Search results for: prospective
546 Genetic and Non-Genetic Factors Affecting the Response to Clopidogrel Therapy
Authors: Snezana Mugosa, Zoran Todorovic, Zoran Bukumiric, Ivan Radosavljevic, Natasa Djordjevic
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Introduction: Various studies have shown that the frequency of clopidogrel resistance ranges from 4-40%. The aim of this study was to provide in depth analysis of genetic and non-genetic factors that influence clopidogrel resistance in cardiology patients. Methods: We have conducted a prospective study in 200 hospitalized patients hospitalized at Cardiology Centre of the Clinical Centre of Montenegro. CYP2C19 genetic testing was conducted, and the PREDICT score was calculated in 102 out of 200 patients treated with clopidogrel in order to determine the influence of genetic and non-genetic factors on outcomes of interest. Adverse cardiovascular events and adverse reactions to clopidogrel were assessed during 12 months follow up period. Results: PREDICT score and CYP2C19 enzymatic activity were found to be statistically significant predictors of expressing lack of therapeutic efficacy of clopidogrel by multivariate logistic regression, without multicollinearity or interaction between the predictors (p = 0.002 and 0.009, respectively). Conclusions: Pharmacogenetics analyses that were done in the Montenegrin population of patients for the first time suggest that these analyses can predict patient response to the certain therapy. Stepwise approach could be used in assessing the clopidogrel resistance in cardiology patients, combining the PREDICT score, platelet aggregation test, and genetic testing for CYP2C19 polymorphism.Keywords: clopidogrel, pharmacogenetics, pharmacotherapy, PREDICT score
Procedia PDF Downloads 351545 Identifying Psychosocial, Autonomic, and Pain Sensitivity Risk Factors of Chronic Temporomandibular Disorder by Using Ridge Logistic Regression and Bootstrapping
Authors: Haolin Li, Eric Bair, Jane Monaco, Quefeng Li
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The temporomandibular disorder (TMD) is a series of musculoskeletal disorders ranging from jaw pain to chronic debilitating pain, and the risk factors for the onset and maintenance of TMD are still unclear. Prior researches have shown that the potential risk factors for chronic TMD are related to psychosocial factors, autonomic functions, and pain sensitivity. Using data from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study’s baseline case-control study, we examine whether the risk factors identified by prior researches are still statistically significant after taking all of the risk measures into account in one single model, and we also compare the relative influences of the risk factors in three different perspectives (psychosocial factors, autonomic functions, and pain sensitivity) on the chronic TMD. The statistical analysis is conducted by using ridge logistic regression and bootstrapping, in which the performance of the algorithms has been assessed using extensive simulation studies. The results support most of the findings of prior researches that there are many psychosocial and pain sensitivity measures that have significant associations with chronic TMD. However, it is surprising that most of the risk factors of autonomic functions have not presented significant associations with chronic TMD, as described by a prior research.Keywords: autonomic function, OPPERA study, pain sensitivity, psychosocial measures, temporomandibular disorder
Procedia PDF Downloads 190544 A Comparison between the McGrath Video Laryngoscope and the Macintosh Laryngoscopy in Children with Expected Normal Airway
Authors: Jong Yeop Kim, Ji Eun Kim, Hyun Jeong Kwak, Sook Young Lee
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Background: This prospective, randomized, controlled study was performed to evaluate the usefulness of the McGrath VL compared to Macintosh laryngoscopy in children with expected normal airway during endotracheal intubation, by comparing the time to intubation and ease of intubation. Methods: Eighty-four patients, aged 1-10 years undergoing endotracheal intubation for elective surgery were randomly assigned to McGrath group (n = 42) or Macintosh group (n = 42). Anesthesia was induced with propofol 2.5-3.0 mg/kg and sevoflurane 5-8 vol%. Orotracheal intubation was performed 2 minutes after injection of rocuronium 0.6 mg/kg with McGrath VL or Macintosh laryngoscope. The primary outcome was time to intubation. The Cormack and Lehane glottic grade, intubation difficulty score (IDS), and success rate of intubation were assessed. Hemodynamic changes also were recorded. Results: Median time to intubation [interquartile range] was not different between the McGrath group and the Macintosh group (25.0 [22.8-28.3] s vs. 26.0 [24.0-29.0] s, p = 0.301). The incidence of grade I glottic view was significantly higher in theMcGrath group than in the Macintosh group (95% vs. 74%, p = 0.013). Median IDS was lower in the McGrath group than in the Macintosh group (0 [0-0] vs. 0 [0-1], p = 0.018). There were no significant differences in success rate on intubation or hemodynamics between the two groups. Conclusions: McGrath VL provides better laryngeal views and lower IDS, but similar intubation times and success rates compared to the Macintosh laryngoscope in children with the normal airway.Keywords: intubation, Macintosh laryngoscopy, Mcgrath videolaryngoscopy, pediatrics
Procedia PDF Downloads 229543 An Information Matrix Goodness-of-Fit Test of the Conditional Logistic Model for Matched Case-Control Studies
Authors: Li-Ching Chen
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The case-control design has been widely applied in clinical and epidemiological studies to investigate the association between risk factors and a given disease. The retrospective design can be easily implemented and is more economical over prospective studies. To adjust effects for confounding factors, methods such as stratification at the design stage and may be adopted. When some major confounding factors are difficult to be quantified, a matching design provides an opportunity for researchers to control the confounding effects. The matching effects can be parameterized by the intercepts of logistic models and the conditional logistic regression analysis is then adopted. This study demonstrates an information-matrix-based goodness-of-fit statistic to test the validity of the logistic regression model for matched case-control data. The asymptotic null distribution of this proposed test statistic is inferred. It needs neither to employ a simulation to evaluate its critical values nor to partition covariate space. The asymptotic power of this test statistic is also derived. The performance of the proposed method is assessed through simulation studies. An example of the real data set is applied to illustrate the implementation of the proposed method as well.Keywords: conditional logistic model, goodness-of-fit, information matrix, matched case-control studies
Procedia PDF Downloads 292542 Influence of Shift Work on Fasting Blood Sugar in Hospital Workers
Authors: Sheila R. Pai, N. K. Subbalakshmi, C. Vidya
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Background: Accumulating evidence from prospective studies suggests an increased risk of type 2 diabetes associated with sleep deprivation and sleep disorders. Shift work by disrupting the circadian rhythm, could possibly cause metabolic disturbances. Objective: To investigate the influence of shift work on fasting blood glucose in hospital workers population. Materials and Methods: This was a cross-sectional study including 90 night shift workers (study group) and 90 day workers (controls) drawn from paramedical personnel. Night shift work was on a forward rotation basis, with an average of one night shift every 4 weeks. Each night shift rotation was for a period of 7 days, with a total of 8 hours of shift work per night. In the entire subjects body mass index (BMI) and fasting blood sugar (FBS) was measured. Statistical analysis included unpaired t test, Mann-Whitney ‘U’ test and Chi-square test. P value less than 0.05 was considered significant. Result: The study and control groups were comparable with regard to age, sex distribution and duration of employment. FBS was higher in study group compared to controls (p < 0.0001). There was no significant difference in BMI between control and study group. Conclusion: Shift work may adversely influence glucose metabolism.Keywords: shift work, fasting blood sugar, sleep disturbances, diabetes
Procedia PDF Downloads 270541 Tranexamic Acid in Prevention of Postpartum Haemorrhage in Elective Cesarean Section
Authors: Ajay Agrawal, Pravin Shah, Shailaja Chhetri, Pappu Rijal
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Background and Objectives: Postpartum hemorrhage (PPH) is a common and occasionally life-threatening complication of labour. Cesarean section (CS) is associated with more blood loss than vaginal delivery. There is a trend for increasing CS rates in both developed and developing countries. This could increase the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of Intravenous Tranexamic Acid (TA) on blood loss during and after elective CS delivery. Materials and Methods: It is a prospective, randomized controlled study. 160 eligible pregnant women of 37 or more POG planned for CS were randomized into two groups either to receive 10ml(1gm) of tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation. Results: The mean estimated blood loss was significantly lower in women treated with TA compared with women in the placebo group (392.13 ml ± 10.06 versus 498.69 ml ± 15.87, respectively; p < 0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the tranexamic acid group than in the control group (0.31 ± 0.18 versus 0.79 ± 0.23, respectively; p < 0.001). Conclusion: Pre-operative use of tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where PPH is a major threat to the life of the mothers, it seems to be a promising option.Keywords: blood loss, cesarean section, postpartum hemorrhage, tranexamic acid
Procedia PDF Downloads 273540 Pain Control by Ketamine in Combat Situation; Consideration and Outcomes
Authors: Mohammad Javad Behzadnia, Hamidreza Javadzadeh
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Background: Pain management is essential to surmounting multi-injured people in an overcrowded emergency setting. Its role would be more apparent when the physician encounters a mass casualty in a war zone or even a military prehospital. Having sedative and analgesic properties, rapid onset and offset effects, and maintaining the cardiovascular and respiratory contain are the main reason for selecting Ketamine as a good choice in the war zone. Methods: In a prospective interventional study in a war zone, we have selected and followed two groups of casualties for pain management. All were men with an average age of 26.6±8 y/o and 27.5 ±7 y/o in A and B groups, respectively. Group A received only Ketamine and Group B received Ketamine and diazepam. Results: This study showed that all of the injured patients who received Ketamine had experienced some agitation, and they may finally need benzodiazepines for sedation, but in group B that received benzodiazepine before or simultaneous with Ketamine, the agitation was significantly reduced. (P Value ≤0.05) Conclusion: Various factors may affect pain score and perception; patients' culture, mental health, previous drug usage, and addiction could alter the pain score in similar situations. It seems that the significant agitation is due to catecholamine release in stressful Moments of the battlefield. Accordingly, this situation could be exacerbated due to ketamine properties. Nonetheless, as a good choice in the war zone, Ketamine is now recommended to combine with benzodiazepines for procedural sedation and analgesia (PSA).Keywords: battlefield, ketamine, benzodiazepine, pain control
Procedia PDF Downloads 103539 Impact of Agricultural Waste Utilization and Management on the Environment
Authors: Ravi Kumar
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Agricultural wastes are the non-product outcomes of agricultural processing whose monetary value is less as compared to its collection cost, transportation, and processing. When such agricultural waste is not properly disposed of, it may damage the natural environment and cause detrimental pollution in the atmosphere. Agricultural development and intensive farming methods usually result in wastes that remarkably affect the rural environments in particular and the global environment in general. Agricultural waste has toxicity latent to human beings, animals, and plants through various indirect and direct outlets. The present paper explores the various activities that result in agricultural waste and the routes that can utilize the agricultural waste in a manageable manner to reduce its adverse impact on the environment. Presently, the agricultural waste management system for ecological agriculture and sustainable development has emerged as a crucial issue for policymakers. There is an urgent need to consider agricultural wastes as prospective resources rather than undesirable in order to avoid the transmission and contamination of water, land, and air resources. Waste management includes the disposal and treatment of waste with a view to eliminate threats of waste by modifying the waste to condense the microbial load. The study concludes that proper waste utilization and management will facilitate the purification and development of the ecosystem and provide feasible biofuel resources. This proper utilization and management of these wastes for agricultural production may reduce their accumulation and further reduce environmental pollution by improving environmental health.Keywords: agricultural waste, utilization, management, environment, health
Procedia PDF Downloads 96538 A Prospective Study on Alkali Activated Bottom Ash-GGBS Blend in Paver Blocks
Authors: V. Revathi, J. Thaarrini, M. Venkob Rao
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This paper presents a study on use of alkali activated bottom ash (BA) and ground granulated blast furnace slag (GGBS) blend in paver blocks. A preliminary effort on alkali-activated bottom ash, blast furnace slag based geopolymer (BA-GGBS-GP) mortar with river sand was carried out to identify the suitable mix for paver block. Several mixes were proposed based on the combination of BA-GGBS. The percentage ratio of BA:GGBS was selected as 100:0, 75:25, 50:50, 25:75 and 0:100 for the source material. Sodium based alkaline activators were used for activation. The molarity of NaOH was considered as 8M. The molar ratio of SiO2 to Na2O was varied from 1 to 4. Two curing mode such as ambient and steam curing 60°C for 24 hours were selected. The properties of paver block such as compressive strength split tensile strength, flexural strength and water absorption were evaluated as per IS15658:2006. Based on the preliminary study on BA-GGBS-GP mortar, the combinations of 25% BA with 75% GGBS mix for M30 and 75% BA with 25% GGBS mix for M35 grade were identified for paver block. Test results shows that the combination of BA-GGBS geopolymer paver blocks attained remarkable compressive strength under steam curing as well as in ambient mode at 3 days. It is noteworthy to know BA-GGBS-GP has promising future in the construction industry.Keywords: bottom ash, GGBS, alkali activation, paver block
Procedia PDF Downloads 353537 Thyroid Stimulating Hormone Is a Biomarker for Stress: A Prospective Longitudinal Study
Authors: Jeonghun Lee
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Thyroid-stimulating hormone (TSH) is regulated by the negative feedback of T3 and T4 but is affected by cortisol and cytokines during allostasis. Hence, TSH levels can be influenced by stress through cortisol. In the present study, changes in TSH levels under stress and the potential of TSH as a stress marker were examined in patients lacking T3 or T4 feedback after thyroid surgery. The three stress questionnaires (Korean version of the Daily Stress Inventory, Social Readjustment Rating Scale, and Stress Overload Scale-Short [SOSS]), open-ended question (OQ), and thyroid function tests were performed twice in 106 patients enrolled from January 2019 to October 2020. Statistical analysis was performed using the generalized linear mixed effect model (GLMM) in R software version 4.1.0. In a multiple LMM involving 106 patients, T3, T4, SOSS (category), open-ended questions, the extent of thyroidectomy, and preoperative TSH were significantly correlated with lnTSH. T3 and T4 increased by 1 and lnTSH decreased by 0.03, 3.52, respectively. In case of a stressful event on OQ, lnTSH increased by 1.55. In the high-risk group, lnTSH increased by 0.79, compared with the low group (p<0.05). TSH had a significant relationship with stress, together with T3, T4, and the extent of thyroidectomy. As such, it has the potential to be used as a stress marker, though it showed a low correlation with other stress questionnaires. To address this limitation, questionnaires on various social environments and research on copy strategies are necessary for future studies.Keywords: stress, surgery, thyroid stimulating hormone, thyroidectomy
Procedia PDF Downloads 92536 The Effect of Size and Tumor Depth on Histological Clearance Margins of Basal Cell Carcinomas
Authors: Martin Van, Mohammed Javed, Sarah Hemington-Gorse
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Aim: Our aim was to determine the effect of size and tumor depth of basal cell carcinomas (BCCs) on surgical margin clearance. Methods: A retrospective study was conducted at the Welsh Centre for Burns and Plastic Surgery (WCBPS), Morriston Hospital between 1 Jan 2016 – 31 July 2016. Only patients with confirmed BCC on histopathological analysis were included. Patient data including anatomical region treated, lesion size, histopathological clearance margins and histological sub-types were recorded. An independent T-test was performed determine statistical significance. Results: A total of 228 BCCs were excised in 160 patients. Eleven lesions (4.8%) were incompletely excised. The nose area had the highest rate of incomplete excision. The mean diameter of incompletely excised lesions was 11.4mm vs 11.5mm in completely excised lesions (p=0.959) and the mean histological depth of incompletely excised lesions was 4.1mm vs. 2.5mm for completely excised BCCs (p < 0.05). Conclusions: BCC tumor depth of > 4.1 mm was associated with high rate of incomplete margin clearance. Hence, in prospective patients, a BCC tumor depth (>4 mm) on tissue biopsy should alert the surgeon of potentially higher risk of incomplete excision of lesion.Keywords: basal cell carcinoma, excision margins, plastic surgery, treatment
Procedia PDF Downloads 239535 Artificial Intelligence in Disease Diagnosis
Authors: Shalini Tripathi, Pardeep Kumar
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The method of translating observed symptoms into disease names is known as disease diagnosis. The ability to solve clinical problems in a complex manner is critical to a doctor's effectiveness in providing health care. The accuracy of his or her expertise is crucial to the survival and well-being of his or her patients. Artificial Intelligence (AI) has a huge economic influence depending on how well it is applied. In the medical sector, human brain-simulated intellect can help not only with classification accuracy, but also with reducing diagnostic time, cost and pain associated with pathologies tests. In light of AI's present and prospective applications in the biomedical, we will identify them in the paper based on potential benefits and risks, social and ethical consequences and issues that might be contentious but have not been thoroughly discussed in publications and literature. Current apps, personal tracking tools, genetic tests and editing programmes, customizable models, web environments, virtual reality (VR) technologies and surgical robotics will all be investigated in this study. While AI holds a lot of potential in medical diagnostics, it is still a very new method, and many clinicians are uncertain about its reliability, specificity and how it can be integrated into clinical practice without jeopardising clinical expertise. To validate their effectiveness, more systemic refinement of these implementations, as well as training of physicians and healthcare facilities on how to effectively incorporate these strategies into clinical practice, will be needed.Keywords: Artificial Intelligence, medical diagnosis, virtual reality, healthcare ethical implications
Procedia PDF Downloads 133534 Chest Trauma and Early Pulmonary Embolism: The Risks
Authors: Vignesh Ratnaraj, Daniel Marascia, Kelly Ruecker
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Purpose: Pulmonary embolism (PE) is a major cause of morbidity and mortality in trauma patients. Data suggests PE is occurring earlier in trauma patients, with attention being turned to possible de novo events. Here, we examine the incidence of early PE at a level 1 trauma center and examine the relationship with a chest injury. Method: A retrospective analysis was performed from a prospective trauma registry at a level 1 trauma center. All patients admitted from 1 January 2010 to 30 June 2019 diagnosed with PE following trauma were included. Early PE was considered a diagnosis within 72 hours of admission. The severity of the chest injury was determined by the Abbreviated Injury Score (AIS). Analysis of severe chest injury and incidence of early PE was performed using chi-square analysis. Sub-analysis on the timing of PE and PE location was also performed using chi-square analysis. Results: Chest injury was present in 125 of 184 patients diagnosed with PE. Early PE occurred in 28% (n=35) of patients with a chest injury, including 24.39% (n=10) with a severe chest injury. Neither chest injury nor severe chest injury determined the presence of early PE (p= > 0.05). Sub-analysis showed a trend toward central clots in early PE (37.14%, n=13) compared to late (27.78%, n=25); however, this was not found to be significant (p= > 0.05). Conclusion: PE occurs early in trauma patients, with almost one-third being diagnosed before 72 hours. This analysis does not support the paradigm that chest injury, nor severe chest injury, results in statistically significant higher rates of early PE. Interestingly, a trend toward early central PE was noted in those suffering chest trauma.Keywords: trauma, PE, chest injury, anticoagulation
Procedia PDF Downloads 102533 Role of Physiotherapist: How Their Job and Working Area Could Be Known
Authors: Juan Pablo Hervas-Perez, Jesus Guodemar-Perez, Montserrat Ruiz-Lopez, Elena Sonsoles Rodriguez-Lopez, Noemi Mayoral-Gonzalo, Eduardo Cimadevilla Fernandez-Pola, Mario Caballero-Corella
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Physiotherapy is a healthcare discipline that covers many fields of action within the recovery and prevention of health. Some are well known, but others, such as working with newborns and premature children are not so. Physical therapist functions are well defined, but the impression of the population is that there are other professionals who can develop them, and a large part are unknown. Objective: To evaluate the level of knowledge of the sample on the role of the physiotherapist in general, and more specifically in the neonatal intensive care (NICU) units, and estimate your level of notions on the development centered care (DCC). Method: A descriptive, transversal, observational and prospective study developed on a 125 participants' sample. Results: From the sample studied, 87.2% had already had contact with physiotherapy previously. An 80.9% believed that the physiotherapist intervention was decisive for the cure, and 84.0% would recommend physiotherapy treatment to others. Of the total surveyed, 98.0% felt that the physiotherapist is who should run the physiotherapeutic treatments, but shares with other professions 71.0% of votes. The field's best-known work is rehabilitation (94.0%); Neonatology is on the 4th place (66.0% of votes). Conclusions: Many areas of work of physical therapy are unknown to a big part of the population, including the own health workers. Less than half of the sample meets the DCC, and only 58% of the interviewed physiotherapists know them.Keywords: functions of physiotherapist, neonatal intensive care, physiotherapy, prematurity
Procedia PDF Downloads 330532 Islamic Banking Adoption Model from Technology Prospective
Authors: Amer Alzaidi
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Islamic banking is an alternative solution to those people who are worried about Riba (interest) in all forms of transaction while using banking services and products. Today, banks around the world have Islamic banking services and products the in one form or another. The use of Islamic banking is not only restricted to Muslims world but have reached to non-Muslim countries like UK, USA, Australia and Canada as well. Compared to conventional banking, the adoption rate of Islamic banking is low because of unawareness of customers, financial cost, and performance issues. The interest in Islamic banking by financial institutions as well as low adoption rate motivated us to look this matter into detail in order to identify Critical Success Factors, which are positively motivating customers to use Islamic banking services/ products and Critical Risk Factors, which have significantly negative effect on the adoption of Islamic banking. The CSFs and CRFs will be initially identified from the literature using methodology called Systematic Literature Review, followed by the empirical analysis of these factors using survey research method. Later, we will develop Islamic Banking Adoption Model (IBAM) to help banks to assess their Islamic banking strategic positioning and to improve their operational efficiency. The first potential contribution of this research study will be the development of IBAM protocol that will provide us guidelines for conducting our actual SLR. The second major contribution of this research will be the development of Islamic Banking Adoption Model (IBAM), and the third contribution of this research study will be the evaluation of the developed IBMA.Keywords: Islamic banking, adoption model, protocol, technology
Procedia PDF Downloads 281531 The Conditionality of Financial Risk: A Comparative Analysis of High-Tech and Utility Companies Listed on the Shenzhen Stock Exchange (SSE)
Authors: Joseph Paul Chunga
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The investment universe is awash with a myriad of financial choices that investors have to opt for, which principally culminates into a duality between aggressive or conservative approaches. Howbeit, it is pertinent to emphasize that the investment vehicles with an aggressive approach tend to take on more risk than the latter group in an effort to generate higher future returns for their respective investors. This study examines the conditionality effect that such partiality in financing has on the High-Tech and Public Utility companies listed on the Shenzhen Stock Exchange (SSE). Specifically, it examines the significance of the relationship between capitalization ratios of Total Debt Ratio (TDR), Degree of Financial Leverage (DFL) and profitability ratios of Earnings per Share (EPS) and Returns on Equity (ROE) on the Financial Risk of the two industries. We employ a modified version of the Panel Regression Model used by Rahman (2017) to estimate the relationship. The study finds that there is a significant positive relationship between the capitalization ratios on the financial risk of Public Utility companies more than High-Tech companies and a substantial negative relationship between the profitability ratios and the financial risk of the former than the latter companies. This then spells an important insight for prospective investors with regards to the volatility of earnings of such companies.Keywords: financial leverage, debt financing, conservative firms, aggressive firms
Procedia PDF Downloads 187530 Use of Yeast-Chitosan Bio-Microcapsules with Ultrafiltration Membrane to Remove Ammonia Nitrogen and Organic Matter in Raw Water
Authors: Chao Ding, Jun Shi, Huiping Deng
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This study reports the preparation of a new type yeast-chitosan bio-microcapsule coating sodium alginate and chitosan, with good biocompatibility and mechanical strength. Focusing on the optimum preparation conditions of bio-microcapsule, a dynamic test of yeast-chitosan bio-microcapsule combined with ultrafiltration membrane was established to evaluate both the removal efficiency of major pollutants from raw water and the applicability of this system. The results of orthogonal experiments showed that the optimum preparation procedure are as follows: mix sodium alginate solution (3%) with bacteria liquid in specific proportion, drop in calcium chloride solution (4%) and solidify for 30 min; put the plastic beads into chitosan liquid (1.8%) to overlay film for 10 min and then into glutaraldehyde solution (1%) to get cross-linked for 5 min. In dynamic test, the microcapsules were effective as soon as were added in the system, without any start-up time. The removal efficiency of turbidity, ammonia nitrogen and organic matter was 60%, 80%, and 40%. Besides, the bio-microcapsules were prospective adsorbent for heavy metal; they adsorb Pb and Cr⁶⁺ in water while maintaining high biological activity to degrade ammonia nitrogen and small molecular organics through assimilation. With the presence of bio-microcapsules, the internal yeast strains’ adaptability on the external environment and resistance ability on toxic pollutants will be increased.Keywords: ammonia nitrogen, bio-microcapsules, ultrafiltration membrane, yeast-chitosan
Procedia PDF Downloads 346529 Role of Diplomacy toward Social Welfare, Equity and Economic Growth: Case Study of President Joko Widodo's Economic Diplomacy in Investment Sector in Indonesia
Authors: Raihan Zahirah Mauludy Ridwan, Frisca Devi Choirina
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Indonesia with its former presidents has enhanced the bilateral cooperation also multilateral cooperation in terms of economy but the result was not significant towards eradicating poverty, unemployment, income inequality, and economic growth. To eradicate these problems, President Joko Widodo through his several points of Nawacita wants to boost Indonesia’s economic relationship and cooperation which manifested in “Economic Diplomacy” as one of Indonesia’s foreign policy priority and he pitches it in international forums. The economic diplomacy does not only attracts prospective countries but also attracts the foreign businessman and investors. The economic diplomacy includes four sectors which are vital for economic growth, one of them is investment. This paper would like to answer how economic diplomacy can have significant impact towards social welfare, equity and economic growth especially in Indonesia. The purpose of this paper is to explore the role of economic diplomacy and its impact toward Indonesia’s welfare, equity, and economic growth. This paper uses the theory of economic diplomacy to link the current international political economic sphere and the impact of economic diplomacy for Indonesia through case study method. The paper affirms that economic diplomacy in investment sector does have significant impact, especially in the development of infrastructures, foreign direct investment in several sectors, and food security.Keywords: economic diplomacy, economic growth, equity, Indonesia, Joko Widodo, social welfare
Procedia PDF Downloads 310528 The Influence of Teacher’s Non-Verbal Communication on Ondo State Secondary School Students’ Learning Outcomes in English Language
Authors: Bola M. Tunde-Awe
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The study investigated the influence of teacher’s non-verbal communication on secondary school students’ learning outcomes in English language. The study was a survey research. Participants were three hundred Senior Secondary School II students randomly selected from ten schools in Akoko South West Local Government Area of Ondo State, Nigeria. The instrument used for data collection was a questionnaire containing twenty items on a four-point Likert scale which measured teacher’s use of three types of non-verbal communication modes: body movement, eye contact and spatial distance. The data collected was analysed using simple percentage. Findings revealed that teacher’s use of these non-verbal communication modes enhanced learners’ learning outcomes in English language: a total of 271 (90.33%) participants affirmed that teacher’s body language influenced their learning of English; 224 (74.66%) maintained the same stand for eye contact; while 202 (67.33%) affirmed that teacher’s spatial distance had positive influence. Consequent upon these findings, it was recommended that teachers of English language should constantly utilize non-verbal communication in their instructional delivery. Also, non-verbal communication modes should be included in teacher education programme to equip prospective pre-service teachers with the art of non-verbal communication.Keywords: non-verbal communication, body language, eye contact, spatial distance, learning outcomes
Procedia PDF Downloads 423527 Unlocking the Power of Social Media for Tourism Marketing: How Travel Bloggers Shape Destination Trust, Travel Intention with the Moderating Role of Trustworthiness on Social Media Posts
Authors: Saad Saif
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Tourism promotion in the digital age is significantly influenced by social media, particularly in developing travel markets such as Pakistan. This study examines how travel bloggers use social media to inspire people to plan journeys and increase trust in destinations. It examines how trustworthiness works as a moderator to enhance the legitimacy of social media posts. This study aims to comprehend the dynamics of social media's influence on the travel and tourism industry. This study investigates the influence of travel bloggers' content, with a focus on tone (positive/negative) and emotional intensity (strong/weak), on prospective Pakistani travelers' travel preferences and levels of trust toward a particular location. The study used an experimental design to validate its hypotheses. The results indicate that the emotive content and tone of bloggers influence travel intentions and that destination trust mediates this relationship. It is interesting to observe that variations in the emotional intensity of positive and negative ratings are not always accompanied by changes in destination trust and travel intent. In addition, the influence of a blogger's review tone on travel intention and destination trust is moderated by the credibility of online reviews, whereas the influence of emotional intensity on these outcomes is unaffected by review credibility.Keywords: tourism marketing, destination trust, travel intention, trustworthiness
Procedia PDF Downloads 74526 Levels of Anxiety during the 1st Stage of Labour, Respectively Cervical Effacement
Authors: Shpresa Agani, Nysret Agani
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Studies have found that women, during the 1st stage of labour, respectively cervical effacement, experience anxiety. This study aims to measure the degree of anxiety during cervical effacement, using Hopkins Symptom Checklist-25 (HSCL-25) for measuring anxiety symptoms (HSCL-25). A randomized prospective study with 300 women during the 1st stage of labour was conducted where cervical effacement percentage in parallel with the symptoms of anxiety was examined. Anxiety degree levels were examined by HSCL-25. Results showed that 81% were primiparous, while 19% were multiparous. All participants experienced anxiety symptoms, and the degree of anxiety depended on the stage of the birth process. Groups-based modeling according to HSCL- 2 identified three distinct groups of anxiety symptoms: group 1 (low degree, 32 cases or 11%), group 2 (mild degree, 186 cases or 62%), and group 3 (high degree, 82 cases or 27%). Depending on the percentage of cervical effacement, the anxiety degree increased. In a cervical effacement of 0-60-%, 125 cases or 41.6% had symptoms of anxiety, while in a cervical effacement of 60-100%, 174 cases or 58.4% had symptoms of anxiety (Chi-Square X2 (4,N=300)=10.755, p=0.02). This study showed a correlation between cervical effacement and the degree of anxiety. Further, it was found that the majority of participants experienced symptoms of anxiety during the cervical effacement process. The degree of anxiety increased in direct proportion to the degree of the cervical effacement process. The higher the percentage of cervical effacement, the higher the degree of anxiety. A continuing assessment of the psychological well-being of women throughout the birth process.Keywords: anxiety, cervical effacement, pregnancy, HSCL-25
Procedia PDF Downloads 205525 Prevalence and Associated Factors with Burnout Among Secondary School Teachers in the City of Cotonou in Benin in 2022
Authors: Antoine Vikkey Hinson, Ranty Jolianelle Dassi, Menonli Adjobimey, Rose Mikponhoue, Paul Ayelo
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Introduction: The psychological hardship of the teaching profession maintains a chronic stress that inevitably evolves into burnout (BO) in the absence of adequate preventive measures. The objective of this study is to study the prevalence and factors associated with burnout among secondary school teachers in the city of Cotonou in 2022. Methods: This was a descriptive cross-sectional study with an analytical aim and prospective data collection that took place over a period of 2 months, from July 19 to August 19 and from October 1 to October 31, 2022. Sampling was done using a three-stage probability sampling technique. Data analysis was performed using R 4.1.1 software. Bivariate logistic regression was used to identify associated factors. The significance level chosen was 5% (p < 0.05). Results: A total of 270 teachers were included in the study, of whom 208 (77.00%) were men. The mean age of the workers was 38.03 ± 8.30 years. According to the Maslach Burnout Inventory, 58.51% of the teachers had burnout, with 41.10% of teachers in emotional exhaustion, 27.40% in depersonalization and 21.90% in loss of personal accomplishment. The severity of the syndrome was low to moderate in almost all teachers. The occurrence of BO was associated with), not practicing sports (ORa= 2,38 [1,32; 4,28]), jobs training (ORa= 1,86 [1,04; 3,34]) and an imbalance of effort/reward (ORa= 5,98 [2,24;15,98]). Conclusion: The prevalence of BO is high among secondary school teachers in the city of Cotonou. A larger scale study, including research on its consequences on the teacher and the learner, is necessary in order to act quickly to implement a prevention program.Keywords: burnout, teachers, Maslach burnout inventory, associated factors, Benin
Procedia PDF Downloads 77524 Association Nephropathy and Hypertension in Diabetic Patients
Authors: Bahlous Afef, Bouzid Kahena, Bardkis Ahlem, Mrad Mehdi, Kalai Eya, Sonia Bahri, Abdelmoula Jaouida
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Diabetic nephropathy is the first cause of chronic renal failure and hemodialysis use in several countries including Tunisia. The role of hypertension (HT) as major risk factor for nephropathy is undeniable. The aim of our study was to determine the relationship between blood pressure and nephropathy in a population of diabetic type 2 recently discovered. Materials and methods: We conducted a prospective study focused on 60 patients with type 2 diabetes recently discovered (<5 years). Each patient have benefited from: -a full clinical examination with measurement of blood pressure - exploring a blood-glucose control and renal function -urinary exploration with the determination of proteinuria microalbuminumie of 24 hours with a immunoturbidimetric method using Architect (ABBOTT CI 8200). Results and discussion: Hypertension was present in 46.7% of cases. Twenty patients, 35% of the study population showed nephropathy. Four of these patients (6.66% of cases) had proteinuria, while 16 (26.6% of patients) had microalbuminuria (> 30mg/24 hours). Systolic blood pressure was significantly (p < 0.05) associated with the presence of nephropathy (139 +19.44) vs. for the group with normal renal function (128.65 +15.12 mmHg). Conclusion: The etiology of diabetic nephropathy is multifactorial. However, systolic blood pressure and glycemic control remains the major risk factors. Better glycemic control and treatment of hypertension allowed preventing and slowing the progression of diabetic nephropathy.Keywords: hypertension, nephropathy, hemodialysis, diabetes
Procedia PDF Downloads 316523 Socio-Economic Impact of Education on Urban Women in Pakistan
Authors: Muhammad Ali Khan
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Education is a word has been derived from Latin word "Educare", means to train. Therefore, the harmonious growth of the potentialities for achieving the qualities desirable and useful in the human society is called education. It is claimed that by educating women we can develop our economy, family health and decrease population growth. To explore the socio-economic impact of education on urban women. A prospective study design was used. Over a period of six months 50 respondents were randomly selected from Hayat Abad, an urban city in the North West of Pakistan. A questionnaire was used to explore marital, educational, occupational, social, economical and political status of urban women. Of the total, 50% (25) were employed, where 56% were married and 44% unmarried. Of the employed participants, 56% were teachers fallowed by social worker 16%. Monthly income was significantly high (p=001) of women with master degree. Understanding between wife and husband was also very significant in women with masters. . 78% of employed women replied that Parda (Hija) should be on choice not imposed. 52% of educated women replied participation in social activates, such as parties, shopping etc. Education has a high impact on urban women because it is directly related to employment, decision of power, economy and social life. Urban women with high education have significant political awareness and empowerment. Improving women educational level in rural areas of Pakistan is the key for economic growth and political empowermentKeywords: women, urban, Pakistan, socio economic
Procedia PDF Downloads 102522 Correlation of Spirometry with Six Minute Walk Test and Grading of Dyspnoea in COPD Patients
Authors: Anand K. Patel
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Background: Patients with COPD have decreased pulmonary functions, which in turn reflect on their day-to-day activities. Objectives: To assess the correlation between functional vital capacity (FVC) and forced expiratory volume in one second (FEV1) with 6 minutes walk test (6MWT). To correlate the Borg rating for perceived exertion scale (Borg scale) and Modified medical research council (MMRC) dyspnea scale with the 6MWT, FVC and FEV1. Method: In this prospective study total 72 patients with COPD diagnosed by the GOLD guidelines were enrolled after taking written consent. They were first asked to rate physical exertion on the Borg scale as well as the modified medical research council dyspnea scale and then were subjected to perform pre and post bronchodilator spirometry followed by 6 minute walk test. The findings were correlated by calculating the Pearson coefficient for each set and obtaining the p-values, with a p < 0.05 being clinically significant. Result: There was a significant correlation between spirometry and 6MWT suggesting that patients with lower measurements were unable to walk for longer distances. However, FVC had the stronger correlation than FEV1. MMRC scale had a stronger correlation with 6MWT as compared to the Borg scale. Conclusion: The study suggests that 6MWT is a better test for monitoring the patients of COPD. In spirometry, FVC should be used in monitoring patients with COPD, instead of FEV1. MMRC scale shows a stronger correlation than the Borg scale, and we should use it more often.Keywords: spirometry, 6 minute walk test, MMRC, Borg scale
Procedia PDF Downloads 202521 A Prospective Study of a Modified Pin-In-Plaster Technique for Treatment of Distal Radius Fractures
Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi
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Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment
Procedia PDF Downloads 511520 Examining the Association between Stigmatizing Attitudes in Nursing Students and Their Desire for a Career in Mental Health Nursing: A Comparative Analysis of Generic and Accelerated Programs in Israel
Authors: Merav Ben Natan, Adam Gharra, Baher Faduos, Abedallah Magadlah, Abedalrahman Biadsy
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Introduction: Mental health nursing is often perceived as an unattractive career choice among nursing students, and it remains unclear whether the type of nursing program influences this view. Aim: This cross-sectional study aimed to explore the association between stigmatizing attitudes in nursing students and their desire for a career in mental health nursing, comparing students in generic and accelerated programs. Method: A total of 220 nursing students from generic and accelerated programs in North-Center Israel participated in this cross-sectional study, completing a questionnaire on stigmatizing attitudes and their interest in a mental health nursing career. Results: Nursing students displayed a generally low desire for mental health nursing, influenced by factors such as enrollment in the generic program, previous mental health work experience, and stigmatizing attitudes. Discussion: Students in the generic program, with lower stigmatizing attitudes and prior mental health experience, exhibited a higher inclination towards mental health nursing. Implications for Practice: Prospective mental health nursing professionals may be identified in the generic program, particularly those with prior mental health experience and lower stigmatizing attitudes. Additional studies are required to confirm and broaden their applicability to other contexts.Keywords: nursing students, mental health nursing, stigmatizing attitudes, desire for a career in mental health nursing, generic program
Procedia PDF Downloads 34519 Child Trafficking for Adoption Purposes: A Study into the Criminogenic Factors of the German Intercountry Adoption System
Authors: Elvira Loibl
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In Western countries, the demand for adoptable children, especially healthy babies, has been considerably high for several years. Rising infertility rates, liberal abortion politics, the widespread use of contraception, and the increasing acceptance of unmarried motherhood are factors that have decreased the number of infants available for domestic adoption in the U.S. and Europe. As a consequence, many involuntarily childless couples turn to intercountry adoption as a viable alternative to have a child of their own. However, the demand for children far outpaces the supply of orphans with the desired characteristics. The imbalance between the number of prospective adopters and the children available for intercountry adoption results in long waiting lists and high prices. The inordinate sums of money involved in the international adoption system have created a commercial ‘underbelly’ where unethical and illicit practices are employed to provide the adoption market with adoptable children. Children are being purchased or abducted from their families, hospitals or child care institutions and then trafficked to receiving countries as ‘orphans’. This paper aims to uncover and explain the factors of the German adoption system that are conducive to child trafficking for adoption purposes. It explains that the tension between money and integrity as experienced by German adoption agencies, blind trust in the authorities in the sending countries as well as a lenient control system encourage and facilitate the trafficking in children to Germany.Keywords: child trafficking, intercountry adoption, market in adoptable babies, German adoption system
Procedia PDF Downloads 293518 Role of Preoperative and Postoperative Endovaginal Ultrasound and 24-Hour Pad Test in Evaluation of Efficacy of Various Treatment Modalities for Stress Urinary Incontinence
Authors: J. B. Sharma, Vivek Kakkar, Sunesh Kumar, K. K. Roy, Rajesh Kumari, Kavita Pandey, Smriti Hari
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Background: Stress urinary incontinence (SUI) is a common problem affecting the quality of life of women. Methods: It is a prospective study conducted over 40 women of SUI by endovaginal ultrasound on rest and Valsalva preoperatively and six months postoperatively for levator hiatus, pubovisceral thickness, urethral length, and bladder neck position. A 24-hour pad test was also performed on all women at the same time for grading of SUI. Treatment given was medical in 4 (10%), Burch colposuspension in 18 (45%), and tension-free obturator tape in 18 (45%). Results: Mean age, parity, and body mass index in the study were 41.60 years, 2.73, and 24.2 kg/m², respectively. All 40 (100%) patients had SUI, with the mean duration of symptoms being 4.04 years. On the 24-hour pad test, mild SUI was in 4 (10%), moderate SUI in 33 (82.5%), and severe SUI in 3 (7.5%), with mean preoperative 24-hour pad test being 36.69 gm which significantly reduced to 9.79 gm postoperatively (p 0.001). There was a significant change in levator hiatus and pubovisceral thickness with the treatment of SUI. Overall urethral length increased, but there was a significant decrease in urethral length on Valsalva after the treatment (0.40 versus 0.28 cm, p 0.04) and a significant reduction in bladder neck descent after Valsalva after treatment (0.41 cm versus 0.27 cm, p 0.001). Conclusion: Endovaginal ultrasound and 24-hour pad test are useful diagnostic modalities for SUI diagnosis and to see the impact of treatment.Keywords: stress urinary incontinence, endovaginal ultrasound, 24-hours pad test, pubovisceral muscle thickness
Procedia PDF Downloads 96517 Exploring the Issue of Occult Hypoperfusion in the Pre-Hospital Setting
Authors: A. Fordham, A. Hudson
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Background: Studies have suggested 16-25% of normotensive trauma patients with no clinical signs of shock have abnormal lactate and BD readings evidencing shock; a phenomenon known as occult hypoperfusion (OH). In light of the scarce quantity of evidence currently documenting OH, this study aimed to identify the prevalence of OH in the pre-hospital setting and explore ways to improve its identification and management. Methods: A quantitative retrospective data analysis was carried out on 75 sets of patient records for trauma patients treated by Kent Surrey Sussex Air Ambulance Trust between November 2013 and October 2014. The KSS HEMS notes and subsequent ED notes were collected. Trends between patients’ SBP on the scene, whether or not they received PRBCs on the scene as well as lactate and BD readings in the ED were assessed. Patients’ KSS HEMS notes written by the HEMS crew were also reviewed and recorded. Results: -Suspected OH was identified in 7% of the patients who did not receive PRBCs in the pre-hospital phase. -SBP heavily influences the physicians’ decision of whether or not to transfuse PRBCs in the pre-hospital phase. Preliminary conclusions: OH is an under-studied and underestimated phenomenon. We suggest a prospective trial is carried out to evaluate whether detecting trauma patients’ tissue perfusion status in the pre-hospital phase using portable devices capable of measuring serum BD and/or lactate could aid more accurate detection and management of all haemorrhaging trauma patients, including patients with OH.Keywords: occult hypoperfusion, PRBC transfusion, point of care testing, pre-hospital emergency medicine, trauma
Procedia PDF Downloads 359