Search results for: care needs
702 Kidney Stones in Individuals Living with Diabetes Mellitus at King Abdul-Aziz Medical City - Tertiary Care Center, Jeddah, Saudi Arabia: A Retrospective Cohort Study
Authors: Suhaib Radi, Ibrahim Basem Nafadi, Abdullah Ahmed Alsulami, Nawaf Faisal Halabi, Abdulrhman Abdullah Alsubhi, Sami Wesam Maghrabi, Waleed Saad Alshehri
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Background: Kidney stones greatly affect individuals. The range of these effects regarding multiple kidney stone factors (size, presence of obstruction, and modality of treatment) in stone formers with and without diabetes has not been well explored in the literature to the best of the author's knowledge. Our goal is to investigate this unexplored correlation between diabetes and kidney stones by conducting a Cohort retrospective study to precisely evaluate the effects of this condition and the existence of complications in adult individuals with diabetes in Saudi Arabia in comparison to a non-diabetic control group. Methodology: This is a retrospective cohort study aiming to evaluate the range of effects of kidney stones in stone formers in a group of adults diagnosed with type 2 diabetes mellitus and adults without diabetes between 2017 and 2019 in Jeddah, Saudi Arabia. An IRB approval has been granted for this study. The data was analyzed using SPSS. The data was collected from the 1st of December 2022 until the 1st of March 2023. Results: A total of 254 individuals diagnosed with kidney stones were included, 127 of whom were adult individuals with type 2 diabetes, and 127 were non-diabetics. Our study shows that the individuals affected with diabetes were more likely to have larger kidney stones in comparison to individuals without diabetes (13.12 mm vs. 10.53 mm, p-value = 0.03). Moreover, individuals with hypertension and dyslipidemia also had significantly larger stones. On the other hand, no significant difference was found in the presence of obstruction and modality of treatment between the two groups. Conclusion: This study done in Saudi Arabia found that individuals with kidney stones who concurrently had diabetes formed larger kidney stones, and they were also found to have other comorbidities such as HTN, dyslipidemia, obesity, and renal disease. The significance of these findings could assist in the future of primary and secondary prevention of renal stones.Keywords: kidney stone, type 2 DM, metabolic syndrome, lithotripsy
Procedia PDF Downloads 98701 Beyond Information Failure and Misleading Beliefs in Conditional Cash Transfer Programs: A Qualitative Account of Structural Barriers Explaining Why the Poor Do Not Invest in Human Capital in Northern Mexico
Authors: Francisco Fernandez de Castro
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The Conditional Cash Transfer (CCT) model gives monetary transfers to beneficiary families on the condition that they take specific education and health actions. According to the economic rationale of CCTs the poor need incentives to invest in their human capital because they are trapped by a lack of information and misleading beliefs. If left to their own decision, the poor will not be able to choose what is in their best interests. The basic assumption of the CCT model is that the poor need incentives to take care of their own education and health-nutrition. Due to the incentives (income cash transfers and conditionalities), beneficiary families are supposed to attend doctor visits and health talks. Children would stay in the school. These incentivized behaviors would produce outcomes such as better health and higher level of education, which in turn will reduce poverty. Based on a grounded theory approach to conduct a two-year period of qualitative data collection in northern Mexico, this study shows that this explanation is incomplete. In addition to the information failure and inadequate beliefs, there are structural barriers in everyday life of households that make health-nutrition and education investments difficult. In-depth interviews and observation work showed that the program takes for granted local conditions in which beneficiary families should fulfill their co-responsibilities. Data challenged the program’s assumptions and unveiled local obstacles not contemplated in the program’s design. These findings have policy and research implications for the CCT agenda. They bring elements for late programming due to the gap between the CCT strategy as envisioned by policy designers, and the program that beneficiary families experience on the ground. As for research consequences, these findings suggest new avenues for scholarly work regarding the causal mechanisms and social processes explaining CCT outcomes.Keywords: conditional cash transfers, incentives, poverty, structural barriers
Procedia PDF Downloads 105700 Assessment of the Performance of the Sonoreactors Operated at Different Ultrasound Frequencies, to Remove Pollutants from Aqueous Media
Authors: Gabriela Rivadeneyra-Romero, Claudia del C. Gutierrez Torres, Sergio A. Martinez-Delgadillo, Victor X. Mendoza-Escamilla, Alejandro Alonzo-Garcia
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Ultrasonic degradation is currently being used in sonochemical reactors to degrade pollutant compounds from aqueous media, as emerging contaminants (e.g. pharmaceuticals, drugs and personal care products.) because they can produce possible ecological impacts on the environment. For this reason, it is important to develop appropriate water and wastewater treatments able to reduce pollution and increase reuse. Pollutants such as textile dyes, aromatic and phenolic compounds, cholorobenzene, bisphenol-A and carboxylic acid and other organic pollutants, can be removed from wastewaters by sonochemical oxidation. The effect on the removal of pollutants depends on the type of the ultrasonic frequency used; however, not much studies have been done related to the behavior of the fluid into the sonoreactors operated at different ultrasonic frequencies. Based on the above, it is necessary to study the hydrodynamic behavior of the liquid generated by the ultrasonic irradiation to design efficient sonoreactors to reduce treatment times and costs. In this work, it was studied the hydrodynamic behavior of the fluid in sonochemical reactors at different frequencies (250 kHz, 500 kHz and 1000 kHz). The performances of the sonoreactors at those frequencies were simulated using computational fluid dynamics (CFD). Due to there is great sound speed gradient between piezoelectric and fluid, k-e models were used. Piezoelectric was defined as a vibration surface, to evaluate the different frequencies effect on the fluid into sonochemical reactor. Structured hexahedral cells were used to mesh the computational liquid domain, and fine triangular cells were used to mesh the piezoelectric transducers. Unsteady state conditions were used in the solver. Estimation of the dissipation rate, flow field velocities, Reynolds stress and turbulent quantities were evaluated by CFD and 2D-PIV measurements. Test results show that there is no necessary correlation between an increase of the ultrasonic frequency and the pollutant degradation, moreover, the reactor geometry and power density are important factors that should be considered in the sonochemical reactor design.Keywords: CFD, reactor, ultrasound, wastewater
Procedia PDF Downloads 183699 Clinical Empathy: The Opportunity to Offer Optimal Treatment to People with Serious Illness
Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno
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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.Keywords: clinical empathy, determinants, healthcare, psychological wellbeing
Procedia PDF Downloads 115698 Study on the Effect of Pre-Operative Patient Education on Post-Operative Outcomes
Authors: Chaudhary Itisha, Shankar Manu
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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education.Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction
Procedia PDF Downloads 315697 Effectiveness of Adrenal Venous Sampling in the Management of Primary Aldosteronism: Single Centered Cohort Study at a Tertiary Care Hospital in Sri Lanka
Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.
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Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism
Procedia PDF Downloads 55696 Comparison of Maternal and Perinatal Outcomes of Obstetric Population Diagnosed with Covid-19 in Reference to Influenza A/H1N1: A Systematic Review and Meta-Analysis
Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz
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In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes
Procedia PDF Downloads 210695 Fathers’ Depression and its Relationship with Mothers’ Depression During Postpartum Period
Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami
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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.Keywords: depression, men, postpartum, risk factors, women
Procedia PDF Downloads 73694 Maternal Perception of Using Epidural Anesthesia and the Childbirth Outcomes
Authors: Jiyoung Kim, Chae Weon Chung
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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.Keywords: epidural anesthesia, delivery outcomes, labor pain, perception
Procedia PDF Downloads 149693 Use of Telephone Counselling in Employee Assistance Program
Authors: Andy S.K. Cheng, Samuel Leung, Cindy Kwok, Hector Tsang
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Background: Telephone counselling is one of the essential interventions that can be found in most of the Employee Assistance Programs (EAP). The purposes of this study were to (1) explore the trend of the telephone counselling from 2003-2016 in Hong Kong; (2) explore which EAP issue requires more follow-up; and 3) examine the relationship between the EAP issues and demographic data such as gender and job ranking. Method: Date of EAP services usage was collected from EAP providers in Hong Kong during 2003-2016. EAP issues were categorized into two domains, namely workplace issues and personal issues. Each domain has 12 sub-categories. Two hypotheses were formulated in this study (1) there was a gender difference in EAP issues and the follow-up hours; and (2) there was a significant difference between job ranking, EAP issues and follow-up hours. Results: A total of eight hundred and ninety-three valid cases were identified for analysis. Of them, three hundred and forty-three cases sought for follow-up. The duration of follow-up by hours was calculated for each of the follow-up cases. The results of the study shows that the top three workplace issues that required the longest duration of follow-up were (1) workload, (2) supervisor-subordinate relationship; and (3) team member’s relationship. On the other hand, the top three personal issues that required the longest duration of follow-up were (1) parenting/parent-child relationship, (2) family care, and (3) marital relationship. Two-way ANOVA was performed to compare the total follow-up hours (excluding first intake) between gender and EAP issues. There was no statistical significance for gender (p =.891), but a statistically significant main effect for EAP issues (p <.001) was found. Post-hoc analysis (Tukey’s test) showed that total follow-up hour in personal issues was statistically significant higher than that in handling workplace issues (p <.001). However, there was no statistically significant interaction effect between gender and EAP issues (p=.879) and between job ranking and EAP issues (p=.843). Conclusion: Telephone counselling is a very common intervention in addressing EAP issues arising from workplace and personal level in Hong Kong. It was frequently used to handle interpersonal relationships and the service usage was independent of gender and job ranking.Keywords: employee assistance program, follow-up time, interpersonal relationships, telephone counselling
Procedia PDF Downloads 208692 Sero-Prevalence of Hepatitis B Surface Antigen and Associated Factors among Pregnant Mothers Attending Antenatal Care Service, Mekelle, Ethiopia: Evidence from Institutional Based Quantitative Cross-Sectional Study
Authors: Semaw A., Awet H., Yohannes M.
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Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.Keywords: HBsAg, hepatitis B, pregnant women, prevalence
Procedia PDF Downloads 331691 D-Epi App: Mobile Application to Control Sodium Valproat Administration in Children with Idiopatic Epilepsy in Indonesia
Authors: Nyimas Annissa Mutiara Andini
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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.Keywords: application, children, D-Epi, epilepsy
Procedia PDF Downloads 269690 Interprofessional School-Based Mental Health Services for Rural Adolescents in South Australia
Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik
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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.Keywords: adolescent health, psychotherapy, school based mental health services, DAS21
Procedia PDF Downloads 153689 Mental Health Conditions and Their Risk Factors Among Women in Garissa County, Kenya
Authors: Njoroge Margaret W., Johnson Deborah
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Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD
Procedia PDF Downloads 37688 On or Off-Line: Dilemmas in Using Online Teaching-Learning in In-Service Teacher Education
Authors: Orly Sela
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The lecture discusses a Language Teaching program in a Teacher Education College in northern Israel. An on-line course was added to the program in order to keep on-campus attendance at a minimum, thus allowing the students to keep their full-time jobs in school. In addition, the use of educational technology to allow students to study anytime anywhere, in keeping with 21st-century innovative teaching-learning practices, was also an issue, as was the wish for this course to serve as a model which the students could then possibly use in their K-12 teaching. On the other hand, there were strong considerations against including an online course in the program. The students in the program were mostly Israeli-Arab married women with young children, living in a traditional society which places a strong emphasis on the place of the woman as a wife, mother, and home-maker. In addition, as teachers, they used much of their free time on school-related tasks. Having careers at the same time as studying was ground-breaking for these women, and using their time at home for studying rather than taking care of their families may have been simply too much to ask of them. At the end of the course, feedback was collected through an online questionnaire including both open and closed questions. The data collected shows that the students believed in online teaching-learning in principle, but had trouble implementing it in practice. This evidence raised the question of whether or not such a course should be included in a graduate program for mature, professional students, particular women with families living in a traditional society. This issue is not relevant to Israel alone, but also to academic institutions worldwide serving such populations. The lecture discusses this issue, sharing the researcher’s conclusions with the audience. Based on the evidence offered, it is the researcher’s conclusion that online education should, indeed, be offered to such audiences. However, the courses should be designed with the students’ special needs in mind, with emphasis placed on initial planning and course organization based on acknowledgment of the teaching context; modeling of online teaching/learning suited for in-service teacher education, and special attention paid to social-constructivist aspects of learning.Keywords: course design, in-service teacher-education, mature students, online teaching/learning
Procedia PDF Downloads 224687 A Prospective Study on the Pattern of Antibiotics Use and Prevalence of Multidrug Resistant Escherichia Coli in Poultry Chickens and Its Correlation with Urinary Tract Infection
Authors: Stelvin Sebastian, Andriya Annie Tom, Joyalanna Babu, Merin Joshy
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Introduction: The worldwide increase in the use of antibiotics in poultry and livestock industry to treat and prevent bacterial diseases and as growth promoters in feeds has led to the problem of development of antibiotic resistance both in animals and human population. Aim: To study the pattern of antibiotic use and prevalence of multidrug-resistant Escherichia coli in poultry chickens in selected farms in Muvattupuzha and to compare the spread of multidrug-resistant bacteria from poultry environment to UTI patients. Methodology: Two farms from each of 6 localities in Muvattupuzha were selected. A questionnaire on the pattern of antibiotic use and various farming practices were surveyed from farms. From each farm, 60samples of fresh fecal matter, litter from inside, litter from the outside shed, agricultural soil and control soil were collected, and antimicrobial susceptibility testing of E. coli was done. Antibiogram of UTI patients was collected from the secondary care hospital included in the study, and those were compared with resistance patterns of poultry samples. Results: From survey response antibiotics such as ofloxacin, enrofloxacin, levofloxacin, ciprofloxacin, colistin, ceftriaxone, neomycin, cephalexin, and oxytetracycline were used for treatment and prevention of infections in poultry. 31of 48 samples (51.66%) showed E. coli growth. 7 of 15 antibiotics (46.6%) showed resistance. Ampicillin, amoxicillin, meropenem, tetracycline showed 100% resistance to all samples. Statistical analysis confirmed similar resistance pattern in the poultry environment and UTI patients for antibiotics such as ampicillin, amoxicillin, amikacin, and ofloxacin. Conclusion: E. coli were resistant not only to extended-spectrum beta-lactams but also to carbapenems, which may be disseminated to the environment where litter was used as manure. This may due to irrational use of antibiotics in chicken or from their use in poultry feed as growth promoters. The study concludes the presence of multidrug-resistant E.coli in poultry and its spread to environment and humans, which may cause potentially serious implications for human health.Keywords: multidrug resistance, escherichia coli, urinary tract infection, poultry
Procedia PDF Downloads 141686 The Incidence of Cardiac Arrhythmias Using Trans-Telephonic, Portable Electrocardiography Recorder, in Out-Patients Faculty of Medicine Ramathibodi Hospital
Authors: Urasri Imsomboon, Sopita Areerob, Kanchaporn Kongchauy, Tuchapong Ngarmukos
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Objective: The Trans-telephonic Electrocardiography (ECG) monitoring is used to diagnose of infrequent cardiac arrhythmias and improve outcome of early detection and treatment on suspected cardiac patients. The objectives of this study were to explore incidence of cardiac arrhythmia using Trans-Telephonic and to explore time to first symptomatic episode and documented cardiac arrhythmia in outpatients. Methods: Descriptive research study was conducted between February 1, 2016, and December 31, 2016. A total of 117 patients who visited outpatient clinic were purposively selected. Research instruments in this study were the personal data questionnaire and the record form of incidence of cardiac arrhythmias using Trans-Telephonic ECG recorder. Results: A total of 117 patients aged between 15-92 years old (mean age 52.7 ±17.1 years), majority of studied sample was women (64.1%). The results revealed that 387 ECGs (Average 2.88 ECGs/person, SD = 3.55, Range 0 – 21) were sent to Cardiac Monitoring Center at Coronary Care Unit. Of these, normal sinus rhythm was found mostly 46%. Top 5 of cardiac arrhythmias were documented at the time of symptoms: sinus tachycardia 43.5%, premature atrial contraction 17.7%, premature ventricular contraction 14.3%, sinus bradycardia 11.5% and atrial fibrillation 8.6%. Presenting symptom were tachycardia 94%, palpitation 83.8%, dyspnea 51.3%, chest pain 19.6%, and syncope 14.5%. Mostly activities during symptom were no activity 64.8%, sleep 55.6% and work 25.6%.The mean time until the first symptomatic episode occurred on average after 6.88 ± 7.72 days (median 3 days). The first documented cardiac arrhythmia occurred on average after 9 ± 7.92 days (median 7 day). The treatments after patients known actual cardiac arrhythmias were observe themselves 68%, continue same medications 15%, got further investigations (7 patients), and corrected causes of cardiac arrhythmias via invasive cardiac procedures (5 patients). Conclusion: Trans-telephonic: portable ECGs recorder is effective in the diagnosis of suspected symptomatic cardiac arrhythmias in outpatient clinic.Keywords: cardiac arrhythmias, diagnosis, outpatient clinic, trans-telephonic: portable ECG recorder
Procedia PDF Downloads 187685 Qualitative Inquiry for Understanding Factors Associated to Intergenerational Transmission of Child Maltreatment
Authors: Marie-Claude Richard, Amelie Bolduc-Mokhtar, Mathieu Parent
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People who have experienced maltreatment in childhood subsequently face many parenting issues of their own, in particular when it comes to distancing themselves from the abusive behaviors they were exposed and had access to positive role models. Few studies have explored the factors explaining the ability to break the generational cycle of child maltreatment. However, deeper knowledge of the factors associated with intergenerational discontinuity could facilitate the development of innovative interventions and increase the preventive potential of existing programs. This poster presentation will be about a better understanding of the intergenerational transmission of maltreatment (IGTM) from the perspective of both youth protection workers and parents receiving child protection services. The data used to meet this goal were collected from a group interview with eight youth protection workers whose caseloads involved IGTM situations and through semi-structured interviews with four parents with a history of child protection services and who were currently receiving such services for at least one of their children. In the view of the youth protection workers, the IGTM refers to everything that is transmitted and not transmitted from one generation to the next within a family. The study participants painted quite a bleak portrait of the families affected by IGTM. However, three main avenues of intervention were mentioned by the participants: working within the network, favoring long-term interventions and being empathic. The results also show that the mothers were in a trajectory of intergenerational discontinuity in child maltreatment. Support from their families and friends as well as from formal support services brought out some possible explanatory factors for intergenerational discontinuity in child maltreatment. From a prevention perspective, developing meaningful and trusting relationships seems a source of resilience for parents who were placed in the care of the child protection system as children. The small number of participants limits the generalizability of these results. The difficulty of recruiting parents is a substantial challenge regarding gaining knowledge on the intergenerational transmission of child maltreatment. Future studies should examine this question and seek to develop effective strategies to help recruit study participants.Keywords: child maltreatment, intergenerational transmission, prevention, qualitative data
Procedia PDF Downloads 186684 Fungal Profile and Antifungal Susceptibility Patterns among Symptomatic Pediatrics Patients Attending Aboozar Children’s Hospital, Ahvaz, Iran
Authors: Nasrin Amirrajab, Yasaman Razavi Ghahfarokhi, Zahra Tootak, Maryam Hadian, Fatemeh Abooali Shamshiri
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Urinary tract infections (UTIs) have been reported in children with nephrotic syndrome. However, the only causes for the infection reported to date are bacteria, but not many prior reported occurrences of fungi or yeast as causative organisms. Hence, the present study aimed to describe the epidemiology of urinary tract fungal infections in a tertiary care pediatric. A single-center cross-sectional study was conducted at the nephrology ward of Aboozar Pediatric Hospital between March 21, 2021, and April 28, 2022. Urine was collected aseptically from children, inoculated onto culture media, and incubated at 37 °C for 18–48 hours. Yeast was identified following standard procedures. Antifungal susceptibility testing was determined by the disk diffusion method according to the CLSI guideline. Descriptive statistics and logistical regressions were used to estimate the crude ratio with a 95% confidence interval. P-value < 0.05 was considered significant. Among 68 individuals referred to the mycology lab, the result of direct examination and culture of all patients approved for C.albicans. Of these, 38 individuals (55.8%) were male, and 30 (44.2%) were female. The patients' age ranges were between one month and an 18-year-old. In the study of infection intensity, the patients were classified into three levels such as few (73.5%), moderate (20.6%), and many (5.9%). In the present study, all the patients were sensitive to Posaconazole. Also, the eagle effect was found in Amphotericin B, Voriconazole, and Fluconazole with frequencies of 91.7%, 91.7%, and 83%, respectively. In addition, just 8.3% of isolates were resistant to Itraconazole. It has not shown resistance in other mentioned medicine. The patients showed an intermediate response to Itraconazole (91.7%), Fluconazole (17%), Voriconazole (8.3%), and Amphotericin B (8.3%). There is a high prevalence of yeast infections in children with suspected UTIs. Also, boys are more likely to get yeast infections, and the severity of the infection is higher than girls. The present study demonstrated the importance of diagnosing and selecting the appropriate drug for urinary tract fungal infections in hospitalized children.Keywords: urinary tract infections, children, fungal infections, yeast, antifungal susceptibility
Procedia PDF Downloads 86683 Cognitive Emotion Regulation Strategies in 9–14-Year-Old Hungarian Children with Neurotypical Development in the Light of the Hungarian Version of Cognitive Emotion Regulation Questionnaire for Children
Authors: Dorottya Horváth, Andras Lang, Diana Varro-Horvath
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This research activity and study is part of a major research effort to gain an integrative, neuropsychological, and personality psychological understanding of Attention Deficit Hyperactivity Disorder (ADHD) and thus improve the specification of diagnostic and therapeutic care. In the past, the neuropsychology section has investigated working memory, executive function, attention, and behavioural manifestations in children. Currently, we are looking for personality psychological protective factors for ADHD and its symptomatic exacerbation. We hypothesise that secure attachment, adaptive emotion regulation, and high resilience are protective factors. The aim of this study is to measure and report the results of a Hungarian sample of the Cognitive Emotion Regulation Questionnaire for Children (CERQ-k) because before studying groups with different developmental differences, it is essential to know the average scores of groups with neurotypical devel-opment. Until now, there was no Hungarian version of the above test, so we used our own translation. This questionnaire has been developed to assess children's thoughts after experiencing negative life events. It consists of 4-4 items per subscale, for a total of 36 items. The response categories for each item range from 1 (almost never) to 5 (almost always). The subscales were self-blame, blaming others, acceptance, planning, positive refocusing, rumination or thought-focusing, positive reappraisal, putting into perspective, and catastrophizing. The data for this study were collected from 120 children aged 9-14 years. It was analysed using descriptive statistical analysis, where the mean and standard deviation values for each age group, as well as the Cronbach's alpha value, were significant in testing the reliability of the questionnaire. The results showed that the questionnaire is a reliable and valid measuring instrument also on a Hungarian sample. These developments and results will allow the use of a version of the Cognitive Emotion Regulation Questionnaire for children in Hungarian and pave the way for the study of different developmental groups such as children with learning disabilities and/or with ADHD.Keywords: neurotypical development, emotion regulation, negative life events, CERQ-k, Hungarian average scores
Procedia PDF Downloads 63682 Creating Smart and Healthy Cities by Exploring the Potentials of Emerging Technologies and Social Innovation for Urban Efficiency: Lessons from the Innovative City of Boston
Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando
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The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.Keywords: computing paradigm, emerging technologies, equitable healthcare, healthy cities, open data, smart city, social innovation
Procedia PDF Downloads 324681 Behavior Adoption on Marine Habitat Conservation in Indonesia
Authors: Muhammad Yayat Afianto, Darmawan, Agung Putra Utama, Hari Kushardanto
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Fish Forever, Rare’s innovative coastal fisheries program, combined community-based conservation management approach with spatial management to restore and protect Indonesia’s small-scale fisheries by establishing Fishing Managed Access Area. A ‘TURF-Reserve’ is a fishery management approach that positions fishers at the center of fisheries management, empowering them to take care of and make decisions about the future of their fishery. After two years of the program, social marketing campaigns succeeded in changing their behavior by adopting the new conservation behavior. The Pride-TURF-R campaigns developed an overarching hypothesis of impact that captured the knowledge, attitude and behavior changes needed to reduce threats and achieve conservation results. Rare help Batu Belah fishers to develop their group, developed with their roles, sustainable fisheries plan, and the budget plan. On 12th February 2017, the Head of Loka Kawasan Konservasi Perairan Nasional (LKKPN) which is a Technical Implementation Unit for National Marine Conservation Areas directly responsible to the Directorate General for Marine Spatial Management in the Ministry of Marine Affairs and Fisheries had signed a Partnership Agreement with the Head of Batu Belah Village to manage a TURF+Reserve area as wide as 909 hectares. The fishers group have been collecting the catch and submitting the report monthly, initiated the installation of the buoy markers for the No Take Zone, and formed the Pokmaswas (community-based surveillance group). Prior to this behavior adoption, they don’t have any fisheries data, no group of fishers, and they have still fishing inside the No Take Zone. This is really a new behavior adoption for them. This paper will show the process and success story of the social marketing campaign to conserve marine habitat in Anambas through Pride-TURF-R program.Keywords: behavior adoption, community participation, no take zone, pride-TURF-R
Procedia PDF Downloads 259680 Managing Work–Family Conflict in Today's Nursing Profession: The Role of Supervisors
Authors: Alshutwi Sitah
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Many countries around the world are struggling to maintain an adequate number of nurses. Inadequate nursing staffing could compromise the quality of patient care. Among many factors that contribute to registered nurses (RN) turnover, the influence of work–family conflict (WFC) has gained little attention. WFC was found to be significantly associated with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative consequences, including lower job satisfaction and organizational commitment, sleep insufficiency, insomnia symptoms, obesity, cardiovascular diseases, sleep insufficiency, and high cholesterol. In an effort to find strategies to manage the consequences of WFC, many behavioral, psychological, and career scholars have focused on the role of supervisor support. Family Supportive Supervisor Behaviors (FSSB) has been found to be a promising approach contributing to the reduction of TI in employees’ experiencing WFC. Despite the importance of work–family issues and the influence of FSSB, limited studies have been conducted among the nursing population and none were found that included a sample from Saudi Arabia. Therefore, the main Purpose of this study was to evaluate the influence of FSSB on the relationship among WFC, Stress, and TI in Saudi Arabian registered nurses. Method: A cross-sectional study. Sample: Convenience sampling; 113 Saudi female nurse. Result: Fifty percent of nurses intended to leave their workplace, 68 % of nurses reported having a conflict between work and family, and 44% reported having a high level of stress. A significant positive correlation was found between WFC and TI (r= .43, P < 0.01). A negative correlation was found between FSSB and TI (r= -.53, P < 0.01). Both WFC and stress were associated with TI; however, these associations were buffered (weaken), when nurses had higher FSSB. Conclusion: The FSSB could be seen as a tool to help married, female nurses to demonstrate their professional role without compromising their family responsibilities. Nurses’ turnover is a complex issue that may require multiple prevention strategies; however, enhancing FSSB could be a key resource for maintaining a positive workplace environment and reducing TI.Keywords: turnover intention, work-family conflict, supervisor support, nursing retention
Procedia PDF Downloads 219679 Service Blueprint for Improving Clinical Guideline Adherence via Mobile Health Technology
Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue
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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint
Procedia PDF Downloads 407678 Anaesthetic Management of Congenitally Corrected Transposition of Great Arteries with Complete Heart Block in a Parturient for Emergency Caesarean Section
Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala
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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia
Procedia PDF Downloads 123677 Antecedents and Impacts of Human Capital Flight in the Sub-Saharan Africa with Specific Reference to the Higher Education Sector: Conceptual Model
Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink
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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development
Procedia PDF Downloads 244676 Review and Comparison of Iran`s Sixteenth Topic of the Building with the Ranking System of the Water Sector Lead to Improve the Criteria of the Sixteenth Topic
Authors: O. Fatemi
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Considering growing building construction industry in developing countries and sustainable development concept, as well as the importance of taking care of the future generations, codifying buildings scoring system based on environmental criteria, has always been a subject for discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables. In this article, the most important common LEED (Leadership in Energy and Environmental Design) and BREEAM (Building Research Establishment Environmental Assessment Method) common and Global environmental scoring systems, used in UK, USA, and Japan, respectively, have been discussed and compared with a special focus on CASBEE (Comprehensive Assessment System for Built Environment Efficiency), to credit assigning field (weighing and scores systems) as well as sustainable development criteria in each system. Then, converging and distinct fields of the foregoing systems are examined considering National Iranian Building Code. Furthermore, the common credits in the said systems not mentioned in National Iranian Building Code have been identified. These credits, which are generally included in well-known fundamental principles in sustainable development, may be considered as offered options for the Iranian building environmental scoring system. It is suggested that one of the globally and commonly accepted systems is chosen considering national priorities in order to offer an effective method for buildings environmental scoring, and then, a part of credits is added and/or removed, or a certain credit score is changed, and eventually, a new scoring system with a new title is developed for the country. Evidently, building construction industry highly affects the environment, economy, efficiency, and health of the relevant occupants. Considering the growing trend of cities and construction, achieving building scoring systems based on environmental criteria has always been a matter of discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables.Keywords: scoring system, sustainability assessment, water efficiency, national Iranian building code
Procedia PDF Downloads 170675 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova
Authors: Balkibekova Venera Serikpaevna
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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications
Procedia PDF Downloads 56674 Role of Education on Shaping the Personality of the Students in Rural Areas: A Case Study of Daund Taluka in Pune District of Maharashtra, India
Authors: L. K. Shitole
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Usually on the face of it, personality is regarded as the external appearance of an individual. In psychology, the personality is not viewed merely as self or external appears, but it adds much more. Human resources development encompasses the personality development of the students. The student’s development starts right from the childhood and gradually continues right up to the completion of education in professional courses. This paper attempts to find out the role of the educational institutions in shaping the personality of the students from the rural area. Schools and colleges have infrastructural limitations, obtaining good quality and devoted teaching staff poses problems and even outside the school environment there are no private classes which may take care of this deficiency. The researcher has used the standardized test namely “Vyaktitva Shodhika” developed by Gyan Prabodhini, Pune for the students in Daund Taluka. There are 68 objective types of questions in the said questionnaire. Totally a sample size of 4191 students was selected. The sample was quite representative. It is observed that by and large the response indicates that the educational institutions are taking sincere efforts in shaping the personality of the students. In the semi-urban area i.e. at educational institutions of all levels, the performance on this front is excellent and at rest of Daund Taluka there is scope for improvement. Educational institutions of all levels are showing excellent performance in ensuring availability of the requisite infrastructure conducive for the development of the personality of the students. In rest of Daund Taluka there is ample scope for improving the situation. As far as data relating to role of co-curricular activities and sports programs in mental and physical development at various educational institutions is concerned Daund educational institutions have repeated their performance in securing “A” category, while in the rural area of Daund Taluka, there is need to step up the efforts in this regard. In today’s world of knowledge industry, one cannot ignore the importance of education and thereby the personality growth of the students. Accordingly, the educational institutions should undertake consistent research and extension activities in the area of personality development.Keywords: personality, attitude, infrastructure, quality of education, learning environment, teacher’s contribution, family and society’s role
Procedia PDF Downloads 463673 Impact of Positive Psychology Education and Interventions on Well-Being: A Study of Students Engaged in Pastoral Care
Authors: Inna R. Edara, Haw-Lin Wu
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Positive psychology investigates human strengths and virtues and promotes well-being. Relying on this assumption, positive interventions have been continuously designed to build pleasure and happiness, joy and contentment, engagement and meaning, hope and optimism, satisfaction and gratitude, spirituality, and various other positive measures of well-being. In line with this model of positive psychology and interventions, this study investigated certain measures of well-being in a group of 45 students enrolled in an 18-week positive psychology course and simultaneously engaged in service-oriented interventions that they chose for themselves based on the course content and individual interests. Students’ well-being was measured at the beginning and end of the course. The well-being indicators included positive automatic thoughts, optimism and hope, satisfaction with life, and spirituality. A paired-samples t-test conducted to evaluate the impact of class content and service-oriented interventions on students’ scores of well-being indicators indicated statistically significant increase from pre-class to post-class scores. There were also significant gender differences in post-course well-being scores, with females having higher levels of well-being than males. A two-way between groups analysis of variance indicated a significant interaction effect of age by gender on the post-course well-being scores, with females in the age group of 56-65 having the highest scores of well-being in comparison to the males in the same age group. Regression analyses indicated that positive automatic thought significantly predicted hope and satisfaction with life in the pre-course analysis. In the post-course regression analysis, spiritual transcendence made a significant contribution to optimism, and positive automatic thought made a significant contribution to both hope and satisfaction with life. Finally, a significant test between pre-course and post-course regression coefficients indicated that the regression coefficients at pre-course were significantly different from post-course coefficients, suggesting that the positive psychology course and the interventions were helpful in raising the levels of well-being. The overall results suggest a substantial increase in the participants’ well-being scores after engaging in the positive-oriented interventions, implying a need for designing more positive interventions in education to promote well-being.Keywords: hope, optimism, positive automatic thoughts, satisfaction with life, spirituality, well-being
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