Search results for: acute care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4408

Search results for: acute care

1588 Unfolding Simulations with the Use of Socratic Questioning Increases Critical Thinking in Nursing Students

Authors: Martha Hough RN

Abstract:

Background: New nursing graduates lack the critical thinking skills required to provide safe nursing care. Critical thinking is essential in providing safe, competent, and skillful nursing interventions. Educational institutions must provide a curriculum that improves nursing students' critical thinking abilities. In addition, the recent pandemic resulted in nursing students who previously received in-person clinical but now most clinical has been converted to remote learning, increasing the use of simulations. Unfolding medium and high-fidelity simulations and Socratic questioning are used in many simulations debriefing sessions. Methodology: Google Scholar was researched with the keywords: critical thinking of nursing students with unfolding simulation, which resulted in 22,000 articles; three were used. A second search was implemented with critical thinking of nursing students Socratic questioning, which resulted in two articles being used. Conclusion: Unfolding simulations increase nursing students' critical thinking, especially during the briefing (pre-briefing and debriefing) phases, where most learning occurs. In addition, the use of Socratic questions during the briefing phases motivates other questions, helps the student analyze and critique their thinking, and assists educators in probing students' thinking, which further increases critical thinking.

Keywords: briefing, critical thinking, Socratic thinking, unfolding simulations

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1587 Electron Microscopical Analysis of Arterial Line Filters During Cardiopulmonary Bypass

Authors: Won-Gon Kim

Abstract:

Introduction: The clinical value of arterial line filters is still a controversial issue. Proponents of arterial line filtration argue that filters remove particulate matter and undissolved gas from circulation, while opponents argue the absence of conclusive clinical data. We conducted scanning electron microscope (SEM) studies of arterial line filters used clinically in the CPB circuits during adult cardiac surgery and analyzed the types and characteristics of materials entrapped in the arterial line filters. Material and Methods: Twelve arterial line filters were obtained during routine hypothermic cardiopulmonary bypass in 12 adult cardiac patients. The arterial line filter was a screen type with a pore size of 40 ㎛ (Baxter Health care corporation Bentley division, Irvine, CA, U.S.A.). After opening the housing, the woven polyester strands were examined with SEM. Results and Conclusion: All segments examined(120 segments, each 2.5 X 2.5 cm in size) contained no embolic particles larger in their cross-sectional area than the pore size of the filter(40 ㎛). The origins of embolic particulates were mostly from environmental foreign bodies. This may suggest a possible need for more aggressive filtration of smaller particulates than is generally carried out at the present time.

Keywords: arterial line filter, tubing wear, scanning electron microscopy, SEM

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1586 Factors Influencing Prevalence of HIV/AIDS Among Men Who Have Sex With men (MSM) Aged 18-24 years in Mtwapa Town, Kilifi County, Kenya

Authors: Oscar Maina Irungu

Abstract:

Background: Men who have sex with men (MSM) in Mtwapa Town, Kilifi County are at high risk of HIV infection. Probability sample surveys to determine HIV prevalence among MSM in Mtwapa are needed to inform prevention and care services. Methods: In 2013, a cross-sectional survey was conducted among MSM aged 18-24 years old, using respondent-driven sampling (RDS) in Mtwapa. Consenting MSM were tested for HIV (fingerstick rapid test). Population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS Analysis Tool (RDSAT). Results: Among 274 MSM, the median age was 20 years (IQR: 19-23 years). Fifty percent of MSM reported not selling sex, while 13.2 % reported sex work as their “main occupation”, and another 28.4 % reported selling sex in the past two months (but not as their main occupation).Overall HIV prevalence was 19.2 % (CI: 12.2-23.6%). HIV prevalence was higher among MSM who reported sex work as their main occupation (28.3%,CI: 12.1-42.3%) or selling sex in the past two months (26.6 %, CI: 17.2-35.7 %),than among MSM who did not sell sex (11.6%,CI: 7.0-18.1%). Conclusion: HIV prevalence among MSM were high than among Kilifi’s general population aged 15-64 years (8.8%; 2010 KAIS) and highest in male sex workers. Health programs need to address concerns and modify services to meet needs of diverse subgroups of MSM. We recommend continued, periodic surveillance to monitor HIV prevalence among MSM in Mtwapa, and expansion to other areas in Kenya.

Keywords: power point, Kenya, homosexuality, sex

Procedia PDF Downloads 363
1585 Reducing the Incidence of Hyperphosphatemia in Patients Receiving Dialysis

Authors: Tsai Su Hui

Abstract:

Background: Hyperphosphatemia in patients receiving dialysis can cause hyperparathyroidism, which can lead to renal osteodystrophy, cardiovascular disease and mortality. Data showed that 26% of patients receiving dialysis had blood phosphate levels of >6.0 mg/dl at this unit from January to March 2017, higher than the Taiwan Society of Nephrology evaluation criteria of < 20%. After analysis, possible reasons included: 1. Incomprehensive education for nurse and lack of relevant training. 2. Insufficient assistive aids for nursing health education instruction. 3. Patients were unsure which foods are high or low in phosphate. 4. Patients did not have habits of taking medicine with them and how to correctly administer the medication. Purpose: To reduce the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl to less than 20% at this unit. Method: (1) Improve understanding of hyperphosphatemia and food for patients receiving dialysis and their families, (2) Acquire more nursing instruction assistive aids and improve knowledge of hyperphosphatemia for nurse. Results: After implementing the project, the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl decreased from 26.0% to 18.8% at this unit. By implementing the project, the professional skills of nurse improved, blood phosphate levels of patients receiving dialysis were reduced, and the quality of care for patients receiving dialysis at this unit was enhanced.

Keywords: hemodialysis, hyperphosphatemia, incidence, reducing

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1584 Study of the Toxic Activity of the Entomopathogenic Fungus Beauveria bassiana on the Wistar Rat Rattus norvegicus

Authors: F. Haddadj, S. Hamdi, A. Milla, S. Zenia, A. Smai, H. Saadi, F. Marniche, B. Doumandji-Mitiche

Abstract:

The use of a biopesticide based on a microorganism scale requires particular care including safety against the useful auxiliary fauna and mammals among other human beings. Due to its persistence in soil and its apparent human and animal safety, Beauveria bassiana is a cryptogram used for controlling pests organizations, particularly in the locust where its effectiveness has been proven. This fungus is also called for greater respect for biotic communities and the environment. Indeed, biopesticides have several environmental benefits: biodegradability, their activity and selectivity decrease unintended non-target species effects, decreased resistance to some of them. It is in this sense that we contribute by presenting our work on the safety of B. bassiana against mammals. For this we conducted a toxicological study of this fungus strain on Wistar rats Rattus norvegicus, first its effect on weight gain. In a second time were performed histological target organ is the liver. After 20 days of treatment, the results of the toxicological studies have shown that B. bassiana caused no change in the physiological state of rats or weight gain, behavior and diet. On cuts in liver histology revealed no disturbance on the organ.

Keywords: B. bassiana, entomopathogenic fungus, histology, Rattus norvegicus

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1583 Dental Appointments and Related Fear and Anxiety among the General Population during the COVID-19 Pandemic

Authors: Paria Koraei, Meysam Ahmadzadeh, Reza Shahriarirad, Keivan Ranjbar, Farzane Farahmand

Abstract:

The rapid spread of the coronavirus disease 2019 (COVID-19) has enlisted dental offices in high-risk places. A cross-sectional survey was carried out among the general population aged 17 and above in Shiraz, Fars, Iran. The patients' demographic features were recorded and analyzed against questions regarding fear, anxiety, and attitude toward dental appointments. The Dental Anxiety Scale (DAS) questionnaire was used for the evaluation of anxiety levels. Among a total of 760 participants, the average age was 32.33±11.27 years, while 242 (31.8%) were male and 357 (47%) were single. Based on the anxiety scores, 336 (44.2%) participants had mild anxiety, 215 (28.3%) had moderate anxiety, 74 (9.7%) had high, and 135 (17.8%) had severe anxiety. The majority of participants used masks (93.8%) and disinfectants (79.9%) during dental visits, and the most emphasized policies during dental visits were using disposable face masks by the personnel (83.6%) and controlling the number of visitors in the office (81.8%). Only 226 (29.7%) reported that they hadn’t postponed their dental visits. Our findings demonstrated that anxiety in people increases toward dental treatments during the COVID-19 pandemic, resulting in decreased dental appointments. Dentally anxious people were more likely to be female and married couples. Being female and older age are possible risk factors for developing a fear of dental procedures.

Keywords: Covid-19, anxiety, fear, dentistry, dental care

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1582 Phytochemical Screening, Proximate Analysis, Lethality Studies and Anti-Tumor Potential of Annona muricata L. (Soursop) Fruit Extract in Rattus novergicus

Authors: O. C. Abbah, O. Obidoa, J. Omale

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Prostate tumor is fast becoming a leading cause of morbidity and mortality in human male adults, with 50 percent of men aged 50 years and above having histological evidence of the benign tumor. The study was set out to undertake phytochemical screening and proximate analysis of the pulp of A. muricata fruit - soursop; to determine the acute toxicity of the fruit pulp extract and its effect on male albino Wistar rats with concurrent induction of experimental benign prostate hyperplasia (BPH). Eighteen rats (average weight of 100g) were used for the lethality studies and were orally administered graded doses of aqueous extracts of the fruit pulp up to 5000 mg/kg body weight. Twenty five rats weighing 150-200g were divided into five groups of five rats each for the tumor studies. The groups included four controls – Hormone control, HC, which took Testosterone, T; and Estradiol, E2 – only, in olive oil as vehicle; Vehicle control, VC; Soursop control, SC, which received the extract only; VS, Vehicle and Soursop – and the Test group, TG (500mg/kg b.w.). All rats were dosed orally. Tumor was induced with exogenous Testosterone propionate: Estradiol valerate at 300µg: 80µg/kg b.w. (respectively) in olive oil, administered subcutaneously in the inguinal region of the rats on alternate days for 21 days. Administration of the fruit pulp at graded doses up to 5000mg/kg resulted in no lethality even after 72 hours. Results from tumor studies revealed that the administration of the fruit extracts significantly (p < 0.05) reduced the relative prostate weight of the TG compared with the HC, with values of 006±0.001 and 0.010±0.003 respectively. Treatment with vehicle, soursop and vehicle with soursop caused no significant (p>0.05) change in prostate size, with their respective relative prostate weights being 0.002±0.001, 0.004±0.002 and 0.002±0.001 compared with TG. Also, treatment with A. muricata fruit extract significantly decreased (p < 0.05) serum prostate specific antigen, PSA, in TG compared with HC, with values 0.055±0.017 and 0.194±0.068 ng/ml respectively. Furthermore, A. muricata administration displayed Testosterone boosting, Estradiol lowering and consequently testosterone-estradiol ratio increasing potential at the end of the 21 days. The preventive property of soursop against experimental BPH was corroborated by histological evidence in this study. The study concludes that A. muricata fruit holds a great potential for benign prostate tumor prevention and, possibly, management.

Keywords: annona muricata, benign prostate tumor, hormone, preventive potential, soursop

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1581 The Art and Science of Trauma-Informed Psychotherapy: Guidelines for Inter-Disciplinary Clinicians

Authors: Daphne Alroy-Thiberge

Abstract:

Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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1580 Changing Body Ideals of Ethnically Diverse Gay and Heterosexual Men and the Proliferation of Social and Entertainment Media

Authors: Cristina Azocar, Ivana Markova

Abstract:

A survey of 565 male undergraduates examined the effects of exposure to social networking sites and entertainment media on young men’s body image. Exposure to social and to entertainment media was found to have negative effects on men’s body satisfaction, social comparison, and thin ideal internalization. Findings indicated significant differences in those men who were more exposed to social and to entertainment media than those who were not as exposed. Consistent with past studies, gay men were found to be more dissatisfied with their bodies than straight men. Gay men compared themselves to other better-looking individuals and internalized ideal body types seen in media significantly more than their straight counterparts. Surprisingly, straight men seem to care as much about their physical attractiveness/appearance as gay men do, but only in public settings such as at the beach, at athletic events (including gyms) and social events. Although on average ethnic groups were more similar than different, small but significant differences occurred with Asian men indicating significantly higher body dissatisfaction than White/European men and Middle Eastern/Arab men their counterparts. The study increases our knowledge about SNS and entertainment use and its associated body image, and body satisfaction affects among low-income ethnic minority men.

Keywords: body dissatisfaction, body image, entertainment media, gay men, race and ethnicity, social economic status, social comparison, social media

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1579 Solar Energy Management: A Case Study of Bhubaneswar City

Authors: Rachita Lal

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Solar energy is a clean energy source. Because it is readily available in India and has many potential decentralized uses, urban local authorities may use it in various ways to manage the energy needs in the territory under their control. Apart from these and other services for which people pay a substantial number of money, urban local councils play a crucial role in administering essential services like water supply, street lighting, and health care. ULBs may contribute considerably to the transition to solar energy, both for their benefit and simultaneously for several additional direct and indirect advantages at multiple levels. The research primarily focuses on using clean energy management to reduce urban areas' reliance on traditional (electricity) energy. A technique for estimating the rooftop solar power potential using GIS (Geographical Information System) is described. Given that the combustion of fossil fuels produces 75% of India's power, meeting the country's energy needs through renewable energy sources is a step toward sustainable development and combating climate change. The study will further help in categorization, phasing, and understanding the demand and supply and thus calculating the cumulative benefits. The main objectives are to study the consumption of conventional energy in the study area and to identify the potential areas where solar photovoltaic intervention can be installed.

Keywords: solar energy, GIS, clean energy management, sustainable development

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1578 A Deep-Learning Based Prediction of Pancreatic Adenocarcinoma with Electronic Health Records from the State of Maine

Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

Abstract:

Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

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1577 Confirming the Factors of Professional Readiness in Athletic Training

Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin

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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.

Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills

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1576 A Script for Presentation to the Management of a Teaching Hospital on DXplain Clinical Decision Support System

Authors: Jacob Nortey

Abstract:

Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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1575 Impacts of Transformational Leadership: Petronas Stations in Sabah, Malaysia

Authors: Lizinis Cassendra Frederick Dony, Jirom Jeremy Frederick Dony, Cyril Supain Christopher

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The purpose of this paper is to improve the devotion to leadership through HR practices implementation at the PETRONAS stations. This emphasize the importance of personal grooming and Customer Care hospitality training for their front line working individuals and teams’ at PETRONAS stations in Sabah. Based on Thomas Edison, International Leadership Journal, theory, research, education and development practice and application to all organizational phenomena may affect or be affected by leadership. FINDINGS – PETRONAS in short called Petroliam Nasional Berhad is a Malaysian oil and gas company that was founded on August 17, 1974. Wholly owned by the Government of Malaysia, the corporation is vested with the entire oil and gas resources in Malaysia and is entrusted with the responsibility of developing and adding value to these resources. Fortune ranks PETRONAS as the 68th largest company in the world in 2012. It also ranks PETRONAS as the 12th most profitable company in the world and the most profitable in Asia. As of the end of March 2005, the PETRONAS Group comprised 103 wholly owned subsidiaries, 19 partly owned outfits and 57 associated companies. The group is engaged in a wide spectrum of petroleum activities, including upstream exploration and production of oil and gas to downstream oil refining, marketing and distribution of petroleum products, trading, gas processing and liquefaction, gas transmission pipeline network operations, marketing of liquefied natural gas; petrochemical manufacturing and marketing; shipping; automotive engineering and property investment. PETRONAS has growing their marketing channel in a competitive market. They have combined their resources to pursue common goals. PETRONAS provides opportunity to carry out Industrial Training Job Placement to the University students in Malaysia for 6-8 months. The effects of the Industrial Training have exposed them to the real working environment experience acting representing on behalf of General Manager for almost one year. Thus, the management education and reward incentives schemes have aspire the working teams transformed to gain their good leadership. Furthermore, knowledge and experiences are very important in the human capital development transformation. SPSS extends the accurate analysis PETRONAS achievement through 280 questionnaires and 81 questionnaires through excel calculation distributed to interview face to face with the customers, PETRONAS dealers and front desk staffs stations in the 17 stations in Kota Kinabalu, Sabah. Hence, this research study will improve its service quality innovation and business sustainability performance optimization. ORIGINALITY / VALUE – The impact of Transformational Leadership practices have influenced the working team’s behaviour as a Brand Ambassadors of PETRONAS. Finally, the findings correlation indicated that PETRONAS stations needs more HR resources practices to deploy more customer care retention resources in mitigating the business challenges in oil and gas industry. Therefore, as the business established at stiff competition globally (Cooper, 2006; Marques and Simon, 2006), it is crucial for the team management should be capable to minimize noises risk, financial risk and mitigating any other risks as a whole at the optimum level. CONCLUSION- As to conclude this research found that both transformational and transactional contingent reward leadership4 were positively correlated with ratings of platoon potency and ratings of leadership for the platoon leader and sergeant were moderately inter correlated. Due to this identification, we recommended that PETRONAS management should offers quality team management in PETRONAS stations in a broader variety of leadership training specialization in the operation efficiency at the front desk Customer Care hospitality. By having the reliability and validity of job experiences, it leverages diversity teamwork and cross collaboration. Other than leveraging factor, PETRONAS also will strengthen the interpersonal front liners effectiveness and enhance quality of interaction through effective communication. Finally, through numerous CSR correlation studies regression PETRONAS performance on Corporate Social Performance and several control variables.1 CSR model activities can be mis-specified if it is not controllable under R & D which evident in various feedbacks collected from the local communities and younger generation is inclined to higher financial expectation from PETRONAS. But, however, it created a huge impact on the nation building as part of its social adaptability overreaching their business stakeholders’ satisfaction in Sabah.

Keywords: human resources practices implementation (hrpi), source of competitive advantage in people’s development (socaipd), corporate social responsibility (csr), service quality at front desk stations (sqafd), impacts of petronas leadership (iopl)

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1574 Operation and Management System of New Ahmadi Hospital Facility

Authors: Abdulrahman H. Alrashidi

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Kuwait Oil Company provides health care services through Ahmadi hospital for oil sector employee and their families. Due to increasing number of entitled patients in Ahmadi hospital, the company starts health insurance option in 2010. In addition, a new Ahmadi hospital decided to build to accumulate all entitled patients. Operation and management of new Ahmadi hospital investigated in this research. In order to maintain the high quality of medical services and satisfaction rate among oil sector community and reducing the operation cost. Six operation and management options evaluated in order to implement in new Ahmadi hospital. Qualitative Risk assessment method used to investigate proposed options for operation and management of new Ahmadi hospital. Evaluation criteria consist of quality of medical services, operation cost and satisfaction rate among oil sector community. Results show that using the same operation and management system in existing Ahmadi hospital with new Ahmadi hospital will bring cost higher. This approach brings risk to KOC. Results from risk assessment show that partially operated new Ahmadi hospital is the best opportunity to meet the objectives of KOC’s medical group.

Keywords: Kuwait Oil Company, new Ahmadi hospital, operation and management, risk assessment

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1573 Anti-Gravity to Neo-Concretism: The Epodic Spaces of Non-Objective Art

Authors: Alexandra Kennedy

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Making use of the notion of ‘epodic spaces’ this paper presents a reconsideration of non-objective art practices, proposing alternatives to established materialist, formalist, process-based conceptualist approaches to such work. In his Neo-Concrete Manifesto (1959) Ferreira Gullar (1930-2016) sought to create a distinction between various forms of non-objective art. He distinguished the ‘geometric’ arts of neoplasticism, constructivism, and suprematism – which he described as ‘dangerously acute rationalism’ – from other non-objective practices. These alternatives, he proposed, have an expressive potential lacking in the former and this formed the basis for their categorisation as neo-concrete. Gullar prioritized the phenomenological over the rational, with an emphasis on the role of the spectator (a key concept of minimalism). Gullar highlighted the central role of sensual experience, colour and the poetic in such work. In the early twentieth century, Russian Cosmism – an esoteric philosophical movement – was highly influential on Russian avant-garde artists and can account for suprematist artists’ interest in, and approach to, planar geometry and four-dimensional space as demonstrated in the abstract paintings of Kasimir Malevich (1879-1935). Nikolai Fyodorov (1823-1903) promoted the idea of anti-gravity and cosmic space as the field for artistic activity. The artist and writer Kuzma Petrov-Vodkin (1878-1939) wrote on the concept of Euclidean space, the overcoming of such rational conceptions of space and the breaking free from the gravitational field and the earth’s sphere. These imaginary spaces, which also invoke a bodily experience, present a poetic dimension to the work of the suprematists. It is a dimension that arguably aligns more with Gullar’s formulation of his neo-concrete rather than that of his alignment of Suprematism with rationalism. While found in experiments with planar geometry, the interest in forms suggestive of an experience of breaking free–both physically from the earth and conceptually from rational, mathematical space (in a pre-occupation with non-Euclidean space and anti-geometry) and in their engagement with the spatial properties of colour, Suprematism presents itself as imaginatively epodic. The paper discusses both historical and contemporary non-objective practices in this context, drawing attention to the manner in which the category of the non-objective is used to categorise art works which are, arguably, qualitatively different.

Keywords: anti-gravity, neo-concrete, non-Euclidian geometry, non-objective painting

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1572 Couple Relationship Satisfaction: The Role of Recollection of Parental Acceptance, Self-Differentiation and Spousal Caregiving

Authors: Ricky Finzi-Dottan

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The actor–partner interdependence model (APIM) was employed in this study to investigate the mediating effect self-differentiation and spousal caregiving have on the relationship between recollection of parental care and acceptance and couple satisfaction. One hundred and forty-four non-clinical couples (N=288) in enduring relationships were recruited. Results for actor effects revealed two mediating paths whereby, among both partners, recollection of maternal (but not paternal) acceptance was associated with their self-differentiation and responsive spousal caregiving, which, in turn, were linked to their spousal relationship satisfaction. Partner effects revealed three mediating paths: for both partners, recollection of childhood maternal acceptance was associated with responsive caregiving, which, in turn, was linked with their partner’s relationship satisfaction. Interestingly, the husbands’ recollection of maternal acceptance was associated with their partners' responsive spousal caregiving, which was linked to both spouses’ relationship satisfaction. Our results may support the theoretical assumptions regarding intergenerational continuity from perceptions of childhood via self-differentiation effecting couple caregiving to couple relationship, but only on the mother's part.

Keywords: couple relationship satisfaction, childhood parental acceptance, self-differentiation, couple caregiving, dyadic perspective

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1571 Force Sensing Resistor Testing of Hand Forces and Grasps during Daily Functional Activities in the Covid-19 Pandemic

Authors: Monique M. Keller, Roline Barnes, Corlia Brandt

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Introduction Scientific evidence on the hand forces and the types of grasps measurement during daily tasks are lacking, leaving a gap in the field of hand rehabilitation and robotics. Measuring the grasp forces and types produced by the individual fingers during daily functional tasks is valuable to inform and grade rehabilitation practices for second to fifth metacarpal fractures with robust scientific evidence. Feix et al, 2016 identified the most extensive and complete grasp study that resulted in the GRASP taxonomy. Covid-19 virus changed data collection across the globe and safety precautions in research are essential to ensure the health of participants and researchers. Methodology A cross-sectional study investigated six healthy adults aged 20 to 59 years, pilot participants’ hand forces during 105 tasks. The tasks were categorized into five sections namely, personal care, transport and moving around, home environment and inside, gardening and outside, and office. The predominant grasp of each task was identified guided by the GRASP Taxonomy. Grasp forces were measured with 13mm force-sensing resistors glued onto a glove attached to each of the dominant and non-dominant hand’s individual fingers. Testing equipment included Flexiforce 13millimetres FSR .5" circle, calibrated prior to testing, 10k 1/4w resistors, Arduino pro mini 5.0v – compatible, Esp-01-kit, Arduino uno r3 – compatible board, USB ab cable - 1m, Ftdi ft232 mini USB to serial, Sil 40 inline connectors, ribbon cable combo male header pins, female to female, male to female, two gloves, glue to attach the FSR to glove, Arduino software programme downloaded on a laptop. Grip strength measurements with Jamar dynamometer prior to testing and after every 25 daily tasks were taken to will avoid fatigue and ensure reliability in testing. Covid-19 precautions included wearing face masks at all times, screening questionnaires, temperatures taken, wearing surgical gloves before putting on the testing gloves 1.5 metres long wires attaching the FSR to the Arduino to maintain social distance. Findings Predominant grasps observed during 105 tasks included, adducted thumb (17), lateral tripod (10), prismatic three fingers (12), small diameter (9), prismatic two fingers (9), medium wrap (7), fixed hook (5), sphere four fingers (4), palmar (4), parallel extension (4), index finger extension (3), distal (3), power sphere (2), tripod (2), quadpod (2), prismatic four fingers (2), lateral (2), large-diameter (2), ventral (2), precision sphere (1), palmar pinch (1), light tool (1), inferior pincher (1), and writing tripod (1). Range of forces applied per category, personal care (1-25N), transport and moving around (1-9 N), home environment and inside (1-41N), gardening and outside (1-26.5N), and office (1-20N). Conclusion Scientifically measurements of finger forces with careful consideration to types of grasps used in daily tasks should guide rehabilitation practices and robotic design to ensure a return to the full participation of the individual into the community.

Keywords: activities of daily living (ADL), Covid-19, force-sensing resistors, grasps, hand forces

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1570 Anti-Inflammatory Studies on Chungpye-Tang in Asthmatic Human Lung Tissue

Authors: J. H. Bang, H. J. Baek, K. I. Kim, B. J. Lee, H. J. Jung, H. J. Jang, S. K. Jung

Abstract:

Asthma is a chronic inflammatory lung disease characterized by airway hyper responsiveness (AHR), airway obstruction and airway wall remodeling responsible for significant morbidity and mortality worldwide. Genetic and environment factors may result in asthma, but there are no the exact causes of asthma. Chungpye-tang (CPT) has been prescribed as a representative aerosol agent for patients with dyspnea, cough and phlegm in the respiratory clinic at Kyung Hee Korean Medicine Hospital. This Korean herbal medicines have the effect of dispelling external pathogen and dampness pattern. CPT is composed of 4 species of herbal medicines. The 4 species of herbal medicines are Ephedrae herba, Pogostemonis(Agatachis) herba, Caryophylli flos and Zingiberis rhizoma crudus. CPT suppresses neutrophil infiltration and the production of pro-inflammatory cytokines in lipopolysaccharide (LPS)-induced acute lung injury (ALI) mouse model. Moreover, the anti-inflammatory effects of CPT on a mouse model of Chronic Obstructive Pulmonary Disease (COPD) was proved. Activation of the NF-κB has been proven that it plays an important role in inflammation via inducing transcription of pro-inflammatory genes. Over-expression of NF-κB has been believed be related to many inflammatory diseases such as arthritis, gastritis, asthma and COPD. So we firstly hypothesize whether CPT has an anti-inflammatory effect on asthmatic human airway epithelial tissue via inhibiting NF-κB pathway. In this study, CPT was extracted with distilled water for 3 hours at 100°C. After process of filtration and evaporation, it was freeze dried. And asthmatic human lung tissues were provided by MatTek Corp. We investigated the precise mechanism of the anti-inflammatory effect of CPT by western blotting analysis. We observed whether the decoction extracts could reduce NF-κB activation, COX-2 protein expression and NF-κB-mediated pro-inflammatory cytokines such as TNF-α, eotaxin, IL-4, IL-9 and IL-13 in asthmatic human lung tissue. As results of this study, there was a trend toward decreased NF-κB expression in asthmatic human airway epithelial tissue. We found that the inhibition effects of CPT on COX-2 expression was not determined. IL-9 and IL-13 secretion was significantly reduced in the asthmatic human lung tissue treated with CPT. Overall, our results indicate that CPT has an anti-inflammatory effect through blocking the signaling pathway of NF-κB, thereby CPT may be a potential remedial agent for allergic asthma.

Keywords: Chungpye-tang, allergic asthma, asthmatic human airway epithelial tissue, nuclear factor kappa B (NF-κB) pathway, COX-2

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1569 Lecturers’ Need to Alter Their Identity in Remote Learning Environments: Case Study of Experiences from Uk and USA Universities

Authors: Richard Nelson

Abstract:

The knowledge, skills, and identity of the Higher Education professional are constantly challenged with a demanding environment of teaching, research, administration, and pastoral care. It is more important than ever for professors and lecturers to maintain their professional development in a constantly changing environment. The importance of professional development has become more focused as new skills are needed to meet the demands of remote teaching and learning during a pandemic. Uncertainty and performance pressures influence teachers to try to return to physical spaces or recreate lecture and seminar rooms despite more effective online spaces being available. This case study uses the Boys’ spatial triad as a framework for qualitative interviews to capture the Lecturers’ experiences in Universities in the UK and the USA of moving to online learning spaces. The study finds that without effective professional development and time to reflect critically on remote learning innovation in their teaching practices, lecturers attempt to defer to lecture theatres and seminar rooms, or similes of, as their preferred space for teaching and learning. Professional Development is needed to encourage teachers to reflect on their professional identity and relationship to the teaching space.

Keywords: professional identity, learning, online, remote

Procedia PDF Downloads 131
1568 The Problem of Legal Regulation of Joint Physical Custody: The Polish Perspective

Authors: Katarzyna Kamińska

Abstract:

The main purpose of the work is to present the results of the studies regarding joint physical custody in the Polish legal system. The issues addressed fit into the ongoing process of modernising family law regulations and their adaptation to changing social reality in Poland. The Polish legislator now faces a dilemma: whether to introduce into Polish law a developed substantive or procedural regulation of joint physical custody and then whether it should be considered a legal presumption. Joint physical custody after divorce or separation is theoretically possible in Poland. It can either follow from the court’s independent proposal based on the assessment of the circumstances or from the parenting plan submitted by parents wishing to jointly retain full parental authority. However, joint physical custody does not result directly from the Polish Family and Guardianship Code. Therefore, there is real legal uncertainty in this matter, which leads to different treatment of citizens by the public authorities and courts. Another problem is that joint physical custody is misunderstood by the Polish courts. The main thesis of the work is that joint physical custody does not only mean the system of symmetrical child care (50/50), and the possibility to award joint physical custody will require the courts to carefully weigh the pros and cons of such an arrangement in each individual case.

Keywords: joint physical custody, shared parenting, divorce, separation, parental authority

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1567 Effect of Sodium Arsenite Exposure on Pharmacodynamic of Meloxicam in Male Wistar Rats

Authors: Prashantkumar Waghe, N. Prakash, N. D. Prasada, L. V. Lokesh, M. Vijay Kumar, Vinay Tikare

Abstract:

Arsenic is a naturally occurring metalloid with potent toxic effects. It is ubiquitous in the environment and released from both natural and anthropogenic sources. It has the potential to cause various health hazards in exposed populations. Arsenic exposure through drinking water is considered as one of the most serious global environmental threats including Southeast Asia. The aim of present study was to evaluate the modulatory role of subacute exposure to sodium (meta) arsenite on the antinociceptive, anti-inflammatory and antipyretic responses mediated by meloxicam in rats. Rats were exposed to arsenic as sodium arsenite through drinking water for 28 days. A single dose of meloxicam (2 mg/kg b. wt.) was administered by oral gavage on the 29th day. The exact time of meloxicam administration depended on the type of test. Rats were divided randomly into 5 groups (n=6). Group I served as normal control and received arsenic free drinking water, while rats in group II were maintained similar to Group I but received meloxicam on 29th day. Groups III, IV and V were pre-exposed to arsenic through drinking water at 0.5, 5.0 and 50 ppm, respectively, for 28 days and was administered meloxicam next day and; pain and inflammation carried out by using formalin-induced nociception and carrageenan-induced inflammatory model(s), respectively by using standard protocol. For assessment of antipyretic effects, one more additional group (Group VI) was taken and given LPS @ 1.8 mg/kg b. wt. for induction of pyrexia (LPS control). Higher dose of arsenic inhibited the meloxicam mediated antinociceptive, anti-inflammatory and antipyretic responses. Further, meloxicam inhibited the arsenic induced level of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 and COX2 mediated prostaglandin E2 in hind paw muscle. These results suggest a functional antagonism of meloxicam by arsenic. This may relate to arsenic mediated local release of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 releases COX2 mediated prostaglandin E2. Based on the experimental study, it is concluded that sub-acute exposure to arsenic through drinking water aggravate pyrexia, inflammation and pain at environment relevant concentration and decrease the therapeutic efficacy of meloxicam at higher level of arsenite exposure. Thus, the observation made has clinical relevance in situations where animals are exposed to arsenite epidemic geographical locations.

Keywords: arsenic, analgesic activity, meloxicam, Wistar rats

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1566 Seasonal Short-Term Effect of Air Pollution on Cardiovascular Mortality in Belgium

Authors: Natalia Bustos Sierra, Katrien Tersago

Abstract:

It is currently proven that both extremes of temperature are associated with increased mortality and that air pollution is associated with temperature. This relationship is complex, and in countries with important seasonal variations in weather such as Belgium, some effects can appear as non-significant when the analysis is done over the entire year. We, therefore, analyzed the effect of short-term outdoor air pollution exposure on cardiovascular mortality during the warmer and colder months separately. We used daily cardiovascular deaths from acute cardiovascular diagnostics according to the International Classification of Diseases, 10th Revision (ICD-10: I20-I24, I44-I49, I50, I60-I66) during the period 2008-2013. The environmental data were population-weighted concentrations of particulates with an aerodynamic diameter less than 10 µm (PM₁₀) and less than 2.5 µm (PM₂.₅) (daily average), nitrogen dioxide (NO₂) (daily maximum of the hourly average) and ozone (O₃) (daily maximum of the 8-hour running mean). A Generalized linear model was applied adjusting for the confounding effect of season, temperature, dew point temperature, the day of the week, public holidays and the incidence of influenza-like illness (ILI) per 100,000 inhabitants. The relative risks (RR) were calculated for an increase of one interquartile range (IQR) of the air pollutant (μg/m³). These were presented for the four hottest months (June, July, August, September) and coldest months (November, December, January, February) in Belgium. We applied both individual lag model and unconstrained distributed lag model methods. The cumulative effect of a four-day exposure (day of exposure and three consecutive days) was calculated from the unconstrained distributed lag model. The IQR for PM₁₀, PM₂.₅, NO₂, and O₃ were respectively 8.2, 6.9, 12.9 and 25.5 µg/m³ during warm months and 18.8, 17.6, 18.4 and 27.8 µg/m³ during cold months. The association with CV mortality was statistically significant for the four pollutants during warm months and only for NO₂ during cold months. During the warm months, the cumulative effect of an IQR increase of ozone for the age groups 25-64, 65-84 and 85+ was 1.066 (95%CI: 1.002-1.135), 1.041 (1.008-1.075) and 1.036 (1.013-1.058) respectively. The cumulative effect of an IQR increase of NO₂ for the age group 65-84 was 1.066 (1.020-1.114) during warm months and 1.096 (1.030-1.166) during cold months. The cumulative effect of an IQR increase of PM₁₀ during warm months reached 1.046 (1.011-1.082) and 1.038 (1.015-1.063) for the age groups 65-84 and 85+ respectively. Similar results were observed for PM₂.₅. The short-term effect of air pollution on cardiovascular mortality is greater during warm months for lower pollutant concentrations compared to cold months. Spending more time outside during warm months increases population exposure to air pollution and can, therefore, be a confounding factor for this association. Age can also affect the length of time spent outdoors and the type of physical activity exercised. This study supports the deleterious effect of air pollution on cardiovascular mortality (CV) which varies according to season and age groups in Belgium. Public health measures should, therefore, be adapted to seasonality.

Keywords: air pollution, cardiovascular, mortality, season

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1565 Illness Representations of Injury: A Comparison of Patients and Their Primary Caregivers

Authors: Bih-O Lee, Hsiu-Wan Hsieh, Hsiu-Chen Liu, Mer Yu Pan

Abstract:

Background: Illness perceptions are developed when people face health-threatening situations. Previous research suggests that understanding discrepancies between illness perceptions of patients and caregivers may need to improve quality of health care. Objective: This study examined the differences between illness perceptions of injured patients and those of their caregivers. Methods: Comparative study design was used. The study setting was the surgical wards of a teaching hospital in Taiwan. Participants were 127 pairs of injured patients and their caregivers. The participants completed socio-demographic data and completed the Chinese Illness Perception Questionnaire Revised-Trauma, which comprises eight subscales. Clinical data of the injured patients was obtained from medical records. Results: This study found that injured patients were more pessimistic than their caregivers about the injury. There were significant differences between patients and caregivers insofar as patients perceived more physical symptoms, scored higher in terms of reasons for their injury, had more negative emotions and experienced more consequences than caregivers. Elderly caregivers and caregivers for patients who were over 65, severely injured and admitted to an ICU perceived more negative perceptions about the injury. Conclusions: This study indicated that patients and caregivers had negative illness representations several months after injury although the intensity of their perceptions was different. The interventions should highlight the need to assist patients and caregivers after injury.

Keywords: illness representations, injury, caregivers, comparative study

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1564 Iranian Sexual Health Needs in Viewpoint of Policy Makers: A Qualitative Study

Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

Abstract:

Introduction: Identifying sexual health needs, developing appropriate plans, and delivering services to meet those needs is an essential component of health programs for women, men, and children all over the world, especially in poor countries. Main Subject: The aim of this study was to describe the needs of sexual health from the viewpoint of health policymakers in Iran. Methods: A qualitative study using thematic content analysis was designed and conducted. Data gathering was conducted through semi-structured, in-depth interviews with 25 key informants within the healthcare system. Key informants were selected through both purposive and snowball sampling. MAXQUDA software (version 10) was used to facilitate transcription, classification of codes, and conversion of data into meaningful units, by the process of reduction and compression. Results: The analysis of narratives and information categorized sexual health needs into five categories: culturalization of sexual health discourse, sexual health care services, sexual health educational needs, sexual health research needs, and organizational needs. Conclusion: Identifying and explaining sexual health needs is an important factor in determining the priority of sexual health programs and identification of barriers to meet these needs. This can help other policymakers and health planners to develop appropriate programs to promote sexual and reproductive health.

Keywords: sexual health, sexual health needs, policy makers, health system, qualitative study

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1563 Effect of Urban Informal Settlements and Outdoor Advertisement on the Quality of Built Environment and Urban Upgrading in Nigeria

Authors: Amao Funmilayo Lanrewaju, T. Ogunlade

Abstract:

The paper examines the causes and characteristics of informal settlements and outdoor advertisement in the evaluation of quality of environment. The paper identifies the problems that have aided informal settlements to: Urbanization, poverty, growth of informal sector, non-affordability of land and housing shortage. The paper asserts that the informal settlements have serious adverse effects on the people’s health, their built environment and quality of life. The secondary data was obtained from books, journals and seminar papers. The paper argues that, although the urban upgrading possesses great potential for improving quality of built environment in informal settlements, there is a need to repackage the upgrading exercise so that majority can benefit from it. It is necessary to incorporate community participation into the urban upgrading in order to assist the very poor that cannot take care of their housing consumption needs. Therefore, government is encouraged to see informal settlements as a solution to new city planning rather than problem to the urban areas. This paper suggests the implementation of policies and planning, physical infrastructural development, social economic improvement, environment and health improvement. Government, private and communities interventions on informal settlements are required in order to prevent further decay for sustainable development.

Keywords: quality of environment, informal settlements, urban upgrading, outdoor advertisement

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1562 Analysis of the Treatment Hemorrhagic Stroke in Multidisciplinary City Hospital №1 Nur-Sultan

Authors: M. G. Talasbayen, N. N. Dyussenbayev, Y. D. Kali, R. A. Zholbarysov, Y. N. Duissenbayev, I. Z. Mammadinova, S. M. Nuradilov

Abstract:

Background. Hemorrhagic stroke is an acute cerebrovascular accident resulting from rupture of a cerebral vessel or increased permeability of the wall and imbibition of blood into the brain parenchyma. Arterial hypertension is a common cause of hemorrhagic stroke. Male gender and age over 55 years is a risk factor for intracerebral hemorrhage. Treatment of intracerebral hemorrhage is aimed at the primary pathophysiological link: the relief of coagulopathy and the control of arterial hypertension. Early surgical treatment can limit cerebral compression; prevent toxic effects of blood to the brain parenchyma. Despite progress in the development of neuroimaging data, the use of minimally invasive techniques, and navigation system, mortality from intracerebral hemorrhage remains high. Materials and methods. The study included 78 patients (62.82% male and 37.18% female) with a verified diagnosis of hemorrhagic stroke in the period from 2019 to 2021. The age of patients ranged from 25 to 80 years, the average age was 54.66±11.9 years. Demographic, brain CT data (localization, volume of hematomas), methods of treatment, and disease outcome were analyzed. Results. The retrospective analyze demonstrate that 78.2% of all patients underwent surgical treatment: decompressive craniectomy in 37.7%, craniotomy with hematoma evacuation in 29.5%, and hematoma draining in 24.59% cases. The study of the proportion of deaths, depending on the volume of intracerebral hemorrhage, shows that the number of deaths was higher in the group with a hematoma volume of more than 60 ml. Evaluation of the relationship between the time before surgery and mortality demonstrates that the most favorable outcome is observed during surgical treatment in the interval from 3 to 24 hours. Mortality depending on age did not reveal a significant difference between age groups. An analysis of the impact of the surgery type on mortality reveals that decompressive craniectomy with or without hematoma evacuation led to an unfavorable outcome in 73.9% of cases, while craniotomy with hematoma evacuation and drainage led to mortality only in 28.82% cases. Conclusion. Even though the multimodal approaches, the development of surgical techniques and equipment, and the selection of optimal conservative therapy, the question of determining the tactics of managing and treating hemorrhagic strokes is still controversial. Nevertheless, our experience shows that surgical intervention within 24 hours from the moment of admission and craniotomy with hematoma evacuation improves the prognosis of treatment outcomes.

Keywords: hemorragic stroke, Intracerebral hemorrhage, surgical treatment, stroke mortality

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1561 Documentation of Traditional Knowledge on Wild Medicinal Plants of Egypt

Authors: Nahla S. Abdel-Azim, Khaled A. Shams, Elsayed A. Omer, Mahmoud M. Sakr

Abstract:

Medicinal plants play a significant role in the health care system in Egypt. Knowledge developed over the years by people is mostly unrecorded and orally passes on from one generation to the next. This knowledge is facing the danger of becoming extinct. Therefore there is an urgent need to document the medicinal and aromatic plants associated with traditional knowledge. The Egyptian Encyclopedia of wild medicinal plants (EEWMP) is the first attempt to collect most of the basic elements of the medicinal plant resources of Egypt and their traditional uses. It includes scientific data on about 500 medicinal plants in the form of monographs. Each monograph contains all available information and scientific data on the selected species including the following: names, description, distribution, parts used, habitat, conservational status, active or major chemical constituents, folk medicinal uses and heritage resources, pharmacological and biological activities, authentication, pharmaceutical products, and cultivation. The DNA bar-coding is also included (when available). A brief Arabic summary is given for every monograph. This work revealed the diversity in plant parts used in the treatment of different ailments. In addition, the traditional knowledge gathered can be considered a good starting point for effective in situ and ex-situ conservation of endangered plant species.

Keywords: encyclopedia, medicinal plant, traditional medicine, wild flora

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1560 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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1559 The Balancing of the Parental Responsibilities and Right and the Best Interest of the Child within the Parent-Child Relationship

Authors: R. Prinsloo

Abstract:

Amniotic fluid stem cells (AFSC) have been shown to contribute towards the amelioration of Acute Renal Failure (ARF), but the mechanisms underlying the renoprotective effect are largely unknown. Therefore, the main goal of the current study was to evaluate the therapeutic efficacy of AFSC in a cisplatin-induced rat model of ARF and to investigate the underlying mechanisms responsible for its renoprotective effect. To study the therapeutic efficacy of AFSC, ARF was induced in Wistar rats by an intra-peritoneal injection of cisplatin, and five days after administration, the rats were randomized into two groups and injected with either AFSC or normal saline intravenously. On day 8 and 12 after cisplatin injection, i.e., day 3 and day7 post-therapy respectively, the blood biochemical parameters, histopathological changes, apoptosis, and expression of pro-apoptotic, anti-apoptotic and autophagy-related proteins in renal tissues were studied in both groups of rats. Administration of AFSC in ARF rats resulted in improvement of renal function and attenuation of renal damage as reflected by significant decrease in blood urea nitrogen, serum creatinine levels, tubular cell apoptosis as assessed by Bax/Bcl2 ratio, and expression of the pro-apoptotic proteins viz. PUMA, Bax, cleaved caspase-3 and cleaved caspase-9 as compared to saline-treated group. Furthermore, in the AFSC-treated group as compared to saline-treated group, there was a significant increase in the activation of autophagy as evident by increased expression of LC3-II, ATG5, ATG7, Beclin1 and phospho-AMPK levels with a concomitant decrease in phospho-p70S6K and p62 expression levels. To further confirm whether the protective effects of AFSC on cisplatin-induced apoptosis were dependent on autophagy, chloroquine, an autophagy inhibitor was administered by the intra-peritoneal route. Chloroquine administration led to significant reduction in the anti-apoptotic effects of the AFSC therapy and further deterioration in the renal structure and function caused by cisplatin. Collectively, our results put forth that AFSC ameliorates cisplatin-induced ARF through induction of autophagy and inhibition of apoptosis. Furthermore, the protective effects of AFSC were blunted by chloroquine, highlighting that activation of autophagy is an important mechanism of action for the protective role of AFSC in cisplatin-induced renal injury.

Keywords: best interest of the child, children's rights, parent and child relationship, parental responsibilities and rights

Procedia PDF Downloads 92