Search results for: Peter Williams
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 586

Search results for: Peter Williams

286 Effect of Serum Electrolytes on a QTc Interval and Mortality in Patients admitted to Coronary Care Unit

Authors: Thoetchai Peeraphatdit, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham, Niyada Naksuk

Abstract:

Background: Serum electrolyte abnormalities are a common cause of an acquired prolonged QT syndrome, especially, in the coronary care unit (CCU) setting. Optimal electrolyte ranges among the CCU patients have not been sufficiently investigated. Methods: We identified 8,498 consecutive CCU patients who were admitted to the CCU at Mayo Clinic, Rochester, the USA, from 2004 through 2013. Association between first serum electrolytes and baseline corrected QT intervals (QTc), as well as in-hospital mortality, was tested using multivariate linear regression and logistic regression, respectively. Serum potassium 4.0- < 4.5 mEq/L, ionized calcium (iCa) 4.6-4.8 mg/dL, and magnesium 2.0- < 2.2 mg/dL were used as the reference levels. Results: There was a modest level-dependent relationship between hypokalemia ( < 4.0 mEq/L), hypocalcemia ( < 4.4 mg/dL), and a prolonged QTc interval; serum magnesium did not affect the QTc interval. Association between the serum electrolytes and in-hospital mortality included a U-shaped relationship for serum potassium (adjusted odds ratio (OR) 1.53 and OR 1.91for serum potassium 4.5- < 5.0 and ≥ 5.0 mEq/L, respectively) and an inverted J-shaped relationship for iCa (adjusted OR 2.79 and OR 2.03 for calcium < 4.4 and 4.4- < 4.6 mg/dL, respectively). For serum magnesium, the mortality was greater only among patients with levels ≥ 2.4 mg/dL (adjusted OR 1.40), compared to the reference level. Findings were similar in sensitivity analyses examining the association between mean serum electrolytes and mean QTc intervals, as well as in-hospital mortality. Conclusions: Serum potassium 4.0- < 4.5 mEq/L, iCa ≥ 4.6 mg/dL, and magnesium < 2.4 mg/dL had a neutral effect on QTc intervals and were associated with the lowest in-hospital mortality among the CCU patients.

Keywords: calcium, electrocardiography, long-QT syndrome, magnesium, mortality, potassium

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285 Modeling and Experimental Verification of Crystal Growth Kinetics in Glass Forming Alloys

Authors: Peter K. Galenko, Stefanie Koch, Markus Rettenmayr, Robert Wonneberger, Evgeny V. Kharanzhevskiy, Maria Zamoryanskaya, Vladimir Ankudinov

Abstract:

We analyze the structure of undercooled melts, crystal growth kinetics and amorphous/crystalline microstructure of rapidly solidifying glass-forming Pd-based and CuZr-based alloys. A dendrite growth model is developed using a combination of the kinetic phase-field model and mesoscopic sharp interface model. The model predicts features of crystallization kinetics in alloys from thermodynamically controlled growth (governed by the Gibbs free energy change on solidification) to the kinetically limited regime (governed by atomic attachment-detachment processes at the solid/liquid interface). Comparing critical undercoolings observed in the crystallization kinetics with experimental data on melt viscosity, atomistic simulation's data on liquid microstructure and theoretically predicted dendrite growth velocity allows us to conclude that the dendrite growth kinetics strongly depends on the cluster structure changes of the melt. The obtained data of theoretical and experimental investigations are used for interpretation of microstructure of samples processed in electro-magnetic levitator on board International Space Station in the frame of the project "MULTIPHAS" (European Space Agency and German Aerospace Center, 50WM1941) and "KINETIKA" (ROSKOSMOS).

Keywords: dendrite, kinetics, model, solidification

Procedia PDF Downloads 96
284 The Ra 9262 (Anti-Violence Against Women and Their Children Act of 2004) in the Literature Classroom via the Movie ‘Enough’

Authors: Jay Neil Garciso Verano, Peter Rosales Bobiles

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This study tried to integrate RA 9262 in literature through the use of film. It identified RA 9262 provisions reflected in the students’ concepts in their oral participation and written outputs and pointed out different attitudes toward violence against women and respect to women as shaped by the film through their responses. Four Literature 121 (World Literature) classes with more or less similar characteristics participated in this study. The discussion of Paulette Kelly’s I Got Flowers Today took place during the first session while the viewing of the film Enough and discussion of the film followed to enrich and bolster students’ concepts and awareness on violence against women and to introduce RA 9262 provisions. The students’ attitudes toward violence against women and respect to women were lifted from the students’ oral and written responses. The film Enough presented eight provisions from RA 9262 reflected in students’ concepts which centered on the acts of violence against women tarnishing women’s rights and dignity. There were 25 attitudes toward violence against women and respect to women which surfaced, 11 of which are what initiate the acts, seven tell about the results from or effects of violence against women, and another seven exemplify respect to women. With the findings, it can be viewed that RA 9262 can be integrated in a literature course to awaken students’ minds on the prevalent issues on violating women’s rights and dignity. The discussion of Paulette Kelly’s I Got Flowers Today reinforced by the viewing of Enough deduced issues on the violation of women’s rights and dignity, attitudes toward violence against women, and students’ perception with regard respect to women.

Keywords: anti-violence against women, literature, film, enough, feminism

Procedia PDF Downloads 357
283 Flame Spray Pyrolysis as a High-Throughput Method to Generate Gadolinium Doped Titania Nanoparticles for Augmented Radiotherapy

Authors: Malgorzata J. Rybak-Smith, Benedicte Thiebaut, Simon Johnson, Peter Bishop, Helen E. Townley

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Gadolinium doped titania (TiO2:Gd) nanoparticles (NPs) can be activated by X-ray radiation to generate Reactive Oxygen Species (ROS), which can be effective in killing cancer cells. As such, treatment with these NPs can be used to enhance the efficacy of conventional radiotherapy. Incorporation of the NPs in to tumour tissue will permit the extension of radiotherapy to currently untreatable tumours deep within the body, and also reduce damage to neighbouring healthy cells. In an attempt to find a fast and scalable method for the synthesis of the TiO2:Gd NPs, the use of Flame Spray Pyrolysis (FSP) was investigated. A series of TiO2 NPs were generated with 1, 2, 5 and 7 mol% gadolinium dopant. Post-synthesis, the TiO2:Gd NPs were silica-coated to improve their biocompatibility. Physico-chemical characterisation was used to determine the size and stability in aqueous suspensions of the NPs. All analysed TiO2:Gd NPs were shown to have relatively high photocatalytic activity. Furthermore, the FSP synthesized silica-coated TiO2:Gd NPs generated enhanced ROS in chemico. Studies on rhabdomyosarcoma (RMS) cell lines (RD & RH30) demonstrated that in the absence of irradiation all TiO2:Gd NPs were inert. However, application of TiO2:Gd NPs to RMS cells, followed by irradiation, showed a significant decrease in cell proliferation. Consequently, our studies showed that the X-ray-activatable TiO2:Gd NPs can be prepared by a high-throughput scalable technique to provide a novel and affordable anticancer therapy.

Keywords: cancer, gadolinium, ROS, titania nanoparticles, X-ray

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282 Impact of Zeolite NaY Synthesized from Kaolin on the Properties of Pyrolytic Oil Derived from Used Tire

Authors: Julius Ilawe Osayi, Peter Osifo

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Solid waste disposal, such as used tires is a global challenge as well as energy crisis due to rising energy demand amidst price uncertainty and depleting fossil fuel reserves. Therefore, the effectiveness of pyrolysis as a disposal method that can transform used tires into liquid fuel and other end-products has made the process attractive to researchers. Although used tires have been converted to liquid fuel using pyrolysis, there is the need to improve on the liquid fuel properties. Hence, this paper reports the investigation of zeolite NaY synthesized from kaolin, a locally abundant soil material in the Benin metropolis as a suitable catalyst and its effect on the properties of pyrolytic oil produced from used tires. The pyrolysis process was conducted for a range of 1 to 10 wt.% of catalyst concentration to used tire at a temperature of 600 oC, a heating rate of 15oC/min and particle size of 6mm. Although no significant increase in pyrolytic oil yield was observed compared to the previously investigated non-catalytic pyrolysis of a used tire. However, the Fourier transform infrared (FTIR), Nuclear Magnetic Resonance (NMR); and Gas chromatography-mass spectrometry (GC-MS) characterization results revealed the pyrolytic oil to possess an improved physicochemical and fuel properties alongside valuable industrial chemical species. This confirms the possibility of transforming kaolin into a catalyst suitable for improved fuel properties of the liquid fraction obtainable from thermal cracking of hydrocarbon materials.

Keywords: catalytic pyrolysis, fossil fuel, kaolin, pyrolytic oil, used tyres, Zeolite NaY

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281 When Sex Matters: A Comparative Generalized Structural Equation Model (GSEM) for the Determinants of Stunting Amongst Under-fives in Uganda

Authors: Vallence Ngabo M., Leonard Atuhaire, Peter Clever Rutayisire

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The main aim of this study was to establish the differences in both the determinants of stunting and the causal mechanism through which the identified determinants influence stunting amongst male and female under-fives in Uganda. Literature shows that male children below the age of five years are at a higher risk of being stunted than their female counterparts. Specifically, studies in Uganda indicate that being a male child is positively associated with stunting, while being a female is negatively associated with stunting. Data for 904 males and 829 females under-fives was extracted form UDHS-2016 survey dataset. Key variables for this study were identified and used in generating relevant models and paths. Structural equation modeling techniques were used in their generalized form (GSEM). The generalized nature necessitated specifying both the family and link functions for each response variable in the system of the model. The sex of the child (b4) was used as a grouping factor and the height for age (HAZ) scores were used to construct the status for stunting of under-fives. The estimated models and path clearly indicated that the set of underlying factors that influence male and female under-fives respectively was different and the path through which they influence stunting was different. However, some of the determinants that influenced stunting amongst male under-fives also influenced stunting amongst the female under-fives. To reduce the stunting problem to the desirable state, it is important to consider the multifaceted and complex nature of the risk factors that influence stunting amongst the under-fives but, more importantly, consider the different sex-specific factors and their causal mechanism or paths through which they influence stunting.

Keywords: stunting, underfives, sex of the child, GSEM, causal mechanism

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280 The Effectiveness of Spatial Planning And Land Use Management Act, 2013 in Fetakgomo Tubatse Local Municipality: Case Study of Apel Nodal Point

Authors: Hlabishi Peter Ntloana

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This paper aims to present the effectiveness of the Spatial Planning and Land Use Management Act, 2013, in addressing key spatial challenges in Fetakgomo Tubatse Local Municipality, mainly focusing on Apel nodal point. Spatial Planning and Land Use Management Act, 2013, popularly known as SPLUMA, aimed at addressing emerging and existing spatial planning and land use management challenges in South Africa. There are critical key spatial challenges that are continuously encountered in Apel Nodal Point, which include dispersed rural settlement mainly in a communal settlement. The spatial patterns and rural settlements development patterns are a challenge, and such results in uncoordinated human settlements. The objective of this research paper is to analyze the spatial planning of Apel nodal points and determine the effectiveness of the SPLUMA policy. Key Informant interviews were conducted with 20 participants, and also the municipal Spatial Development Framework was considered to explore more challenges and proposed recommendations. The results divulged that there is a huge gap in addressing spatial planning, mainly in rural areas, and correlation with the findings of the Municipal Spatial Development framework. In conclusion, spatial planning remains a critical dilemma in most rural settlements, and there must be programmes and strategies to balance the effectiveness of spatial planning in urban and rural settlements.

Keywords: land use management, rural settlement, spatial development framework, spatial planning

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279 Statistical Time-Series and Neural Architecture of Malaria Patients Records in Lagos, Nigeria

Authors: Akinbo Razak Yinka, Adesanya Kehinde Kazeem, Oladokun Oluwagbenga Peter

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Time series data are sequences of observations collected over a period of time. Such data can be used to predict health outcomes, such as disease progression, mortality, hospitalization, etc. The Statistical approach is based on mathematical models that capture the patterns and trends of the data, such as autocorrelation, seasonality, and noise, while Neural methods are based on artificial neural networks, which are computational models that mimic the structure and function of biological neurons. This paper compared both parametric and non-parametric time series models of patients treated for malaria in Maternal and Child Health Centres in Lagos State, Nigeria. The forecast methods considered linear regression, Integrated Moving Average, ARIMA and SARIMA Modeling for the parametric approach, while Multilayer Perceptron (MLP) and Long Short-Term Memory (LSTM) Network were used for the non-parametric model. The performance of each method is evaluated using the Mean Absolute Error (MAE), R-squared (R2) and Root Mean Square Error (RMSE) as criteria to determine the accuracy of each model. The study revealed that the best performance in terms of error was found in MLP, followed by the LSTM and ARIMA models. In addition, the Bootstrap Aggregating technique was used to make robust forecasts when there are uncertainties in the data.

Keywords: ARIMA, bootstrap aggregation, MLP, LSTM, SARIMA, time-series analysis

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278 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit

Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

Abstract:

Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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277 Endoscopic Treatment of Patients with Large Bile Duct Stones

Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

Abstract:

Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

Procedia PDF Downloads 55
276 Effects of Titanium Dioxide Coatings on Building Composites for Sustainable Construction Applications

Authors: Ifeyinwa Ijeoma Obianyo, Luqman Adedeji Taiwo, Olugbenga O. Amu, Azikiwe Peter Onwualu

Abstract:

Improving the durability of building materials saves maintenance costs, construction time, and energy. In this study, titanium dioxide coated conventional and non-conventional composites were produced, and the effects of titanium dioxide coatings were investigated. Conventional composites were produced using river sand and Portland cement, whereas non-conventional composites were produced by partially replacing river sand and Portland cement with quarry dust and rice husk ash. Water absorption and thickness swelling tests were conducted on the produced coated and non-coated block samples. A reduction in water absorption was observed in the coated composite samples when compared to the non-coated composite samples, and this is an indication of the improved durability of the samples coated with titanium dioxide. However, there was an increase in the thickness swelling of coatings on the coated block samples, but this increase has a slight influence on the compressive strength of the coated samples. The outcome of this study indicates that coating composite building blocks with titanium dioxide will improve theirdurability. Also, the site exposure experiments revealed the self-cleansing properties of TiO2-coated composite block samples, while the Rhodamine B discolouration test confirmed the photocatalytic features of TiO2-coated composite block samples.

Keywords: titanium dioxide, water absorption, durability, mechanical properties, building composite

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275 Combat Capability Improvement Using Sleep Analysis

Authors: Gabriela Kloudova, Miloslav Stehlik, Peter Sos

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The quality of sleep can affect combat performance where the vigilance, accuracy and reaction time are a decisive factor. In the present study, airborne and special units are measured on duty using actigraphy fingerprint scoring algorithm and QEEG (quantitative EEG). Actigraphic variables of interest will be: mean nightly sleep duration, mean napping duration, mean 24-h sleep duration, mean sleep latency, mean sleep maintenance efficiency, mean sleep fragmentation index, mean sleep onset time, mean sleep offset time and mean midpoint time. In an attempt to determine the individual somnotype of each subject, the data like sleep pattern, chronotype (morning and evening lateness), biological need for sleep (daytime and anytime sleepability) and trototype (daytime and anytime wakeability) will be extracted. Subsequently, a series of recommendations will be included in the training plan based on daily routine, timing of the day and night activities, duration of sleep and the number of sleeping blocks in a defined time. The aim of these modifications in the training plan is to reduce day-time sleepiness, improve vigilance, attention, accuracy, speed of the conducted tasks and to optimize energy supplies. Regular improvement of the training supposed to have long-term neurobiological consequences including neuronal activity changes measured by QEEG. Subsequently, that should enhance cognitive functioning in subjects assessed by the digital cognitive test batteries and improve their overall performance.

Keywords: sleep quality, combat performance, actigraph, somnotype

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274 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

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Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

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273 Production of Biogas from Organic Wastes Using Plastic Biodigesternoura

Authors: Oladipo Oluwaseun Peter

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Daily consumption of crude oil is alarming as a result of increasing demand for energy. Waste generation tends to rise with the level of economic advancement of a nation. Hence, this project work researches how wastes which could pose toxic if left unattended to can be processed through biodigestion in order to generate biofuel which could serve as a good substitute for petroleum, a non renewable energy source, so as to reduce over-dependence on petroleum and to prevent environmental pollution. Anaerobic digestion was carried out on organic wastes comprising brewery spent grains, rice husks and poultry droppings in a plastic biodigester of 1000 liters volume using the poultry droppings as a natural inoculums source. The feed composition in ratio 5:3:2, spent grain, rice husks and poultry droppings were mixed with water in the ratio 1:6. Thus, 600 Kg of water was used to prepare the slurry with 100 Kg of feed materials. A plastic biodigester was successfully constructed, and the problem of corrosion and rusting were completely overcome as a result of the use of non-corroding materials of construction. A reasonable quantity of biogas, 33.63m3, was generated over a period of 60 days of biodigestion. The bioslurry was processed through two different process routes; evaporation and filteration. Evaporation process of analysis shows high values of 0.64%, 2.11% and 0.034% for nitrogen, phosphorous and potassium respectively, while filteration process gives 00.61%, 1.93% and 0.026% for nitrogen, phosphorous and potassium respectively.

Keywords: biodigestion, biofuel, digestion, slurry, biogas

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272 Knowledge, Attitude, and Practice of Pre-exposure Prophylaxis on Human immunodeficiency virus Infection of Students at National University–Manila

Authors: Roel Guinto Jr, John Peter Dacanay, Edison Ramos

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The Philippines now has the fastest-growing HIV epidemic in the entire Asia-Pacific region. According to the January 2023 HIV/AIDS Registry of the Philippines of the Department of Health (DOH), there were 86 newly reported HIV cases involving 19 years old and below. A cure for HIV is not yet readily available but effective preventive measures to prevent its transmission. Pre-Exposure Prophylaxis is a biomedical intervention for HIV infection in the form of a pill. Students play a significant role in identifying solutions to preventing the transmission of HIV Infection, making it critical to assess their Knowledge, Attitude, and Practice of Pre-Exposure Prophylaxis on HIV Infection. A study was conducted among 390 regular students from different college departments at National University – Manila. A structured questionnaire was used to collect data and other statistical tools were used to analyze data. The findings reveal that most students had no knowledge or idea about PreExposure Prophylaxis before being interviewed. It also shows that students have a positive attitude toward the practice of Pre-Exposure Prophylaxis. The study revealed that there is also a significant relationship between the Knowledge and the Socio-demographic profile of the respondents. Knowledge, Attitude, and Practices on PrEP of students were overall identified, and areas of improvement were also recognized. Sex Education and Sexual Health Awareness should be implemented to enhance students’ knowledge of practicing safe sex to help prevent HIV Transmission.

Keywords: HIV, cure, biomedical intervention, pre-exposure prophylaxis, pill, knowledge, attitude, practice, sex education, sexual health awareness

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271 Fast Approximate Bayesian Contextual Cold Start Learning (FAB-COST)

Authors: Jack R. McKenzie, Peter A. Appleby, Thomas House, Neil Walton

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Cold-start is a notoriously difficult problem which can occur in recommendation systems, and arises when there is insufficient information to draw inferences for users or items. To address this challenge, a contextual bandit algorithm – the Fast Approximate Bayesian Contextual Cold Start Learning algorithm (FAB-COST) – is proposed, which is designed to provide improved accuracy compared to the traditionally used Laplace approximation in the logistic contextual bandit, while controlling both algorithmic complexity and computational cost. To this end, FAB-COST uses a combination of two moment projection variational methods: Expectation Propagation (EP), which performs well at the cold start, but becomes slow as the amount of data increases; and Assumed Density Filtering (ADF), which has slower growth of computational cost with data size but requires more data to obtain an acceptable level of accuracy. By switching from EP to ADF when the dataset becomes large, it is able to exploit their complementary strengths. The empirical justification for FAB-COST is presented, and systematically compared to other approaches on simulated data. In a benchmark against the Laplace approximation on real data consisting of over 670, 000 impressions from autotrader.co.uk, FAB-COST demonstrates at one point increase of over 16% in user clicks. On the basis of these results, it is argued that FAB-COST is likely to be an attractive approach to cold-start recommendation systems in a variety of contexts.

Keywords: cold-start learning, expectation propagation, multi-armed bandits, Thompson Sampling, variational inference

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270 Monitoring the Drying and Grinding Process during Production of Celitement through a NIR-Spectroscopy Based Approach

Authors: Carolin Lutz, Jörg Matthes, Patrick Waibel, Ulrich Precht, Krassimir Garbev, Günter Beuchle, Uwe Schweike, Peter Stemmermann, Hubert B. Keller

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Online measurement of the product quality is a challenging task in cement production, especially in the production of Celitement, a novel environmentally friendly hydraulic binder. The mineralogy and chemical composition of clinker in ordinary Portland cement production is measured by X-ray diffraction (XRD) and X ray fluorescence (XRF), where only crystalline constituents can be detected. But only a small part of the Celitement components can be measured via XRD, because most constituents have an amorphous structure. This paper describes the development of algorithms suitable for an on-line monitoring of the final processing step of Celitement based on NIR-data. For calibration intermediate products were dried at different temperatures and ground for variable durations. The products were analyzed using XRD and thermogravimetric analyses together with NIR-spectroscopy to investigate the dependency between the drying and the milling processes on one and the NIR-signal on the other side. As a result, different characteristic parameters have been defined. A short overview of the Celitement process and the challenging tasks of the online measurement and evaluation of the product quality will be presented. Subsequently, methods for systematic development of near-infrared calibration models and the determination of the final calibration model will be introduced. The application of the model on experimental data illustrates that NIR-spectroscopy allows for a quick and sufficiently exact determination of crucial process parameters.

Keywords: calibration model, celitement, cementitious material, NIR spectroscopy

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269 Variability in Contraception Choices and Abortion Rates among Female Garment Factory Workers in Urban and Rural Cambodia

Authors: Olalekan Olaluwoye, Joanne Williams, Elizabeth Hoban

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Background: Modern contraceptives are effective in preventing unwanted pregnancies and therefore the potential to reduce abortion rates. There is a need for information about how rates of contraceptive use and abortion vary across Cambodia and the relationship between the prevalence of modern contraception use and abortion rates. This study compares the use of contraception and abortion among female garment factory workers in rural and urban areas of Cambodia. Method: Cross-sectional surveys were conducted with 1701 women working in eleven garment factories in rural and urban areas of Cambodia. Sexual and reproductive health data were collected using Audio-Assisted Survey Interviews and analysed using STATA 14 software. Findings: Over 70% of the respondents were less than 30 years of age across both rural and urban settings and over 50% have only primary education, thus the study population was largely young women with limited education. A significantly higher proportion of the rural women earned over $200 in the previous month compared with their urban counterparts. The majority of the urban women (51.5%) were married, while single women (46.9%) made up the largest group working in the rural factories. A significantly larger proportion of women in the rural areas (83.9%) were sexually active compared to the urban women (50.9%). More women from the rural areas (41.4%) had been pregnant at some time compared with the urban population (37.7%). The use of any contraceptive method among sexually active women was significantly higher in the rural areas (80.1%) compared to the urban areas (65.7%) with p-value=0.000. However, among those women who used contraception, the prevalence of modern contraception use was slightly higher in the urban population (68.8% urban, 63.4% rural, p-value=0.1). For women who had a history of pregnancy the abortion prevalence was higher among rural women (43.8%) compared to their urban counterparts (37.7%). Regression analysis showed that after adjustment for the demographic variables (age, relationship status, income, education) only age and relationship status had a significant influence on the use of modern contraception.Single females who were sexually active and older women, who had potentially completed their families, were more likely to choose modern contraception. Conclusion: Although overall the use of contraception was higher among rural women, the use of modern contraception was higher among urban women.This finding may partly explain the higher rates of abortion among women in the rural areas as traditional contraception methods have higher failure rates and are more likely to result in an unplanned pregnancy.Despite the regional variation, the high rates of abortion across the country suggest there is a need for improve education on family planning among female garment factory workers in Cambodia.

Keywords: abortion, Cambodia, contraception, garment factory

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268 Policies Promoting the Development of Green Buildings in Sub-Saharan Africa: A South African Case-Study

Authors: Peter Adekunle, Clinton Aigbavboa, Matthew Ikuabe, Opeoluwa Akinradewo

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Contemporary building methods typically pay little attention to the built environment's greater economic, environmental, or social impacts or energy efficiency. Green construction aims to sever ties with these conventions. In order to provide better living and working conditions and lessen environmental consequences, green building today combines numerous building design, construction, and operation and maintenance approaches. As one of Sub-Saharan Africa's most industrialized nations, South Africa has a good number of green building projects. Therefore, this study examines the elements impacting the adoption of green buildings and regulations created to encourage the growth of green buildings using South Africa as a case study. The study has a survey-style design. A total of one hundred fifty (150) questionnaires were distributed to professionals in the construction industry in South Africa, of which one hundred and twenty-four (128) were returned and judged appropriate for investigation. The gathered data was examined using percentage, mean item scores, standard deviation, and Kruskal-Wallis. The findings show that cost and market circumstances are the two main elements impacting the adoption of green construction, while leadership advice is the most important policy. The study concluded that in order to encourage the construction of green buildings, additional Sub-Saharan nations should adopt these suggested policies.

Keywords: green building, Sub-Saharan Africa, building design, environmental conditions

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267 Conjugated Linoleic Acid Effect on Body Weight and Body Composition in Women: Systematic Review and Meta-Analysis

Authors: Hanady Hamdallah, H. Elyse Ireland, John H. H. Williams

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Conjugated linoleic acid (CLA) is a food supplement that is reported to have multiple beneficial health effects, including being anti-carcinogenic, anti-inflammatory and anti-obesity. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity related markers in women. Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords 'Conjugated linoleic acid', 'CLA', 'Women', and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Also, these trials provided information about body composition expressed as body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF %), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist. Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p < 0.001), BMI (0.6 ± 0.13kg/m², p < 0.001) and TBF (0.76 ± 0.26 kg, p= 0.003) in women, when supplemented over 6-16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p < 0.001), BMI (0.60 ± 0.14 kg/m², p < 0.001) and TBF (0.82 ± 0.28 kg, p= 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p < 0.001; 1.05 ± 0.36 kg, p= 0.003) and BMI (0.50 ± 0.17 kg/m², p= 0.003; 0.75 ± 0.2 kg/m², p < 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p= 0.003) was only significant in post-menopausal women. Interestingly, CLA supplementation was associated with a significant reduction in BW (1.05 ± 0.35 kg, p< 0.003), BMI (0.73 ± 0.2 kg/m², p < 0.001) and TBF (1.07 ± 0.36 kg, p= 0.003) in the trials without lifestyle monitoring or interventions. No significant effect of CLA on LBM was detected in this meta-analysis. This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6-16 weeks, particularly in overweight-obese women and post-menopausal women. However, this finding requires careful interpretation due to several issues in the designs of available CLA supplementation trials. More well-designed trials are required to confirm this meta-analysis results.

Keywords: body composition, body mass index, body weight, conjugated linoleic acid

Procedia PDF Downloads 266
266 Social Imagination and History Teaching: Critical Thinking's Possibilities in the Australian Curriculum

Authors: Howard Prosser

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This paper examines how critical thinking is framed, especially for primary-school students, in the recently established Australian Curriculum: History. Critical thinking is one of the curriculum’s 'general capabilities.' History provides numerous opportunities for critical thinking’s application in everyday life. The so-called 'history wars' that took place just prior to the curriculum’s introduction in 2014 sought to bring to light the limits of a singular historical narrative and reveal that which had been repressed. Consequently, the Australian history curriculum reflects this shifting mindset. Teachers are presented with opportunities to treat history in the classroom as a repository of social possibility, especially related to democratic potential, beyond hackneyed and jingoistic tales of Australian nationhood. Yet such opportunities are not explicit within the document and are up against pre-existing pedagogic practices. Drawing on political thinker Cornelius Castoriadis’s rendering of the 'social-historical' and 'paidea,' as well as his mobilisation of psychoanalysis, the study outlines how the curriculum’s critical-thinking component opens up possibilities for students and teachers to revise assumptions about how history is understood. This ontological shift is ultimately creative: the teachers’ imaginations connect the students’ imaginations, and vice versa, to the analysis that is at the heart of historical thinking. The implications of this social imagination add to the current discussions about historical consciousness among scholars like Peter Seixas. But, importantly, it has practical application in the primary-school classroom where history becomes creative acts, like play, that is indeterminate and social rather than fixed and individual.

Keywords: Australia, Castoriadis, critical thinking, history, imagination

Procedia PDF Downloads 285
265 Nourishing the Hive: The Interplay of Nutrition, Gene Expression, and Queen Egg-Laying in Honeybee Colonies

Authors: Damien P. Fevre, Peter K. Dearden

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Honeybee population sustainability is a critical concern for environmental stability and human food security. The success of a colony relies heavily on the egg-laying capacity of the queen, as it determines the production of thousands of worker bees who, in turn, perform essential functions in foraging and transforming food to make it digestible for the colony. The main sources of nutrition for honeybees are nectar, providing carbohydrates, and pollen, providing protein. This study delves into the impact of the proportion of these macronutrients on the food consumption patterns of nurse bees responsible for feeding the queen and how it affects the characteristics of the eggs produced. Using nutritional geometry, qRT-PCR, and RNA-seq analysis, this study sheds light on the pivotal role of nutrition in influencing gene expression in nurse bees, honeybee queen egg-laying capacity and embryonic development. Interestingly, while nutrition is crucial, the queen's genotype plays an even more significant role in this complex relationship, highlighting the importance of genotype-by-environment interactions. Understanding the interplay between genotype and nutrition is key to optimizing beekeeping management and strategic queen breeding practices. The findings from this study have significant implications for beekeeping practices, emphasizing the need for an appropriate nutrition to support the social nutrition of Apis mellifera. Implementing these insights can lead to improved colony health, increased productivity, and sustainable honeybee conservation efforts.

Keywords: honeybee, egg-laying, nutrition, transcriptomics

Procedia PDF Downloads 56
264 Economic and Environmental Assessment of Heat Recovery in Beer and Spirit Production

Authors: Isabel Schestak, Jan Spriet, David Styles, Prysor Williams

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Breweries and distilleries are well-known for their high water usage. The water consumption in a UK brewery to produce one litre of beer reportedly ranges from 3-9 L and in a distillery from 7-45 L to produce a litre of spirit. This includes product water such as mashing water, but also water for wort and distillate cooling and for cleaning of tanks, casks, and kegs. When cooling towers are used, cooling water can be the dominating water consumption in a brewery or distillery. Interlinked to the high water use is a substantial heating requirement for mashing, wort boiling, or distillation, typically met by fossil fuel combustion such as gasoil. Many water and waste water streams are leaving the processes hot, such as the returning cooling water or the pot ales. Therefore, several options exist to optimise water and energy efficiency of spirit production through heat recovery. Although these options are known in the sector, they are often not applied in practice due to planning efforts or financial obstacles. In this study, different possibilities and design options for heat recovery systems are explored in four breweries/distilleries in the UK and assessed from an economic but also environmental point of view. The eco-efficiency methodology, according to ISO 14045, is applied to combine both assessment criteria to determine the optimum solution for heat recovery application in practice. The economic evaluation is based on the total value added (TVA) while the Life Cycle Assessment (LCA) methodology is applied to account for the environmental impacts through the installations required for heat recovery. The four case study businesses differ in a) production scale with mashing volumes ranging from 2500 to 40,000 L, in b) terms of heating and cooling technology used, and in c) the extent to which heat recovery is/is not applied. This enables the evaluation of different cases for heat recovery based on empirical data. The analysis provides guidelines for practitioners in the brewing and distilling sector in and outside the UK for the realisation of heat recovery measures. Financial and environmental payback times are showcased for heat recovery systems in the four distilleries which are operating at different production scales. The results are expected to encourage the application of heat recovery where environmentally and economically beneficial and ultimately contribute to a reduction of the water and energy footprint in brewing and distilling businesses.

Keywords: brewery, distillery, eco-efficiency, heat recovery from process and waste water, life cycle assessment

Procedia PDF Downloads 98
263 Magnetic Properties of Bis-Lanthanoates: Probing Dimer Formation in Crystalline, Liquid and Glassy Compounds Using SQUID Magnetometry

Authors: Kane Esien, Eadaoin McCourt, Peter Nockemann, Soveig Felton

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Magnetic ionic liquids (MILs) are a class of ionic liquid incorporating one or more magnetic atoms into the anion or cation of the ionic liquid, endowing the ionic liquid with magnetic properties alongside the existing properties of ionic liquids. MILs have applications in e.g. fluid-fluid separations, electrochemistry, and polymer chemistry. In this study three different types of Bis-Lanthanoates, that exist in different phases, have been synthesised and characterised (Ln = lanthanide): 1) imidazolium lanthanide acetate – [C4Mim]2[Ln2(OAc)8] – forms a crystalline solid at room temperature, 2) phosphonium lanthanide acetate – [P666 14]2[Ln2(OAc)8] – is in a solid glassy state, and 3) phosphonium lanthanide octanoate – [P666 14]2[Ln2(Oct)8] – is an ionic liquid. X-ray diffraction of the crystalline solid imidazolium lanthanide acetate – [C4Mim]2[Ln2(OAc)8] confirm that the Ln(III) ions form dimers, bridged by carboxyl groups, but cannot yield information about samples phosphonium lanthanide acetate – [P666 14]2[Ln2(OAc)8] (glass) and phosphonium lanthanide octanoate – [P666 14]2[Ln2(Oct)8] (ionic liquid) since these lack long-range order. SQUID magnetometry studies show that all three samples have effective magnetic moments consistent with non-interacting Ln(III) ions at room temperature but deviate from this behavior in the same way below 50 K. Through modeling the magnetic response, we are able to show that we have formed magnetic dimers, in all compounds, that are weakly antiferromagnetically interacting

Keywords: dimeric ionic liquids, interactions, SQUID, structure

Procedia PDF Downloads 127
262 Passive Solar-Driven Membrane Distiller for Desalination: Effect of Middle Layer Material and Thickness on Desalination Performance

Authors: Glebert C. Dadol, Camila Flor Y. Lobarbio, Noel Peter B. Tan

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Water scarcity is a global problem. One of the promising solutions to this challenge is the use of membrane-based desalination technologies. In this study, a passive solar-driven membrane (PSDM) distillation was employed to test its desalination performance. The PSDM was fabricated using a TiNOX sheet solar absorber, cellulose-based hydrophilic top and bottom layers, and a middle layer. The effects of the middle layer material and thickness on the desalination performance in terms of distillate flow rate, productivity, and salinity were investigated. An air-gap screen mesh (2 mm, 4 mm, 6 mm thickness) and a hydrophobic PTFE membrane (0.3 mm thickness) were used as middle-layer materials. Saltwater input (35 g/L NaCl) was used for the PSDM distiller on a rooftop setting at the University of San Carlos, Cebu City, Philippines. The highest distillate flow rate and productivity of 1.08 L/m²-h and 1.47 L/kWh, respectively, were achieved using a 2 mm air-gap middle layer, but it also resulted in a high salinity of 25.20 g/L. Increasing the air gap lowered the salinity but also decreased the flow rate and productivity. The lowest salinity of 1.07 g/L was achieved using 6 mm air gap, but the flow rate and productivity were reduced to 0.08 L/m²-h and 0.17 L/kWh, respectively. The use of a hydrophobic PTFE membrane, on the other hand, did not offer a significant improvement in its performance. A PDSM distiller with a thick air gap as the middle layer can deliver a distillate with low salinity and is preferred over a thin hydrophobic PTFE membrane. Various modifications and optimizations to the distiller can be done to improve its performance further.

Keywords: desalination, membrane distillation, passive solar-driven membrane distiller, solar distillation

Procedia PDF Downloads 91
261 Shear Stress and Effective Structural Stress ‎Fields of an Atherosclerotic Coronary Artery

Authors: Alireza Gholipour, Mergen H. Ghayesh, Anthony Zander, Stephen J. Nicholls, Peter J. Psaltis

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A three-dimensional numerical model of an atherosclerotic coronary ‎artery is developed for the determination of high-risk situation and ‎hence heart attack prediction. Employing the finite element method ‎‎(FEM) using ANSYS, fluid-structure interaction (FSI) model of the ‎artery is constructed to determine the shear stress distribution as well ‎as the von Mises stress field. A flexible model for an atherosclerotic ‎coronary artery conveying pulsatile blood is developed incorporating ‎three-dimensionality, artery’s tapered shape via a linear function for ‎artery wall distribution, motion of the artery, blood viscosity via the ‎non-Newtonian flow theory, blood pulsation via use of one-period ‎heartbeat, hyperelasticity via the Mooney-Rivlin model, viscoelasticity ‎via the Prony series shear relaxation scheme, and micro-calcification ‎inside the plaque. The material properties used to relate the stress field ‎to the strain field have been extracted from clinical data from previous ‎in-vitro studies. The determined stress fields has potential to be used as ‎a predictive tool for plaque rupture and dissection.‎ The results show that stress concentration due to micro-calcification ‎increases the von Mises stress significantly; chance of developing a ‎crack inside the plaque increases. Moreover, the blood pulsation varies ‎the stress distribution substantially for some cases.‎

Keywords: atherosclerosis, fluid-structure interaction‎, coronary arteries‎, pulsatile flow

Procedia PDF Downloads 144
260 Nanoparticle-Based Histidine-Rich Protein-2 Assay for the Detection of the Malaria Parasite Plasmodium Falciparum

Authors: Yagahira E. Castro-Sesquen, Chloe Kim, Robert H. Gilman, David J. Sullivan, Peter C. Searson

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Diagnosis of severe malaria is particularly important in highly endemic regions since most patients are positive for parasitemia and treatment differs from non-severe malaria. Diagnosis can be challenging due to the prevalence of diseases with similar symptoms. Accurate diagnosis is increasingly important to avoid overprescribing antimalarial drugs, minimize drug resistance, and minimize costs. A nanoparticle-based assay for detection and quantification of Plasmodium falciparum histidine-rich protein 2 (HRP2) in urine and serum is reported. The assay uses magnetic beads conjugated with anti-HRP2 antibody for protein capture and concentration, and antibody-conjugated quantum dots for optical detection. Western Blot analysis demonstrated that magnetic beads allows the concentration of HRP2 protein in urine by 20-fold. The concentration effect was achieved because large volume of urine can be incubated with beads, and magnetic separation can be easily performed in minutes to isolate beads containing HRP2 protein. Magnetic beads and Quantum Dots 525 conjugated to anti-HRP2 antibodies allows the detection of low concentration of HRP2 protein (0.5 ng mL-1), and quantification in the range of 33 to 2,000 ng mL-1 corresponding to the range associated with non-severe to severe malaria. This assay can be easily adapted to a non-invasive point-of-care test for classification of severe malaria.

Keywords: HRP2 protein, malaria, magnetic beads, Quantum dots

Procedia PDF Downloads 302
259 Physical and Morphological Response to Land Reclamation Projects in a Wave-Dominated Bay

Authors: Florian Monetti, Brett Beamsley, Peter McComb, Simon Weppe

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Land reclamation from the ocean has considerably increased over past decades to support worldwide rapid urban growth. Reshaping the coastline, however, inevitably affects coastal systems. One of the main challenges for coastal oceanographers is to predict the physical and morphological responses for nearshore systems to man-made changes over multiple time-scales. Fully-coupled numerical models are powerful tools for simulating the wide range of interactions between flow field and bedform morphology. Restricted and inconsistent measurements, combined with limited computational resources, typically make this exercise complex and uncertain. In the present study, we investigate the impact of proposed land reclamation within a wave-dominated bay in New Zealand. For this purpose, we first calibrated our morphological model based on the long-term evolution of the bay resulting from land reclamation carried out in the 1950s. This included the application of sedimentological spin-up and reduction techniques based on historical bathymetry datasets. The updated bathymetry, including the proposed modifications of the bay, was then used to predict the effect of the proposed land reclamation on the wave climate and morphology of the bay after one decade. We show that reshaping the bay induces a distinct symmetrical response of the shoreline which likely will modify the nearshore wave patterns and consequently recreational activities in the area.

Keywords: coastal waves, impact of land reclamation, long-term coastal evolution, morphodynamic modeling

Procedia PDF Downloads 146
258 Case Report on ‘Primary Adenocarcinoma of Aberrant HER2+ Anogenital Mammary-like Glands in a Male'

Authors: Shivani Kuttuva, James Sampson, Timothy Simmons, Vinayak Thattaruparambil, Holly Burton, Peter Coyne

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Anogenital mammary-like glands were established to be embryological remnants of breast tissue due to failed resolution of the ectodermal mammary ridge. However, recent studies are now considering this to represent normal constituents of the anogenital area with histological resemblance to the orthotopic breast tissue with multiple benign and malignant lesions arising from it. The incidence of the above has been predominant in females in the vulval region. Due to the paucity of cases reported in men, this poses a diagnostic and therapeutic challenge resulting in a delay in treatment and, thereby, poor outcomes. Our patient presented to the dermatology clinic with an itchy, purplish lesion in the peri-anal region which, on punch biopsy, was diagnosed to be Extra-mammary Paget’s disease and taken up for Wide local excision. Immunochemically, staining was positive for HER2, ER and Cytokeratin 7, keeping with the presence of actual breast tissue with no primary breast carcinoma. Due to the invasive nature of the disease, he required Abdominoperineal resection with flap reconstruction. Despite complete surgical clearance and adjuvant radiotherapy, the disease progressed to adjacent inguinal and obturator lymph nodes with origin resembling anogenital type mammary glands but histology negative for hormonal receptors of the breast.

Keywords: anogenital mammary-like glands, abdominoperineal resection, ectopic breast tissue, ectopic male breast carcinoma, peri-anal skin lesion

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257 Coping Strategies Used by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study

Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

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Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

Procedia PDF Downloads 154