BET, 45.6% of them in RAET and 35.1% of them in 8WLAB (p<0.05). Key mother’s dissatisfaction with midwives were as follows: 55.3% of mothers told that midwives were “poorly-informed” in BET, 17% of them in RAET and 27.7% of them in 8WLAB; 56.9% of mothers told that midwives were “poorly-listening” in BET, 17.6% of them in RAET and 25.5% of them in 8WLAB; 53.2% of mothers told that midwives were “judgmental-embarrassing” in BET, 17% of them in RAET and 29.8% of them in 8WLAB; 56.2% of mothers told that midwives had “fierce facial expressions” in BET, 15.6% of them in RAET and 28.1% of them in 8WLAB. Rates of mothers’ perception that labor was “easy” were 8.1% in BET, 21.6% in RAET and 13.5% in 8WLAB and rates of mothers’ perception that labor was “very difficult and tiring” were 41.9% in BET, 5.4% in RAET and 13.5% in 8WLAB (p<0.05). Conclusion: The effect of empathy training given to midwives upon statements that described mothers’ satisfaction with midwives and their birth perception was positive. Note: This study was financially funded by TUBİTAK project with number 113S672.Keywords: empathy training, labor perception, mother’s satisfaction with midwife, vaginal delivery
Procedia PDF Downloads 370107 Apathetic Place, Hostile Space: A Qualitative Study on the Ability of Immigration Detention in the UK to Promote the Health and Dignity of Detainees
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Background: The UK has one of the largest immigration detention estates in Europe and is under increasing scrutiny, particularly regarding the lack of transparency over the use of detention and the conditions. Therefore, this research seeks to explore the professional perceptions of the ability of immigration detention in the UK to promote health and dignity. Methods: A phenomenological approach to qualitative methods were used, with social constructivist theorisations of health and dignity. Seven semi-structured interviews were conducted using Microsoft Teams. Participants included a range of immigration detention stakeholders who have visited closed immigration detention centres in the UK in a professional capacity. Recorded interviews were transcribed verbatim, and analysis was data-driven through inductive reflexive thematic analysis of the entire data set to account for the small sample size. This study received ethical approval from University College London Research Ethics Committee. Results: Two global themes were created through analysis: apathetic place and hostile space. Apathetic place discusses the lack of concern for detainees' daily living and healthcare needs within immigration detention in the UK. This is explored through participants' perceptions of the lack of ability of monitoring and evaluation processes to ensure detainees are able to live with dignity and understand the unfulfilled duty of care that exists in detention. Hostile space discusses immigration detention in the UK as a wider system of hostility. This is explored through the disempowering impact on detainees, the perception of a failing system as a result of inadequate safeguarding procedures, and a belief that the intention of immigration detention is misaligned with its described purpose. Conclusion: This research explains why the current immigration detention system in the UK is unable to promote health and dignity, offering a social justice and action-orientated approach to research in this sphere. The findings strengthen the discourse against the use of detention as an immigration control tool in the UK. Implications for further research include a stronger emphasis on investigating alternatives to detention and culturally considerate opportunities for patient-centred healthcare.Keywords: access to healthcare, dignity, health, immigration detention, migrant, refugee, UK
Procedia PDF Downloads 103106 Spatiotemporal Evaluation of Climate Bulk Materials Production in Atmospheric Aerosol Loading
Authors: Mehri Sadat Alavinasab Ashgezari, Gholam Reza Nabi Bidhendi, Fatemeh Sadat Alavinasab Ashkezari
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Atmospheric aerosol loading (AAL) from anthropogenic sources is an evidence in industrial development. The accelerated trends in material consumption at the global scale in recent years demonstrate consumption paradigms sensible to the planetary boundaries (PB). This paper is a statistical approach on recognizing the path of climate-relevant bulk materials production (CBMP) of steel, cement and plastics to AAL via an updated and validated spatiotemporal distribution. The methodology of statistical analysis used the most updated regional or global databases or instrumental technologies. This corresponded to a selection of processes and areas capable for tracking AAL within the last decade, analyzing the most validated data while leading to explore the behavior functions or models. The results also represented a correlation within socio economic metabolism idea between the materials specified as macronutrients of society and AAL as a PB with an unknown threshold. The selected country contributors of China, India, US and the sample country of Iran show comparable cumulative AAL values vs to the bulk materials domestic extraction and production rate in the study period of 2012 to 2022. Generally, there is a tendency towards gradual descend in the worldwide and regional aerosol concentration after 2015. As of our evaluation, a considerable share of human role, equivalent 20% from CBMP, is for the main anthropogenic species of aerosols, including sulfate, black carbon and organic particulate matters too. This study, in an innovative approach, also explores the potential role of AAL control mechanisms from the economy sectors where ordered and smoothing loading trends are accredited through the disordered phenomena of CBMP and aerosol precursor emissions. The equilibrium states envisioned is an approval to the well-established theory of Spin Glasses applicable in physical system like the Earth and here to AAL.Keywords: atmospheric aeroso loading, material flows, climate bulk materials, industrial ecology
Procedia PDF Downloads 80105 Is Sodium Channel Nav1.7 an Ideal Therapeutically Analgesic Target? A Systematic Review
Authors: Yutong Wan, John N. Wood
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Introduction: SCN9A encoded Nav1.7 is an ideal therapeutic target with minimal side effects for the pharmaceutical industry because SCN9A variants can cause both human gains of function pain-related mutations and loss of function pain-free mutations. This study reviews the clinical effectiveness of existing Nav1.7 inhibitors, which theoretically should be powerful analgesics. Methods: A systematic review is conducted on the effectiveness of current Nav1.7 blockers undergoing clinical trials. Studies were mainly extracted from PubMed, U.S. National Library of Medicine Clinical Trials, World Health Organization International Clinical Trials Registry, ISRCTN registry platform, and Integrated Research Approval System by NHS. Only studies with full text available and those conducted using double-blinded, placebo controlled, and randomised designs and reporting at least one analgesic measurement were included. Results: Overall, 61 trials were screened, and eight studies covering PF 05089771 (Pfizer), TV 45070 (Teva & Xenon), and BIIB074 (Biogen) met the inclusion criteria. Most studies were excluded because results were not published. All three compounds demonstrated insignificant analgesic effects, and the comparison between PF 05089771 and pregabalin/ibuprofen showed that PF 05089771 was a much weaker analgesic. All three drug candidates only have mild side effects, indicating the potentials for further investigation of Nav1.7 antagonists. Discussion: The failure of current Nav1.7 small molecule inhibitors might attribute to ignorance of the key role of endogenous systems in Nav1.7 null mutants, the lack of selectivity and blocking potency, and central impermeability. The synergistic combination of analgesic drugs, a recent UCL patent, combining a small dose of Nav1.7 blockers and opioids or enkephalinase inhibitors dramatically enhanced the analgesic effects. Conclusion: The current clinical testing Nav1.7 blockers are generally disappointing. However, the newer generation of Nav1.7 targeting analgesics has overcome the major constraints of its predecessors.Keywords: chronic pain, Nav1.7 blockers, SCN9A, systematic review
Procedia PDF Downloads 131104 Emergency Physician Performance for Hydronephrosis Diagnosis and Grading Compared with Radiologist Assessment in Renal Colic: The EPHyDRA Study
Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron
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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician
Procedia PDF Downloads 284103 Delivering Comprehensive Sexuality Education to Students with Disability in Special Schools in Fiji
Authors: Sera Ratu, Jane Chivers, Jessica Botfield
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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools
Procedia PDF Downloads 337102 Vitamin D Levels in Relation to Thyroid Disorders
Authors: Binaya Tamang, Buddhhi Raj Pokhrel, Narayan Gautam
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Background: There may be a connection between thyroid function and vitamin D status since both bind to similar nuclear hormone receptors and have similar response regions on gene promoters. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females who were attending a tertiary care center in western Nepal and were either hypothyroid or euthyroid. Methods: This hospital-based cross-sectional study was carried out between March 2020 and March 2021 by the Biochemistry department of the Universal College of Medical Sciences (UCMS), Bhairahawa, Province No. 5, Nepal, in cooperation with Internal medicine. Prior to the study, institutional review committee approval (UCMS/IRC/008/20) was acquired from UCMS. Women who visited the Internal Medicine OPD of UCMS and were advised to get a thyroid function test (TFT) were included in the study population. Only those who were willing to participate in the study were enrolled after the goals and advantages of the study had been explained to them. Participants who had recently used vitamin D supplements and medications that affected thyroid hormones were excluded. The participants gave their consent verbally and in writing. After getting the consent, a convenient sample technique was applied. Serum was isolated after drawing 3 ml of blood in a plain vial. Chemiluminescence assay was used to analyze vitamin D and thyroid hormones (MAGLUMI 2000). SPSS version 16.0 for Windows was used to conduct the statistical analysis. Statistical significance was defined as a P-value < 0.05. Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. Among the thyroid groups, the median Vitamin D levels were significantly lower in hypothyroid (16.88 ng/ml) as compared to the euthyroid groups (25.01 ng/ml) (P<0.001). Similarly, serum Vitamin D levels were considerably lower in the obese population (16.86 ng/ml) as compared to the normal BMI group (24.90 ng/ml) (P<0.001) as well as in the vegetarian (15.43 ng.ml) than mixed diet consumer (24.89 ng/ml) (P<0.01). Even after the adjustment for these variables, the Vitamin D levels were significantly lower in the hypothyroid population than in the euthyroid group (P<0.001). Conclusion: Comparing the hypothyroid population to the euthyroid, the median serum vitamin D levels were considerably lower. We were alarmed to see that the majority of euthyroid participants also had low levels of vitamin D. Therefore if left untreated, low vitamin D levels in hypothyroid patients could worsen their health further.Keywords: vitamin D, thyroid hormones, euthyroid, hypothyroid, Nepal
Procedia PDF Downloads 142101 Development of a Nursing Care Program Based on Anthroposophic External Therapy for the Pediatric Hospital in Brazil and Germany
Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho
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The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology
Procedia PDF Downloads 266100 Health Psychology Intervention: Identifying Early Symptoms in Neurological Disorders
Authors: Simon B. N. Thompson
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Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/Keywords: cortisol, electromyography, neurology, yawning
Procedia PDF Downloads 59099 Control Mechanisms for Sprayer Used in Turkey
Authors: Huseyin Duran, Yesim Benal Oztekin, Kazim Kubilay Vursavus, Ilker Huseyin Celen
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There are two main approaches to manufacturing, market and usage of plant protection machinery in Turkey. The first approach is called as ‘Product Safety Approach’ and could be summarized as minimum health and safety requirements of consumer needs on plant protection equipment and machinery products. The second approach is the practices related to the Plant Protection Equipment and Machinery Directive. Product safety approach covers the plant protection machinery product groups within the framework of a new approach directive, Machinery Safety Directive (2006/42 / AT). The new directive is in practice in our country by 03.03.2009, parallel to the revision of the EU Regulation on the Directive (03.03.2009 dated and numbered 27158 published in the Official Gazette). ‘Pesticide Application for Machines’ paragraph is added to the 2006/42 / EC Machinery Safety Directive, which is, in particular, reveals the importance of primary health care and product safety issue, explaining the safety requirements for machines used in the application of plant protection products. The Ministry of Science, Industry and Technology is the authorized organizations in our country for the publication and implementation of this regulation. There is a special regulation, carried out by Ministry of Food, Agriculture and Livestock General Directorate of Food and Control, on the manufacture and sale of plant protection machinery. This regulation, prepared based on 5996 Veterinary Services, Plant Health, Food and Feed Law, is ‘Regulation on Plant Protection Equipment and Machinery’ (published on 02.04.2011 whit number 27893 in the Official Gazette). The purposes of this regulation are practicing healthy and reliable crop production, the preparation, implementation and dissemination of the integrated pest management programs and projects for the development of human health and environmentally friendly pest control methods. This second regulation covers: approval, manufacturing, licensing of Plant Protection Equipment and Machinery; duties and responsibilities of the dealers; principles and procedures related to supply and control of the market. There are no inspection procedures for the application of currently used plant protection machinery in Turkey. In this study, content and application principles of all regulation approaches currently used in Turkey are summarized.Keywords: plant protection equipment and machinery, product safety, market surveillance, inspection procedures
Procedia PDF Downloads 25898 Factors Associated with Increase of Diabetic Foot Ulcers in Diabetic Patients in Nyahururu County Hospital
Authors: Daniel Wachira
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The study aims to determine factors contributing to increasing rates of DFU among DM patients attending clinics in Nyahururu County referral hospital, Lakipia County. The study objectives include;- To determine the demographic factors contributing to increased rates of DFU among DM patients, determining the sociocultural factors that contribute to increased rates of DFU among DM patients and determining the health facility factors contributing to increased rates of DFU among DM patients attending DM clinic at Nyahururu county referral hospital, Laikipia County. This study will adopt a descriptive cross-sectional study design. It involves the collection of data at a one-time point without follow-up. This method is fast and inexpensive, there is no loss to follow up as the data is collected at one time point and associations between variables can be determined. The study population includes all DM patients with or without DFU. The sampling technique that will be used is the probability sampling method, a simple random method of sampling will be used. The study will employ the use of questionnaires to collect the required information. Questionnaires will be a research administered questionnaires. The questionnaire developed was done in consultation with other research experts (supervisor) to ensure reliability. The questionnaire designed will be pre-tested by hand delivering them to a sample 10% of the sample size at J.M Kariuki Memorial hospital, Nyandarua county and thereafter collecting them dully filled followed by refining of errors to ensure it is valid for collection of data relevant for this study. Refining of errors on the questionnaires to ensure it was valid for collection of data relevant for this study. Data collection will begin after the approval of the project. Questionnaires will be administered only to the participants who met the selection criteria by the researcher and those who agreed to participate in the study to collect key information with regard to the objectives of the study. The study's authority will be obtained from the National Commission of Science and Technology and Innovation. Permission will also be obtained from the Nyahururu County referral hospital administration staff. The purpose of the study will be explained to the respondents in order to secure informed consent, and no names will be written on the questionnaires. All the information will be treated with maximum confidentiality by not disclosing who the respondent was and the information.Keywords: diabetes, foot ulcer, social factors, hospital factors
Procedia PDF Downloads 1697 Effect of Preoperative Single Dose Dexamethasone and Lignocaine on Post-Operative Quality of Recovery and Pain Relief after Laparoscopic Cholecystectomy
Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan
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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery
Procedia PDF Downloads 12296 A Metric to Evaluate Conventional and Electrified Vehicles in Terms of Customer-Oriented Driving Dynamics
Authors: Stephan Schiffer, Andreas Kain, Philipp Wilde, Maximilian Helbing, Bernard Bäker
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Automobile manufacturers progressively focus on a downsizing strategy to meet the EU's CO2 requirements concerning type-approval consumption cycles. The reduction in naturally aspirated engine power is compensated by increased levels of turbocharging. By downsizing conventional engines, CO2 emissions are reduced. However, it also implicates major challenges regarding longitudinal dynamic characteristics. An example of this circumstance is the delayed turbocharger-induced torque reaction which leads to a partially poor response behavior of the vehicle during acceleration operations. That is why it is important to focus conventional drive train design on real customer driving again. The currently considered dynamic maneuvers like the acceleration time 0-100 km/h discussed by journals and car manufacturers describe longitudinal dynamics experienced by a driver inadequately. For that reason we present the realization and evaluation of a comprehensive proband study. Subjects are provided with different vehicle concepts (electrified vehicles, vehicles with naturally aspired engines and vehicles with different concepts of turbochargers etc.) in order to find out which dynamic criteria are decisive for a subjectively strong acceleration and response behavior of a vehicle. Subsequently, realistic acceleration criteria are derived. By weighing the criteria an evaluation metric is developed to objectify customer-oriented transient dynamics. Fully-electrified vehicles are the benchmark in terms of customer-oriented longitudinal dynamics. The electric machine provides the desired torque almost without delay. This advantage compared to combustion engines is especially noticeable at low engine speeds. In conclusion, we will show the degree to which extent customer-relevant longitudinal dynamics of conventional vehicles can be approximated to electrified vehicle concepts. Therefore, various technical measures (turbocharger concepts, 48V electrical chargers etc.) and drive train designs (e.g. varying the final drive) are presented and evaluated in order to strengthen the vehicle’s customer-relevant transient dynamics. As a rating size the newly developed evaluation metric will be used.Keywords: 48V, customer-oriented driving dynamics, electric charger, electrified vehicles, vehicle concepts
Procedia PDF Downloads 40595 Religious Fundamentalism Prescribes Requirements for Marriage and Reproduction
Authors: Steven M. Graham, Anne V. Magee
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Most world religions have sacred texts and traditions that provide instruction about and definitions of marriage, family, and family duties and responsibilities. Given that religious fundamentalism (RF) is defined as the belief that these sacred texts and traditions are literally and completely true to the exclusion of other teachings, RF should be predictive of the attitudes one holds about these topics. The goals of the present research were to: (1) explore the extent to which people think that men and women can be happy without marriage, a significant sexual relationship, a long-term romantic relationship, and having children; (2) determine the extent to which RF is associated with these beliefs; and, (3) to determine how RF is associated with considering certain elements of a relationship to be necessary for thinking of that relationship as a marriage. In Study 1, participants completed a reliable and valid measure of RF and answered questions about the necessity of various elements for a happy life. Higher RF scores were associated with the belief that both men and women require marriage, a sexual relationship, a long-term romantic relationship, and children in order to have a happy life. In Study 2, participants completed these same measures and the pattern of results replicated when controlling for overall religiosity. That is, RF predicted these beliefs over and above religiosity. Additionally, participants indicated the extent to which a variety of characteristics were necessary to consider a particular relationship to be a marriage. Controlling for overall religiosity, higher RF scores were associated with the belief that the following were required to consider a relationship a marriage: religious sanctification, a sexual component, sexual monogamy, emotional monogamy, family approval, children (or the intent to have them), cohabitation, and shared finances. Interestingly, and unexpectedly, higher RF scores were correlated with less importance placed on mutual consent in order to consider a relationship a marriage. RF scores were uncorrelated with the importance placed on legal recognition or lifelong commitment and these null findings do not appear to be attributable to ceiling effects or lack of variability. These results suggest that RF constrains views about both the importance of marriage and family in one’s life and also the characteristics required to consider a relationship a proper marriage. This could have implications for the mental and physical health of believers high in RF, either positive or negative, depending upon the extent to which their lives correspond to these templates prescribed by RF. Additionally, some of these correlations with RF were substantial enough (> .70) that the relevant items could serve as a brief, unobtrusive measure of RF. Future research will investigate these possibilities.Keywords: attitudes about marriage, fertility intentions, measurement, religious fundamentalism
Procedia PDF Downloads 11894 Physical Inactivity and Junk Food Consumption Consequent Obesity among University Girls: A Cross Sectional Study Unveils the Mayhem
Authors: Shahid Mahmood, Ghulam Mueen-Ud-Din, Farah Naz Akbar, Yousaf Quddoos, Syeda Mahvish Zahra, Wajiha Saeed, Tayyaba Sami Ullah
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Obesity is an epidemic across the globe that affects all the segments of the population. Physical inactivity, passionate consumption of junk food, inadequate water intake and an unhealthy lifestyle are evident among university girls that are ruining their health gravely especially fat accumulation. The study was carried out to investigate the potential etiological factors of obesity development in university girls. The cross sectional study was carried out after approval of the Departmental Review Committee for Ethics (DRCE) as the par Declaration of Helsinki at Institute of Food Science and Nutrition (IFSN), University of Sargodha, Sargodha-Pakistan and Department of Food Science and Home Economics, G. C. Women University, Faisalabad-Pakistan. 400 girls were selected randomly from different departments of both universities. Nutritional status of the volunteers was assessed through approved protocols for demographics, anthropometrics, body composition, energetics, vital signs, clinical signs and symptoms, medical/family history, and dietary intake assessment (FFQ), water intake and physical activity level. The obesity was determined on body fat (%). Alarming and unheeded etiological factors for the development of obesity in girls were explored by the study. About 93 % girls had a sedentary level of physical activity, zealous consumption of junk food (5.31±1.23 servings), drank little water (1.09±0.26 L/day) that consequent high heaps of fat (35.06±3.02 %), measly body water (52.38±3.4 %), poor bone mass (05.14±0.31 Kg), and high BMI (26.68±1.14 Kg/m²) in 34% girls. The malnutrition also depicted by poor vital signs i.e. low body temperature (97.11±0.93 °F), slightly higher blood pressure (124.19±4.08 / 85.25±2.97 mmHg), rapid pulse rate (99.2 ± 6.85 beats/min), reduced blood O₂ saturation (96.53±0.96 %), scanty peak expiratory flow rate (297 ± 15.7 L /min). The outcomes of the research articulated that physical inactivity; extreme intakes of junk food, insufficient water consumption are etiological factors for obesity development among girls which are usually overlooked in Pakistan.Keywords: informed consent, junk food, obesity, physical inactivity
Procedia PDF Downloads 18993 A Critical Examination of the Iranian National Legal Regulation of the Ecosystem of Lake Urmia
Authors: Siavash Ostovar
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The Iranian national Law on the Ramsar Convention (officially known as the Convention of International Wetlands and Aquatic Birds' Habitat Wetlands) was approved by the Senate and became a law in 1974 after the ratification of the National Council. There are other national laws with the aim of preservation of environment in the country. However, Lake Urmia which is declared a wetland of international importance by the Ramsar Convention in 1971 and designated a UNESCO Biosphere Reserve in 1976 is now at the brink of total disappearance due mainly to the climate change, water mismanagement, dam construction, and agricultural deficiencies. Lake Urmia is located in the north western corner of Iran. It is the third largest salt water lake in the world and the largest lake in the Middle East. Locally, it is designated as a National Park. It is, indeed, a unique lake both nationally and internationally. This study investigated how effective the national legal regulation of the ecosystem of Lake Urmia is in Iran. To do so, the Iranian national laws as Enforcement of Ramsar Convention in the country including three nationally established laws of (i) Five sets of laws for the programme of economic, social and cultural development of Islamic Republic of Iran, (ii) The Iranian Penal Code, (iii) law of conservation, restoration and management of the country were investigated. Using black letter law methods, it was revealed that (i) regarding the national five sets of laws; the benchmark to force the implementation of the legislations and policies is not set clearly. In other words, there is no clear guarantee to enforce these legislations and policies at the time of deviation and violation; (ii) regarding the Penal Code, there is lack of determining the environmental crimes, determining appropriate penalties for the environmental crimes, implementing those penalties appropriately, monitoring and training programmes precisely; (iii) regarding the law of conservation, restoration and management, implementation of this regulation is adjourned to preparation, announcement and approval of several categories of enactments and guidelines. In fact, this study used a national environmental catastrophe caused by drying up of Lake Urmia as an excuse to direct the attention to the weaknesses of the existing national rules and regulations. Finally, as we all depend on the natural world for our survival, this study recommended further research on every environmental issue including the Lake Urmia.Keywords: conservation, environmental law, Lake Urmia, national laws, Ramsar Convention, water management, wetlands
Procedia PDF Downloads 20092 Nursing Students' Experience of Using Electronic Health Record System in Clinical Placements
Authors: Nurten Tasdemir, Busra Baloglu, Zeynep Cingoz, Can Demirel, Zeki Gezer, Barıs Efe
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Student nurses are increasingly exposed to technology in the workplace after graduation with the growing numbers of electric health records (EHRs), handheld computers, barcode scanner medication dispensing systems, and automatic capture of patient data such as vital signs. Internationally, electronic health records (EHRs) systems are being implemented and evaluated. Students will inevitably encounter EHRs in the clinical learning environment and their professional practice. Nursing students must develop competency in the use of EHR. Aim: The study aimed to examine nursing students’ experiences of learning to use electronic health records (EHR) in clinical placements. Method: This study adopted a descriptive approach. The study population consisted of second and third-year nursing students at the Zonguldak School of Health in the West Black Sea Region of Turkey; the study was conducted during the 2015–2016 academic year. The sample consisted of 315 (74.1% of 425 students) nursing students who volunteered to participate. The students, who were involved in clinical practice, were invited to participate in the study Data were collected by a questionnaire designed by the researchers based on the relevant literature. Data were analyzed descriptively using the Statistical Package for Social Sciences (SPSS) for Windows version 16.0. The data are presented as means, standard deviations, and percentages. Approval for the study was obtained from the Ethical Committee of the University (Reg. Number: 29/03/2016/112) and the director of Nursing Department. Findings: A total of 315 students enrolled in this study, for a response rate of 74.1%. The mean age of the sample was 22.24 ± 1.37 (min: 19, max: 32) years, and most participants (79.7%) were female. Most of the nursing students (82.3%) stated that they use information technologies in clinical practice. Nearly half of the students (42.5%) reported that they have not accessed to EHR system. In addition, 61.6% of the students reported that insufficient computers available in clinical placement. Of the students, 84.7% reported that they prefer to have patient information from EHR system, and 63.8% of them found more effective to preparation for the clinical reporting. Conclusion: This survey indicated that nursing students experience to learn about EHR systems in clinical placements. For more effective learning environment nursing education should prepare nursing students for EHR systems in their educational life.Keywords: electronic health record, clinical placement, nursing student, nursing education
Procedia PDF Downloads 29191 Ameliorative Effect of Curcuma Longa against Arsenic Induced Reproductive Toxicity in Charles Foster Rats
Authors: Shazia Naheed Akhter, Rekha Kumari
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An estimated 70 million population are exposed to arsenic poisoning in India in recent times. Arsenic contamination in the groundwater has caused serious health hazards among the exposed population. In Bihar, the first district was Bhojpur, where arsenic causing health issues were reported in 2002. Presently, there are 18 districts that are reported arsenic poisoning in the groundwater. The exposed population is firstly diseased with various symptoms such as skin manifestations, loss of appetite, constipation, hormonal disorders, etc. The long duration exposure has led to cause infertility in the male subjects. The present study thus aims to develop the antidote against arsenic-induced male reproductive toxicity in animal models. The study was carried out on Charles Foster Rats after the approval from Institutional Animal Ethics Committee. A total of n=18 rats (12 weeks old) of an average weight of 160 ± 20 g were used for the study. The study group included n=6 control and n= 12 treated with sodium arsenite orally at the dose of 8mg/Kg b.w daily for 40 days. The n= 6 animals were dissected and the rest n=6 was administered orally with Curcuma longa rhizome ethanolic extract at the dose of 600mg/Kg b.w per day for 40 days. At the end of the entire experiment, all the animals were dissected out and their reproductive organs were taken out, especially epididymis for sperm counts, sperm motility, sperm mortality, sperm morphology. The blood samples were collected for the hormonal assay (testosterone and luteinizing hormone), as well as for hematological and biochemical analysis. The study showed a high magnitude of degeneration in the reproductive organs of the rats in the arsenic-treated group. There were degenerative fluctuations in the sperm counts, sperm motility, sperm mortality, sperm morphology and in the hormonal parameters, as well as in the hematological and biochemical parameters in the arsenic-treated rats. But, after the administration of Curcuma longa, there was significant amelioration in all these parameters. Therefore, the present study shows that Curcuma longa plays a vital role to combat arsenic-induced male reproductive toxicity.Keywords: sodium arsenite, Charles foster rats, ethanolic rhizome extract of curcuma longa, male reproductive toxicity, amelioration
Procedia PDF Downloads 22390 Teicoplanin Derivatives with Antiviral Activity: Synthesis and Biological Evaluation
Authors: Zsolt Szucs, Viktor Kelemen, Son Le Thai, Magdolna Csavas, Erzsebet Roth, Gyula Batta, Annelies Stevaert, Evelien Vanderlinden, Aniko Borbas, Lieve Naesens, Pal Herczegh
Abstract:
The approval of modern glycopeptide antibiotics such as dalbavancin and oritavancin which have excellent activity against Gram-positive bacteria, encouraged our research group to prepare semisynthetic compounds from several members of glycopeptides by various chemical methods. Derivatives from the aglycone of ristocetin, eremomycin, vancomycin and a pseudoaglycon of teicoplanin have been synthesized in a systematic manner. Interestingly, some of the aglycoristocetin derivatives displayed noteworthy anti-influenza activity. More recently our group has been focusing on the modifications of one of the pseudoaglycons of teicoplanin. The reaction of N-ethoxycarbonyl maleimide derivatives with the primary amino function, the copper-catalysed azide-alkyne click reaction and the sulfonylation of the N-terminus were utilized to obtain systematic series of compounds. All substituents provide a more lipophilic character to the new molecules compared to the parent antibiotics, which is known to be favourable for activity against resistant bacteria. Lipoglycopeptides are also known to have antiviral properties, which has been predominantly studied on HIV by others. The structure-activity relationship study of our compounds revealed the influence of a few structural elements on biological activity. In many cases, minimal changes in lipophilicity and structure produced great differences in efficacy and cytotoxicity. In vitro experiments showed that these compounds are not only active against glycopeptide resistant Gram-positive bacteria but in several cases they prevent the infection of cell cultures by different strains of influenza viruses. This is probably related to the inhibition of the viral entry into the host cell nucleus, of which the exact mechanism is unknown. In some instances, reasonably low concentrations were sufficient to observe this effect. Several derivatives were highly cytotoxic at the same time, but some of them displayed a good selectivity index. The antiviral properties of the compounds are not restricted to influenza viruses e.g., some of them showed good activity against Human Coronavirus 229E. This work could potentially lead to the development of antiviral drugs which possess the crucial structural motifs that are needed for antiviral activity, while missing those which contribute to the antibacterial effect.Keywords: antiviral, glycopeptide, semisynthetic, teicoplanin
Procedia PDF Downloads 157