Search results for: July 15

Authors: Xu Feifei

Abstract:

The prevalence of COVID-19 currently is the biggest challenge to improving people's quality of life. Its impact on the health-related quality of life (HRQoL) is highly uncertain and has not been summarized so far. The aim of the present systematic review was to assess and provide an up-to-date analysis of the impact of the COVID-19 pandemic on the HRQoL of participants who have been infected, have not been infected but isolated, frontline, with different diseases, and the general population. Therefore, an electronic search of the literature in PubMed databases was performed from 2019 to July 2022 (without date restriction). PRISMA guideline methodology was employed, and data regarding the HRQoL were extracted from eligible studies. Articles were included if they met the following inclusion criteria: (a) reports on the data collection of the health state utility values (HSUVs) related to COVID-19 from 2019 to 2021; (b) English language and peer-reviewed journals; and (c) original HSUV data; (d) using EQ-5D tool to quantify the HRQoL. To identify studies that reported the effects on COVID-19, data on the proportion of overall HSUVs of participants who had the outcome were collected and analyzed using a one-group meta-analysis. As a result, thirty-two studies fulfilled the inclusion criteria and, therefore, were included in the systematic review. A total of 45295 participants and provided 219 means of HSUVs during COVID-19 were included in this systematic review. The range of utility is from 0.224 to 1. The study included participants from Europe (n=16), North America (n=4), Asia (n=10), South America (n=1), and Africa (n=1). Twelve articles showed that the HRQoL of the participants who have been infected with COVID-19 (range of overall HSUVs from 0.6125 to 0.863). Two studies reported the population of frontline workers (the range of overall HSUVs from 0.82 to 0.93). Seven of the articles researched the participants who had not been infected with COVID-19 but suffered from morbidities during the pandemic (range of overall HSUVs from 0.5 to 0.96). Thirteen studies showed that the HRQoL of the respondents who have not been infected with COVID-19 and without any morbidities (range of overall HSUVs from 0.64 to 0.964). Moreover, eighteen articles reported the outcomes of overall HSUVs during the COVID-19 pandemic in different population groups. The estimate of overall HSUVs of direct COVID-19 experience population (n=1333) was 0.751 (95% CI 0.670 - 0.832, I2 = 98.64%); the estimate of frontline population (n=610) was 0.906 ((95% CI 0.854 – 0.957, I2 = 98.61%); participants with different disease (n=132) were 0.768 (95% CI 0.515 - 1.021, I2= 99.26%); general population without infection history (n=29,892) was 0.825 (95% CI 0.766 - 0.885, I2 =99.69%). Conclusively, taking into account these results, this systematic review might confirm that COVID-19 has a negative impact on the HRQoL of the infected population and illness population. It provides practical value for cost-effectiveness model analysis of health states related to COVID-19.

Keywords: COVID-19, health-related quality of life, meta-analysis, systematic review, utility value

Procedia PDF Downloads 53

Authors: Waheed Anwar, Kiran Nawaz, Muhammad Saleem Haider, Ahmad Ali Shahid, Sehrish Iftikhar

Abstract:

The whitefly, Bemisia tabaci (Gennadius), is a complex insect species, including many cryptic species or biotypes. Whitefly causes damage to many ornamental and horticultural crops through directly feeding on phloem sap, resulting in sooty mould and critically decreases the rate of photosynthesis of many host plants. Biological control has emerged as one of the most important methods for the management of soil-borne plant pathogens. Among the natural enemies of insects different entomopathogenic fungi are mostly used as biological control of the pest. The purpose of this research was to find indigenous insect-associated fungi and their virulence against Bemisia tabaci. A detailed survey of cotton fields in sample collection was conducted during July and August 2013 from the central mixed zone of Punjab, Pakistan. For the isolation of T. longibrachiatum, sabouraud dextrose peptone yeast extract agar (SDAY) media was used and morphological characterization of isolated T. longibrachiatum was studied using different dichotomous keys. Molecular Identification of the pathogen was confirmed by amplifying the internal transcribed spacer region. Blastn analysis showed 100% homology with already reported sequences on the database. For these bioassays, two conidial concentrations 4 × 108/mL & 4 × 104/mL of T. longibrachiatum was sprayed in clip cages for nymph and adult B. tabaci respectively under controlled environmental conditions. The pathogenicity of T. longibrachiatum was tested on nymph and adult whitefly to check mortality. Mortality of B. tabaci at nymphal and adult stages were observed after 24-hour intervals. Percentage mortality of nymphs treated with 4 x 104/mL conidia of T. longibrachiatum was 20, 24, 36 and 40% after 48, 72, 96, 72, 96, 120 and 144 hours respectively. However, no considerable difference was recorded in percentage mortality of whitefly after 120 and 144 hours. There were great variations after 24, 48, 72 and 96 hours in the rate of mortality. The efficacy of T. longibrachiatum as entomopathogenic fungi was evaluated in adult and nymphal stages of whitefly. Trichoderma longibrachiatum showed maximum activity on nymphal stages of whitefly as compared to adult stages. The percentage of conidial germination was also recorded on the outer surface of adult and nymphal stages of B. tabaci. The present findings indicated that T. longibrachiatum is an entomopathogenic fungus against B. tabaci and many species of Trichoderma were already reported as an antagonistc organism against a wide range of bacterial and fungal pathogens.

Keywords: efficacy, Trichoderma, virulence, bioassay

Procedia PDF Downloads 234

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

Abstract:

Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

Procedia PDF Downloads 96

Authors: Mei Lin, Chang Liu

Abstract:

Argumentative writing is the most prevalent genre in diverse writing tests. How to construct academic arguments is often regarded as a difficult task by most English as a foreign language (EFL) learners. A failure to generate enough ideas and organise them coherently and logically as well as a lack of competence in supporting their arguments with relevant evidence are frequent problems faced by EFL learners when approaching an English argumentative writing task. Overall, these problems are closely related to planning, and planning an argumentative writing at pre-writing stage plays a vital role in a good academic essay. However, how teachers can effectively guide students to generate ideas is rarely discussed in planning English argumentative writing, apart from brainstorming. Brainstorming has been a common practice used by teachers to help students generate ideas. However, some limitations of brainstorming suggest that it can help students generate many ideas, but ideas might not necessarily be coherent and logic, and could sometimes impede production. It calls for a need to explore effective instructional strategies at pre-writing stage of English argumentative writing. This paper will first examine how a Six Thinking Hats approach can be used to provide a dialogic space for EFL learners to experience and collaboratively generate ideas from multiple perspectives at pre-writing stage. Part of the findings of the impact of a twelve-week intervention (from March to July 2021) on students learning to generate ideas through engaging in group discussions of using Six Thinking Hats will then be reported. The research design is based on the sociocultural theory. The findings present evidence from a mixed-methods approach and fifty-nine participants from two first-year undergraduate natural classes in a Chinese university. Analysis of pre- and post- questionnaires suggests that participants had a positive attitude toward the Six Thinking Hats approach. It fosters their understanding of prewriting and argumentative writing, helps them to generate more ideas not only from multiple perspectives but also in a systematic way. A comparison of participants writing plans confirms an improvement in generating counterarguments and rebuttals to support their arguments. Above all, visual and transcripts data of group discussion collected from different weeks throughout the intervention enable teachers and researchers to ‘see’ the hidden process of learning to generate ideas in action.

Keywords: argumentative writing, innovative pedagogy, six thinking hats, dialogic space, prewriting, higher education

Procedia PDF Downloads 51

Authors: Comsun Thongchai, Vorapoj Promasatayaprot

Abstract:

Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.

Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand

Procedia PDF Downloads 164

Authors: Yasser O. Abualnaja1, Alexandra Pavlidou2, Taha Boksmati3, Ahmad Alharbi3, Hammad Alsulmi3, Saleh Omar Maghrabi3, Hassan Mowalad3, Rayan Mutwalli3, James H. Churchill4, Afroditi Androni2, Dionysios Ballas2, Ioannis Hatzianestis2, Harilaos Kontoyiannis2, Angeliki Konstantinopoulou2, Georgios Krokkos1, 5, Georgios Pappas2, Vassilis P. Papadopoulos2, Konstantinos Parinos2, Elvira Plakidi2, Eleni Rousselaki2, Dimitris Velaoras2, Panagiota Zachioti2, Theodore Zoulias2, Ibrahim Hoteit5.

Abstract:

The coastal areas along the Kingdom of Saudi Arabia on both the Red Sea and Arabian Gulf have been witnessing in the past decades an unprecedented economic growth and a rapid increase in anthropogenic activities. Therefore, the Saudi Arabian government has decided to frame a strategy for sustainable development of the coastal and marine environments, which comes in the context of the Vision 2030, aimed at providing the first comprehensive ‘Status Quo Assessment’ of the Kingdom’s coastal and marine environments. This strategy will serve as a baseline assessment for future monitoring activities; this baseline is relied on scientific evidence of the drivers, pressures, and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressures of the hotspots analysis, which was developed following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. Ten hotspot sites were identified, eight in the Red Sea and two in the Arabian Gulf. Thus, multidisciplinary research cruises were conducted throughout the Red Sea and the Arabian Gulf coastal and marine environments in June/July 2021 and September 2021, respectively, in order to understand the relative impact of hydrography and the various pressures on the quality of seawater and sediments. The main objective was to record the physical and biogeochemical parameters along the coastal waters of the Kingdom, tracing the dispersion of contaminants related to specific pressures. The assessment revealed the effect of hydrography on the trophic status of the southern marine coastal areas of the Red Sea. Jeddah Lagoon system seems to face significant eutrophication and pollution challenges, whereas sediments are enriched in some heavy metals in many areas of the Red Sea and the Arabian Gulf. This multidisciplinary research in the Red Sea and the Arabian Gulf coastal waters will pave the way for future detailed environmental monitoring strategies for the Saudi Arabian marine environment.

Keywords: arabian gulf, contaminants, hotspot, red sea

Procedia PDF Downloads 67

Authors: Muhammad Farhan Saeed, Waheed Aslam Khan, Muhammad Nadeem, Iftikhar Ahmad, Zakir Ali

Abstract:

Milk is an important and fundamental nutrition source of human diet. In Pakistan, the milk used by the consumer is of low quality and is often contaminated due to the lack of quality controls. Mycotoxins produced from molds which contaminate the agriculture commodities of animal feed. Mycotoxins are poisons which affect the animals when they consume contaminated feeds. Aflatoxin AFM1 is naturally occurring form of mycotoxins in milk which is carcinogenic. To assess public awareness regarding milk Aflatoxin contamination, a population-based survey using a questionnaire was carried out from general public and from farmers of both rural and urban areas. It was revealed from the data that people of rural area were more satisfied about quality of available milk but the awareness level about milk contamination was found lower in both areas. Total 297 samples of milk were collected from rural (n=156) and urban (n=141) areas of district Vehari during June-July 2015. Milk samples were collected from three different point sources; farmer, milkman and milkshop. These point sources had three types of dairy milk including cow milk, buffalo milk and mixed milk. After performing ELISA test 18 samples with positive ELISA results were maintain per source for further analysis for aflatoxin M1 (AFM1) by High Performance Liquid Chromatography (HPLC). Higher percentages of samples were found exceeding the permissible limit for urban area. In rural area about 15% samples and from urban area about 35% samples were exceeded the permissible limit of AFM1 with 0.05µg/kg set by European Union. From urban areas about 55% of buffalo, 33% of cows and 17% of mixed milk samples were exceeded the permissible AFM1 level as compared with 17%, 11% and 17% for milk samples from rural areas respectively. Samples from urban areas 33%, 44% and 28% were exceeded the permissible AFM1 level for farmer, milkman and of milk shop respectively as compared with 28% and 17% of farmer and milkman’s samples from rural areas respectively. The presence of AFM1 in milk samples demands the implementation of strict regulations and also urges the need for continuous monitoring of milk and milk products in order to minimize the health hazards. Regulations regarding aflatoxins contamination and adulteration should be strictly imposed to prevent health problems related to milk quality. Permissible limits for aflatoxin should be enforced strongly in Pakistan so that economic loss due to aflatoxin contamination can be reduced.

Keywords: Vehari, aflatoxins AFM1, milk, HPLC

Procedia PDF Downloads 326

Authors: Recep Kesli, Huseyin Bilgin, Yasar Unlu, Gokhan Gungor

Abstract:

Aim: The aim of this study, was to investigate the presence of Helicobacter pylori (H. pylori) infection by culture, histology, and RUT (Rapid Urease Test) in gastric antrum biopsy samples taken from patients presented with dyspeptic complaints and to determine resistance rates of amoxicillin, clarithromycin, levofloxacin and metronidazole against the H. pylori strains by E-test. Material and Methods: A total of 278 patients who admitted to Konya Education and Research Hospital Department of Gastroenterology with dyspeptic complaints, between January 2011-July 2013, were included in the study. Microbiological and histopathological examinations of biopsy specimens taken from antrum and corpus regions were performed. The presence of H. pylori in biopsy samples was investigated by culture (Portagerm pylori-PORT PYL, Pylori agar-PYL, GENbox microaer, bioMerieux, France), histology (Giemsa, Hematoxylin and Eosin staining), and RUT(CLOtest, Cimberly-Clark, USA). Antimicrobial resistance of isolates against amoxicillin, clarithromycin, levofloxacin, and metronidazole was determined by E-test method (bioMerieux, France). As a gold standard in the diagnosis of H. pylori; it was accepted that the culture method alone was positive or both histology and RUT were positive together. Sensitivity and specificity for histology and RUT were calculated by taking the culture as a gold standard. Sensitivity and specificity for culture were also calculated by taking the co-positivity of both histology and RUT as a gold standard. Results: H. pylori was detected in 140 of 278 of patients with culture and 174 of 278 of patients with histology in the study. H. pylori positivity was also found in 191 patients with RUT. According to the gold standard criteria, a false negative result was found in 39 cases by culture method, 17 cases by histology, and 8 cases by RUT. Sensitivity and specificity of the culture, histology, and RUT methods of the patients were 76.5 % and 88.3 %, 87.8 % and 63 %, 94.2 % and 57.2 %, respectively. Antibiotic resistance was investigated by E-test in 140 H. pylori strains isolated from culture. The resistance rates of H. pylori strains to the amoxicillin, clarithromycin, levofloxacin, and metronidazole was detected as 9 (6.4 %), 22 (15.7 %), 17 (12.1 %), 57 (40.7 %), respectively. Conclusion: In our study, RUT was found to be the most sensitive, culture was the most specific test between culture, histology, and RUT methods. Although we detected the specificity of the culture method as high, its sensitivity was found to be quite low compared to other methods. The low sensitivity of H. pylori culture may be caused by the factors affect the chances of direct isolation such as spoild bacterium, difficult-to-breed microorganism, clinical sample retrieval, and transport conditions.

Keywords: antimicrobial resistance, culture, histology, H. pylori, RUT

Procedia PDF Downloads 134

Authors: M. Bučas, A. Skersonas, E. Ivanauskas, J. Lesutienė, N. Nika, G. Srėbalienė, E. Tiškus, J. Gintauskas, A.Šaškov, G. Martin

Abstract:

Submerged vegetation enhances heterogeneity of sublittoral habitats; therefore, macrophyte stands are essential elements of aquatic ecosystems to maintain a diverse fish fauna. Fish-habitat relations have been extensively studied in streams and coastal waters, but in lakes and estuaries are still underestimated. The aim of this study is to assess temporal (diurnal and seasonal) patterns of fish juvenile assemblages associated with common submerged macrophyte habitats, which have significantly spread during the recent decade in the upper littoral part of the Curonian Lagoon. The assessment was performed by means of an upgraded pop-up net approach resulting in much precise sampling versus other techniques. The optimal number of samples (i.e., pop-up nets) required to cover>80% of the total number of fish species depended on the time of the day in both study sites: at least 7and 9 nets in the evening (18-24 pm) in the Southern and Northern study sites, respectively. In total, 14 fish species were recorded, where perch and roach dominated (respectively 48% and 24%). From multivariate analysis, water salinity and seasonality (temperature or sampling month) were primary factors determining fish assemblage composition. The southern littoral area, less affected by brackish water conditions, hosted a higher number of species (13) than in the Northern site (8). In the latter site, brackish water tolerant species (three-spined and nine-spined sticklebacks, spiny loach, roach, and round goby) were more abundant than in the Southern site. Perch and ruffe dominated in the Southern site. Spiny loach and nine-spined stickleback were more frequent in September, while ruffe, perch, and roach occurred more in July. The diel dynamics of the common species such as perch, roach, and ruffe followed the general pattern, but it was species specific and depended on the study site, habitat, and month. The species composition between macrophyte habitats did not significantly differ; however, it differed from the results obtained in 2005 at both study sites indicating the importance of expanded charophyte stands during the last decade in the littoral zone.

Keywords: diel dynamics, charophytes, pondweeds, herbivorous and benthivorous fishes, littoral, nursery habitat, shelter

Procedia PDF Downloads 152

Authors: K. Vallianou, T. Alexopoulos, V. Plaka, M. K. Seleventi, V. Skanavis, C. Skanavis

Abstract:

The present research addresses the role of place attachment and emotions in community resiliency and recovery within the context of a disaster. Natural disasters represent a disruption in the normal functioning of a community, leading to a general feeling of disorientation. This study draws on the trauma caused by a natural hazard such as a forest fire. The changes of the sense of togetherness are being assessed. Finally this research determines how the place attachment of the inhabitants was affected during the reorientation process of the community. The case study area is Mati, a small coastal town in eastern Attica, Greece. The fire broke out on July 23^rd, 2018. A quantitative research was conducted through questionnaires via phone interviews, one year after the disaster, to address community resiliency in the long-run. The sample was composed of 159 participants from the rural community of Mati plus 120 coming from Skyros Island that was used as a control group. Inhabitants were prompted to answer items gauging their emotions related to the event, group identification and emotional significance of their community, and place attachment before and a year after the fire took place. Importantly, the community recovery and reorientation were examined within the context of a relative absence of government backing and official support. Emotions related to the event were aggregated into 4 clusters related to: activation/vigilance, distress/disorientation, indignation, and helplessness. The findings revealed a decrease in the level of place attachment in the impacted area of Mati as compared to the control group of Skyros Island. Importantly, initial distress caused by the fire prompted the residents to identify more with their community and to report more positive feelings toward their community. Moreover, a mediation analysis indicated that the positive effect of community cohesion on place attachment one year after the disaster was mediated by the positive feelings toward the community. Finally, place attachment contributes to enhanced optimism and a more positive perspective concerning Mati’s future prospects. Despite an insufficient state support to this affected area, the findings suggest an important role of emotions and place attachment during the process of recovery. Implications concerning the role of emotions and social dynamics in meshing place attachment during the disaster recovery process as well as community resiliency are discussed.

Keywords: community resilience, natural disasters, place attachment, wildfire

Procedia PDF Downloads 66

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

Procedia PDF Downloads 135

Authors: Gabriel G. Gaft, Xayvinay Xiong, Amanda Sunday

Abstract:

The emergent pandemic from COVID-19 virus has forced people to adjust to major changes. These changes include all elements of family and work life and required people to engage in novel behaviors. For many people, the social norms to which they have been accustomed no longer prevail. Not surprisingly, such enormous changes in daily life have been associated with greater problems in mental health; and research regarding ways in which mental health professionals can support people is more necessary than ever before. It is often useful to assess people’s reactions through surveys and utilize quantitative data to answer questions about coping strategies etc. It is also likely, however, that a host of individual factors are going to contribute to what might be considered 'good' or 'bad' coping mechanisms to a worldwide pandemic. To this end, qualitative studies—where the individual’s subjective experience is highlighted—are likely to provide more vital information for mental health professionals interested in supporting the particular person in front of them. This study reports on qualitative data, where X participants were asked questions about social distancing, coping strategies, and general attitudes towards social changes resulting from the COVID-19 pandemic. Informal interviews were conducted during the months of June-July 2020. Data were analyzed using Interpretative Phenomenological Analyses. Themes were identified first for each participant and then compared across different individual participants. Several findings emerged. First, all participants understood major health messages being imparted by governing bodies such as the CDC and WHO. The researchers feel this finding is important as it suggests health messages are at least being effectively communicated. Second, there was a clear trend for themes which highlighted the conflicting emotions participants felt about the changes they were expected to endure: positive and negative elements were identified, although a participant who had pre-existing conditions placed greater emphasis on the negative elements. One participant who was particularly interested in impression management also exclusively emphasized negative emotions. Third, participants who were able to reevaluate priorities—what Lazarus might call secondary appraisals—experienced social distancing as a positive rather than negative phenomenon. Finally, participants who were able to develop specific strategies—such as boundaries for work and self-care—reported themes of adjustment and contentment. Taken together, these findings suggest mental health practitioners can assist people to adjust more positively through specific techniques focusing on re-evaluation of life priorities and strategic coping skills.

Keywords: COVID-19, pandemic, phenomenology, virus

Procedia PDF Downloads 82

Authors: Joe Collins, Matthias Rother

Abstract:

Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

Procedia PDF Downloads 453

Authors: Phenias Nsabimana, Jérôme W. Some, Hilda Vasanthakaalam, Stefaan De Henauw, Souheila Abbeddou

Abstract:

Tools for the dietary assessment in adults are limited in low- and middle-income settings. The objective of this study was to develop and validate a semi-quantitative food frequency questionnaire (FFQ) against the multiple pass-24 h recall tool for use in urban and rural Rwanda. A total of 212 adults (154 females and 58 males), 18-49 aged, including 105 urban and 107 rural residents, from the four regions of Rwanda, were recruited in the present study. A multiple-pass 24- H recall technique was used to collect dietary data in both urban and rural areas in four different rounds, on different days (one weekday and one weekend day), separated by a period of three months, from November 2020 to October 2021. The details of all the foods and beverages consumed over the 24h period of the day prior to the interview day were collected during face-to-face interviews. A list of foods, beverages, and commonly consumed recipes was developed by the study researchers and ten research assistants from the different regions of Rwanda. Non-standard recipes were collected when the information was available. A single semi-quantitative FFQ was also developed in the same group discussion prior to the beginning of the data collection. The FFQ was collected at the beginning and the end of the data collection period. Data were collected digitally. The amount of energy and macro-nutrients contributed by each food, recipe, and beverage will be computed based on nutrient composition reported in food composition tables and weight consumed. Median energy and nutrient contents of different food intakes from FFQ and 24-hour recalls and median differences (24-hour recall –FFQ) will be calculated. Kappa, Spearman, Wilcoxon, and Bland-Altman plot statistics will be conducted to evaluate the correlation between estimated nutrient and energy intake found by the two methods. Differences will be tested for their significance and all analyses will be done with STATA 11. Data collection was completed in November 2021. Data cleaning is ongoing and the data analysis is expected to be completed by July 2022. A developed and validated semi-quantitative FFQ will be available for use in dietary assessment. The developed FFQ will help researchers to collect reliable data that will support policy makers to plan for proper dietary change intervention in Rwanda.

Keywords: food frequency questionnaire, reproducibility, 24-H recall questionnaire, validation

Procedia PDF Downloads 103

Authors: Charléa M. Smith, Raiden L. Schodowski, Arletty Pinel

Abstract:

Due to the COVID-19 pandemic, the Faculty of Medical Sciences of The University of the West Indies (UWI) Mona in Kingston, Jamaica, had to rapidly migrate to digital and blended learning. Students in the preclinical stage of the program transitioned to full-time online learning, while students in the clinical stage experienced decreased daily patient contact and the implementation of a blend of online lectures and virtual clinical practice. Such sudden changes were coupled with the institutional pressure of the need to introduce a novel approach to education without much time for preparation, as well as additional strain endured by the faculty, who were overwhelmed by serving as frontline workers. During the period July 20 to August 23, 2021, this study surveyed preclinical and clinical students to capture their experiences with these changes and their recommendations for future use of digital modalities of learning to enhance medical education. It was conducted with a fellow student of the 2021 cohort of the MultiPod mentoring program. A questionnaire was developed and distributed digitally via WhatsApp to all medical students of the UWI Mona campus to assess students’ experiences and perceptions of the advantages, challenges, and impact on individual knowledge proficiencies brought about by the transition to predominantly digital learning environments. 108 students replied, 53.7% preclinical and 46.3% clinical. 67.6% of the total were female and 30.6 % were male; 1.8% did not identify themselves by gender. 67.2% of preclinical students preferred blended learning and 60.3% considered that the content presented did not prepare them for clinical work. Only 31% considered that the online classes were interactive and encouraged student participation. 84.5% missed socialization with classmates and friends and 79.3% missed a focused environment for learning. 80% of the clinical students felt that they had not learned all that they expected and only 34% had virtual interaction with patients, mostly by telephone and video calls. Observing direct consultations was considered the most useful, yet this was the least-used modality. 96% of the preclinical students and 100% of the clinical ones supplemented their learning with additional online tools. The main recommendations from the survey are the use of interactive teaching strategies, more discussion time with lecturers, and increased virtual interactions with patients. Universities are returning to face-to-face learning, yet it is unlikely that blended education will disappear. This study demonstrates that students’ perceptions of their experience during mobility restrictions must be taken into consideration in creating more effective, inclusive, and efficient blended learning opportunities.

Keywords: blended learning, digital learning, medical education, student perceptions

Procedia PDF Downloads 129

Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

Abstract:

Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

Procedia PDF Downloads 226

Authors: Ajit Singh, Waliur Rahaman, Parmanand Sharma, Laluraj C. M., Lavkush Patel, Bhanu Pratap, Vinay Kumar Gaddam, Meloth Thamban

Abstract:

The Himalayan glaciers are the potential source of perennial water supply to Asia’s major river systems like the Ganga, Brahmaputra and the Indus. In order to improve our understanding about the source of precipitation and hydrograph components in the interior Himalayan glaciers, it is important to decipher the sources of moisture and their contribution to the glaciers in this river system. In doing so, we conducted an extensive pilot study in a Sutri Dhaka glacier, western Himalaya during 2014-15. To determine the moisture sources, rain, surface snow, ice, and stream meltwater samples were collected and analyzed for stable oxygen (δ¹⁸O) and hydrogen (δD) isotopes. A two-component hydrograph separation was performed for the glacier stream using these isotopes assuming the contribution of rain, groundwater and spring water contribution is negligible based on field studies and available literature. To validate the results obtained from hydrograph separation using above method, snow and ice melt ablation were measured using a network of bamboo stakes and snow pits. The δ¹⁸O and δD in rain samples range from -5.3% to -20.8% and -31.7% to -148.4% respectively. It is noteworthy to observe that the rain samples showed enriched values in the early season (July-August) and progressively get depleted at the end of the season (September). This could be due to the ‘amount effect’. Similarly, old snow samples have shown enriched isotopic values compared to fresh snow. This could because of the sublimation processes operating over the old surface snow. The δ¹⁸O and δD values in glacier ice samples range from -11.6% to -15.7% and -31.7% to -148.4%, whereas in a Sutri Dhaka meltwater stream, it ranges from -12.7% to -16.2% and -82.9% to -112.7% respectively. The mean deuterium excess (d-excess) value in all collected samples exceeds more than 16% which suggests the predominant moisture source of precipitation is from the Western Disturbances. Our detailed estimates of the hydrograph separation of Sutri Dhaka meltwater using isotope hydrograph separation and glaciological field methods agree within their uncertainty; stream meltwater budget is dominated by glaciers ice melt over snowmelt. The present study provides insights into the sources of moisture, controlling mechanism of the isotopic characteristics of Sutri Dhaka glacier water and helps in understanding the snow and ice melt components in Chandra basin, Western Himalaya.

Keywords: D-excess, hydrograph separation, Sutri Dhaka, stable water isotope, western Himalaya

Procedia PDF Downloads 123

Authors: Pierre Mintom, Ebai Patricia, Merlin Dasse, Marlyse Chantal Nyangon Ndongo, Aicha Aretouyap Kouotou, Felix Essiben, Christine Fernande Nyangono Biyegue

Abstract:

Background: The death of women during and after pregnancy remains a major concern in public health policy in Cameroon. Among the causes of this mortality is eclampsia which is a consequence of the Pre-eclampsia characterized by the double burden of pregnancy-induced hypertension and albuminuria in pregnant women. Objective: To determine the various factors associated with the pre-eclampsia in pregnant women of Foumban. Methodology: A cross-sectional and analytical study was carried out during the period from July to August 2020 and supplemented by another study carried out from August 05 to September 05, 2022, at the Foumban district hospital. A questionnaire was administered to pregnant women. It focused on socio-demographic parameters, the state nutritional, health status, and maternal parameters. Blood pressure was taken using an electronic blood pressure monitor, and urinary albumin was measuring using urine dipstick. Pre-eclampsia was defined by three types of double burden: double burden systolic hypertension–hyperalbuminuria (SHH), defined for SBP≥140 mmHg and hyperalbuminuria ≥1+ on urine dipstick, double burden diastolic hypertension–hyperalbuminuria (DHH), defined for PAD≥90 mmHg and hyperalbuminuria ≥1+ on the urine dipstick, and the double burden systolodiastolic arterial hypertension– hyperalbuminuria (SDHH), defined for SBP ≥ 140mmHg, PAD≥90 mmHg and hyperalbuminuria ≥1+ on urine dipstick. IBM SPSS Software was used for statistical analysis. Results: The results of this study show that the prevalence of pre-eclampsia was 17.3% for the double burden SHH, 19.9% for the double burden DHH and 14.1% for double burden SDHH. Associated factors with pre-eclampsia according to the three types of double burden were marital status (P<0.05), religion (P<0.05), history of hypertension before pregnancy (P<0.05). Associated factors for the double burden of DHH and SDHH were the nutritional status before the pregnancy (P<0.05) and the number of prenatal consultations (P<0.05). In terms of food groups, regular consumption of spices significantly increased the risk of pre-eclampsia by 5.318, 6.277 and 11.271 times respectively for the SHH, DHH and SDHH double burdens, while regular consumption of sweets regular consumption of sweets increased by 2.42 times and 2.053 times respectively the double DHH and SDHH burdens respectively. Conclusion: Our study made it possible to redefine pre-eclampsia by considering the subtypes of hypertension. Certain socio-demographic parameters and certain dietary habits influence the occurrence of pre-eclampsia characterized by the double burden Hypertension-hyperalbuminuria in pregnant women, which may later lead to the occurrence of eclampsia. Moreover, albuminemia could be a good predicitive factor of pre-eclampsia and could be explored.

Keywords: hypertension, hyperalbuminuria, pregnant women, foumban

Procedia PDF Downloads 26

Authors: Marutani M, Kawajiri H, Usui C, Takai Y, Kawaguchi T

Abstract:

Background: To build the inclusive society, the Japanese government provides “transition support for employment system” for Persons with Disabilities (PWDs). It is, however, difficult to provide appropriate accommodations due to their changeable health conditions. Mobile phone applications (App) are useful to monitor their health conditions and their environments, and effective to improve reasonable accommodations for PWDs. Purpose: This study aimed to develop an App that PWDs input their self-assessment and make their health conditions and environment conditions visible. To attain the goal, we investigated the items of the App for the first step. Methods: Qualitative and descriptive design was used for this study. Study participants were recruited by snowball sampling in July and August 2023. They had to have had minimum of five-years of experience to support PWDs’ employment. Semi-structured interviews were conducted on their assessment regarding PWDs’ conditions of daily activities, their health conditions, and living and working environment. Verbatim transcript was created from each interview content. We extracted the following items in tree groups from each verbatim transcript: daily activities, health conditions, and living and working. Results: Fourteen participants were involved (average years of experience: 10.6 years). Based on the interviews, tree item groups were enriched. The items of daily activities were divided into fifty-five. The example items were as follows: “have meals on one’s style” “feel like slept well” “wake-up time, bedtime, and mealtime are usually fixed.” “commute to the office and work without barriers.” Thirteen items of health conditions were obtained like “feel no anxiety” “relieve stress” “focus on work and training” “have no pain” “have the physical strength to work for one day.” The items of categories of living and working environments were divided into fifteen-two. The example items were as follows: “have no barrier in home” “have supportive family members” “have time to take medication on time while at work” “commute time is just right” “people at the work understand the symptoms” “room temperature and humidity are just right” “get along well with friends in my own way.” The participants also mentioned the styles to input self-assessment like that a face scale would be preferred to number scale. Conclusion: The items were enriched existent paper-based assessment items in terms of living and working environment because those were obtained from the perspective of PWDs. We have to create the app and examine its usefulness with PWDs toward inclusive society.

Keywords: occupational health, innovatiove tool, people with disability, employment

Procedia PDF Downloads 26

Authors: Terefe Fuge, George Tsourtos , Emma Miller

Abstract:

Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

Procedia PDF Downloads 93

Authors: Scarlet Tabot Enanga Longsti

Abstract:

Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

Procedia PDF Downloads 33

Authors: I. Ling Tsai, Shu Fen Wu, Chen-Fuh Lam, Chia Yu Chen, Shu Jiuan Chen, Yen Lin Liu

Abstract:

Purpose: Following the conduction of the National Health Insurance (NHI) system in Taiwan since 1995, the demand for anesthesia services continues to increase in the operating rooms and other medical units. It has been well recognized that increased work stress not only affects the clinical performance of the medical staff, long-term work load may also result in occupational burnout. Our study aimed to determine the influence of working environment, work stress and job satisfaction on the occupational burnout in nurse anesthetists. The ultimate goal of this research project is to develop a strategy in establishing a friendly, less stressful workplace for the nurse anesthetists to enhance their job satisfaction, thereby reducing occupational burnout and increasing the career life for nurse anesthetists. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator 2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the nurse anesthetists. The relationships between two numeric datasets were analyzed by the Pearson correlation test (SPSS 20.0). Results: A total of 66 completed questionnaires were collected from 75 nurses (response rate 88%). The average scores for the working environment, job satisfaction, and work stress were 69.6%, 61.5%, and 63.9%, respectively. The three perspectives used to assess the occupational burnout, namely emotional exhaustion, depersonalization and sense of personal accomplishment were 26.3, 13.0 and 24.5, suggesting the presence of moderate to high degrees of burnout in our nurse anesthetists. The presence of occupational burnout was closely correlated with the unsatisfactory working environment (r=-0.385, P=0.001) and reduced job satisfaction (r=-0.430, P=0.000). Junior nurse anesthetists (<1-year clinical experience) reported having higher satisfaction in working environment than the seniors (5 to 10-year clinical experience) (P=0.02). Although the average scores for work stress, job satisfaction, and occupational burnout were lower in junior nurses, the differences were not statistically different. The linear regression model, the working environment was the independent factor that predicted occupational burnout in nurse anesthetists up to 19.8%. Conclusions: High occupational burnout is more likely to develop in senior nurse anesthetists who experienced the dissatisfied working environment, work stress and lower job satisfaction. In addition to the regulation of clinical duties, the increased workload in the supervision of the junior nurse anesthetists may result in emotional stress and burnout in senior nurse anesthetists. Therefore, appropriate adjustment of clinical and teaching loading in the senior nurse anesthetists could be helpful to improve the occupational burnout and enhance the retention rate.

Keywords: nurse anesthetists, working environment, work stress, job satisfaction, occupational burnout

Procedia PDF Downloads 246

Authors: Silas Webb, Joseph Hartland

Abstract:

Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

Procedia PDF Downloads 153

Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

Abstract:

Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

Procedia PDF Downloads 48

Authors: Wang Yang

Abstract:

Shenzhen is a modern city of China's reform and opening-up policy, the development of urban morphology has been established on the administration of the Chinese government. This city`s planning paradigm is primarily affected by the spatial structure and human behavior. The subjective urban agglomeration center is divided into several groups and centers. In comparisons of this effect, the city development law has better to be neglected. With the continuous development of the internet, extensive data technology has been introduced in China. Data mining and data analysis has become important tools in municipal research. Data mining has been utilized to improve data cleaning such as receiving business data, traffic data and population data. Prior to data mining, government data were collected by traditional means, then were analyzed using city-relationship research, delaying the timeliness of urban development, especially for the contemporary city. Data update speed is very fast and based on the Internet. The city's point of interest (POI) in the excavation serves as data source affecting the city design, while satellite remote sensing is used as a reference object, city analysis is conducted in both directions, the administrative paradigm of government is broken and urban research is restored. Therefore, the use of data mining in urban analysis is very important. The satellite remote sensing data of the Shenzhen city in July 2018 were measured by the satellite Modis sensor and can be utilized to perform land surface temperature inversion, and analyze city heat island distribution of Shenzhen. This article acquired and classified the data from Shenzhen by using Data crawler technology. Data of Shenzhen heat island and interest points were simulated and analyzed in the GIS platform to discover the main features of functional equivalent distribution influence. Shenzhen is located in the east-west area of China. The city’s main streets are also determined according to the direction of city development. Therefore, it is determined that the functional area of the city is also distributed in the east-west direction. The urban heat island can express the heat map according to the functional urban area. Regional POI has correspondence. The research result clearly explains that the distribution of the urban heat island and the distribution of urban POIs are one-to-one correspondence. Urban heat island is primarily influenced by the properties of the underlying surface, avoiding the impact of urban climate. Using urban POIs as analysis object, the distribution of municipal POIs and population aggregation are closely connected, so that the distribution of the population corresponded with the distribution of the urban heat island.

Keywords: POI, satellite remote sensing, the population distribution, urban heat island thermal map

Procedia PDF Downloads 72

Authors: Monu Ojha, Rahul Rana, Satywati Sharma, Kavya Dashora

Abstract:

The global production rate of plastics has increased enormously and global demand for polyethylene resins –High-density polyethylene (HDPE), Linear low-density polyethylene (LLDPE) and Low-density polyethylene (LDPE) is expected to rise drastically, with very high value. These get accumulated in the environment, posing a potential ecological threat as they are degrading at a very slow rate and remain in the environment indefinitely. The aim of the present study was to investigate the potential of commonly found soil microbes like Bacillus subtilus, Aspergillus niger, Pseudomonas fluroscence for their ability to biodegrade LDPE in the lab on solid and liquid media conditions as well as in presence of 1% salt in the soil. This study was conducted at Indian Institute of Technology, Delhi, India from July to September where average temperature and RH (Relative Humidity) were 33 degrees Celcius and 80% respectively. It revealed that the weight loss of LDPE strip obtained from market of approximately 4x6 cm dimensions is more in liquid broth media than in solid agar media. The percentage weight loss by P. fluroscence, A. niger and B. subtilus observed after 80 days of incubation was 15.52, 9.24 and 8.99% respectively in broth media and 6.93, 2.18 and 4.76 % in agar media. The LDPE strips from same source and on the same were subjected to soil in presence of above microbes with 1% salt (NaCl: obtained from commercial table salt) with temperature and RH 33 degree Celcius and 80%. It was found that the rate of degradation increased in the soil than under lab conditions. The rate of weight loss of LDPE strips under same conditions given in lab was found to be 32.98, 15.01 and17.09 % by P. fluroscence, A. niger and B. subtilus respectively. The breaking strength was found to be 9.65N, 29N and 23.85 N for P. fluroscence, A. niger and B. subtilus respectively. SEM analysis conducted on Zeiss EVO 50 confirmed that surface of LDPE becomes physically weak after biological treatment. There was the increase in the surface roughness indicating Surface erosion of LDPE film. FTIR (Fourier-transform infrared spectroscopy) analysis of the degraded LDPE films showed stretching of aldehyde group at 3334.92 and 3228.84 cm-1,, C–C=C symmetric of aromatic ring at 1639.49 cm-1.There was also C=O stretching of aldehyde group at 1735.93 cm-1. N=O peak bend was also observed which corresponds to 1365.60 cm-1, C–O stretching of ether group at 1217.08 and 1078.21 cm-1.

Keywords: microbial degradation, LDPE, Aspergillus niger, Bacillus subtilus, Peudomonas fluroscence, common salt

Procedia PDF Downloads 130

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

Abstract:

Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

Procedia PDF Downloads 209

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

Procedia PDF Downloads 62

Authors: Aiman Mazhar Qureshi, Ahmed Rachid

Abstract:

Extreme heat events are emerging human environmental health concerns in dense urban areas due to anthropogenic activities. High spatial and temporal resolution heat maps are important for urban heat adaptation and mitigation, helping to indicate hotspots that are required for the attention of city planners. The Heat Vulnerability Index (HVI) is the important approach used by decision-makers and urban planners to identify heat-vulnerable communities and areas that require heat stress mitigation strategies. Amiens is a medium-sized French city, where the average temperature has been increasing since the year 2000 by +1°C. Extreme heat events are recorded in the month of July for the last three consecutive years, 2018, 2019 and 2020. Poor air quality, especially ground-level ozone, has been observed mainly during the same hot period. In this study, we evaluated the HVI in Amiens during extreme heat days recorded last three years (2018,2019,2020). The Principal Component Analysis (PCA) technique is used for fine-scale vulnerability mapping. The main data we considered for this study to develop the HVI model are (a) socio-economic and demographic data; (b) Air pollution; (c) Land use and cover; (d) Elderly heat-illness; (e) socially vulnerable; (f) Remote sensing data (Land surface temperature (LST), mean elevation, NDVI and NDWI). The output maps identified the hot zones through comprehensive GIS analysis. The resultant map shows that high HVI exists in three typical areas: (1) where the population density is quite high and the vegetation cover is small (2) the artificial surfaces (built-in areas) (3) industrial zones that release thermal energy and ground-level ozone while those with low HVI are located in natural landscapes such as rivers and grasslands. The study also illustrates the system theory with a causal diagram after data analysis where anthropogenic activities and air pollution appear in correspondence with extreme heat events in the city. Our suggested index can be a useful tool to guide urban planners and municipalities, decision-makers and public health professionals in targeting areas at high risk of extreme heat and air pollution for future interventions adaptation and mitigation measures.

Keywords: heat vulnerability index, heat mapping, heat health-illness, remote sensing, urban heat mitigation

Procedia PDF Downloads 111

Authors: Tannia Vindel, Angel Matute, Erik Elvir, Kelvin Santos

Abstract:

Currently in Honduras, is been incentivized the generation of energy using renewable fonts, such as: hydroelectricity, wind power, biomass and, more recently with the strongest growth, photovoltaic energy. In July 2015 were installed 455.2 MW of photovoltaic energy, increasing by 24% the installed capacity of the national interconnected system existing in 2014, according the National Energy Company (NEC), that made possible reduce the thermoelectric dependency of the system. Given the good results of those large-scale photovoltaic plants, arises the question: is it interesting for the distribution utility and for the consumers the integration of photovoltaic systems in micro-scale in the urban and rural areas? To answer that question has been researched the insertion of photovoltaic energy in the residential sector in Tegucigalpa and Comayagüela (Central District), Honduras to determine the technical and economic viability. Francisco Morazán department, according the National Statistics Institute (NSI), in 2001 had more than 180,000 houses with power service. Tegucigalpa, department and Honduras capital, and Comayagüela, both, have the highest population density in the region, with 1,300,000 habitants in 2014 (NSI). The residential sector in the south-central region of Honduras represents a high percentage being 49% of total consumption, according with NEC in 2014; where 90% of this sector consumes in a range of 0 to 300 kWh / month. All this, in addition to the high level of losses in the transmission and distribution systems, 31.3% in 2014, and the availability of an annual average solar radiation of 5.20 kWh/(m2∙day) according to the NASA, suggests the feasibility of the implementation of photovoltaic systems as a solution to give a level of independency to the households, and besides could be capable of injecting the non-used energy to the grid. The capability of exchange of energy with the grid could make the photovoltaic systems acquisition more affordable to the consumers, because of the compensation energy programs or other kinds of incentives that could be created. Technical viability of the photovoltaic systems insertion has been analyzed, considering the solar radiation monthly average to determine the monthly average of energy that would be generated with the technology accessible locally and the effects of the injection of the energy locally generated on the grid. In addition, the economic viability has been analyzed too, considering the photovoltaic systems high costs, costs of the utility, location and monthly energy consumption requirements of the families. It was found that the inclusion of photovoltaic systems in Tegucigalpa and Comayagüela could decrease in 6 MW the demand for the region if 100% of the households use photovoltaic systems, which acquisition may be more accessible with the help of government incentives and/or the application of energy exchange programs.

Keywords: grid connected, photovoltaic, residential, technical analysis

Procedia PDF Downloads 226