Search results for: rehabilitation centers
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1724

Search results for: rehabilitation centers

1634 Modeling Sustainable Truck Rental Operations Using Closed-Loop Supply Chain Network

Authors: Khaled S. Abdallah, Abdel-Aziz M. Mohamed

Abstract:

Moving industries consume numerous resources and dispose masses of used packaging materials. Proper sorting, recycling and disposing the packaging materials is necessary to avoid a sever pollution disaster. This research paper presents a conceptual model to propose sustainable truck rental operations instead of the regular one. An optimization model was developed to select the locations of truck rental centers, collection sites, maintenance and repair sites, and identify the rental fees to be charged for all routes that maximize the total closed supply chain profits. Fixed costs of vehicle purchasing, costs of constructing collection centers and repair centers, as well as the fixed costs paid to use disposal and recycling centers are considered. Operating costs include the truck maintenance, repair costs as well as the cost of recycling and disposing the packing materials, and the costs of relocating the truck are presented in the model. A mixed integer model is developed followed by a simulation model to examine the factors affecting the operation of the model.

Keywords: modeling, truck rental, supply chains management.

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1633 Possibility Theory Based Multi-Attribute Decision-Making: Application in Facility Location-Selection Problem under Uncertain and Extreme Environment

Authors: Bezhan Ghvaberidze

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A fuzzy multi-objective facility location-selection problem (FLSP) under uncertain and extreme environments based on possibility theory is developed. The model’s uncertain parameters in the q-rung orthopair fuzzy values are presented and transformed in the Dempster-Shaper’s belief structure environment. An objective function – distribution centers’ selection ranking index as an extension of Dempster’s extremal expectations under discrimination q-rung orthopair fuzzy information is constructed. Experts evaluate each humanitarian aid from distribution centers (HADC) against each of the uncertain factors. HADCs location problem is reduced to the bicriteria problem of partitioning the set of customers by the set of centers: (1) – Minimization of transportation costs; (2) – Maximization of centers’ selection ranking indexes. Partitioning type constraints are also constructed. For an illustration of the obtained results, a numerical example is created from the facility location-selection problem.

Keywords: FLSP, multi-objective combinatorial optimization problem, evidence theory, HADC, q-rung orthopair fuzzy set, possibility theory

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1632 Modeling and Control of a 4DoF Robotic Assistive Device for Hand Rehabilitation

Authors: Christopher Spiewak, M. R. Islam, Mohammad Arifur Rahaman, Mohammad H. Rahman, Roger Smith, Maarouf Saad

Abstract:

For those who have lost the ability to move their hand, going through repetitious motions with the assistance of a therapist is the main method of recovery. We have been developed a robotic assistive device to rehabilitate the hand motions in place of the traditional therapy. The developed assistive device (RAD-HR) is comprised of four degrees of freedom enabling basic movements, hand function, and assists in supporting the hand during rehabilitation. We used a nonlinear computed torque control technique to control the RAD-HR. The accuracy of the controller was evaluated in simulations (MATLAB/Simulink environment). To see the robustness of the controller external disturbance as modelling uncertainty (±10% of joint torques) were added in each joints.

Keywords: biorobotics, rehabilitation, robotic assistive device, exoskeleton, nonlinear control

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1631 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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1630 Financial Centers and BRICS Stock Markets: The Effect of the Recent Crises

Authors: Marco Barassi, Nicola Spagnolo

Abstract:

This paper uses a DCC-GARCH model framework to examine mean and volatility spillovers (i.e. causality in mean and variance) dynamics between financial centers and the stock market indexes of the BRICS countries. In addition, tests for changes in the transmission mechanism are carried out by first testing for structural breaks and then setting a dummy variable to control for the 2008 financial crises. We use weekly data for nine countries, four financial centers (Germany, Japan, UK and USA) and the five BRICS countries (Brazil, Russia, India, China and South Africa). Furthermore, we control for monetary policy using domestic interest rates (90-day Treasury Bill interest rate) over the period 03/1/1990 - 04/2/2014, for a total of 1204 observations. Results show that the 2008 financial crises changed the causality dynamics for most of the countries considered. The same pattern can also be observed in conditional correlation showing a shift upward following the turbulence associated to the 2008 crises. The magnitude of these effects suggests a leading role played by the financial centers in effecting Brazil and South Africa, whereas Russia, India and China show a higher degree of resilience.

Keywords: financial crises, DCC-GARCH model, volatility spillovers, economics

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1629 The Effects of Logistical Centers Realization on Society and Economy

Authors: Anna Dolinayova, Juraj Camaj, Martin Loch

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Presently it is necessary to ensure the sustainable development of passenger and freight transport. Increasing performance of road freight have been a negative impact to environment and society. It is therefore necessary to increase the competitiveness of intermodal transport, which is more environmentally friendly. The study describe the effectiveness of logistical centers realization for companies and society and research how the partial internalization of external costs reflected in the efficient use of these centers and increase the competitiveness of intermodal transport to road freight. In our research, we use the method of comparative analysis and market research to describe the advantages of logistic centers for their users as well as for society as a whole. Method normal costing is used for calculation infrastructure and total costs, method of conversion costing for determine the external costs. We modelling of total society costs for road freight transport and inter modal transport chain (we assumed that most of the traffic is carried by rail) with different loading schemes for condition in the Slovak Republic. Our research has shown that higher utilization of inter modal transport chain do good not only for society, but for companies providing freight services too. Increase in use of inter modal transport chain can bring many benefits to society that do not bring direct immediate financial return. They often bring the multiplier effects, such as greater use of environmentally friendly transport mode and reduce the total society costs.

Keywords: delivery time, economy effectiveness, logistical centers, ecological efficiency, optimization, society

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1628 Cardio-respiratory Rehabilitation in Patients With Chronic or Post-acute Cardiomyopathy and COPD

Authors: Ledi Neçaj

Abstract:

Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

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1627 Heuristic Methods for the Capacitated Location- Allocation Problem with Stochastic Demand

Authors: Salinee Thumronglaohapun

Abstract:

The proper number and appropriate locations of service centers can save cost, raise revenue and gain more satisfaction from customers. Establishing service centers is high-cost and difficult to relocate. In long-term planning periods, several factors may affect the service. One of the most critical factors is uncertain demand of customers. The opened service centers need to be capable of serving customers and making a profit although the demand in each period is changed. In this work, the capacitated location-allocation problem with stochastic demand is considered. A mathematical model is formulated to determine suitable locations of service centers and their allocation to maximize total profit for multiple planning periods. Two heuristic methods, a local search and genetic algorithm, are used to solve this problem. For the local search, five different chances to choose each type of moves are applied. For the genetic algorithm, three different replacement strategies are considered. The results of applying each method to solve numerical examples are compared. Both methods reach to the same best found solution in most examples but the genetic algorithm provides better solutions in some cases.

Keywords: location-allocation problem, stochastic demand, local search, genetic algorithm

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1626 Developing a Risk Rating Tool for Shopping Centres

Authors: Prandesha Govender, Chris Cloete

Abstract:

Purpose: The objective of the paper is to develop a tool for the evaluation of the financial risk of a shopping center. Methodology: Important factors that indicate the success of a shopping center were identified from the available literature. Weights were allocated to these factors and a risk rating was calculated for 505 shopping centers in the largest province in South Africa by taking the factor scores, factor weights, and category weights into account. The ratings for ten randomly selected shopping centers were correlated with consumer feedback and standardized against the ECAI (External Credit Assessment Institutions) data for the same centers. The ratings were also mapped to corporates with the same risk rating to provide a better intuitive assessment of the meaning of the inherent risk of each center. Results: The proposed risk tool shows a strong linear correlation with consumer views and can be compared to expert opinions, such as that of fund managers and REITs. Interpretation of the tool was also illustrated by correlating the risk rating of selected shopping centers to the risk rating of reputable and established entities. Conclusions: The proposed Shopping Centre Risk Tool, used in conjunction with financial inputs from the relevant center, should prove useful to an investor when the desirability of investment in or expansion, renovation, or purchase of a shopping center is being considered.

Keywords: risk, shopping centres, risk modelling, investment, rating tool, rating scale

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1625 Creating a Virtual Perception for Upper Limb Rehabilitation

Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

Abstract:

This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: physical rehabilitation, mirror neuron, virtual reality, stroke therapy

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1624 A Review of the Future of Sustainable Urban Water Supply in South Africa

Authors: Jeremiah Mutamba

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Water is a critical resource for sustainable economic growth and social development. It enables societies to thrive and influences every urban center’s future. Thus, water must always be available in the right quantity and quality. However, in South Africa - a known physically water scarce nation – the future of sustainable urban supply of water may be in jeopardy. The country facing a water crisis influenced by insufficient infrastructure investment and maintenance, recurrent droughts and climate variation, human induced water quality deterioration, as well as growing lack of technical capacity in water institutions, particularly local municipalities. Aside of the eight metropolitan municipalities for the country, most municipalities struggle with provision of reliable water to their citizens. These municipalities contend with having now capable engineers, aging infrastructure with concomitant high system water losses (of 30% and upwards), coupled with growing water demand from expanding industries and population growth. Also, a significant portion (44%) of national water treatment plants are in critically poor condition, requiring urgent rehabilitation. Municipalities also struggle to raise funding to instate projects. All these factors militate against sustainable urban water supply in the country. Urgent mitigation measures are required. This paper seeks to review the extent of the current water supply challenges in South Africa’s urban centers, including searching for practical and cost-effective measures. The study followed a qualitative approach, combining desktop literature research, interviews with key sector stakeholders, and a workshop. Phenomenological data analysis technique was used to study and examine interview data and secondary desktop data. Preliminary findings established the building of technical or engineering capacity, reversal of the high physical water losses, rehabilitation of poor condition and dysfunctional water treatment works, diversification of water resource mix, and water scarcity awareness programs as possible practical solutions. Other proposed solutions include the use of performance-based or value-based contracting to fund initiatives to reduce high system water losses. Out-come based arrangements for revenue increasing water loss reduction projects were considered more practical in funding-stressed local municipalities. If proactively implemented in an integrated manner, these proposed solutions are likely to ensure sustainable urban water supply in South African urban centers in the future.

Keywords: sustainable, water scarcity, water supply, South Africa

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1623 X-Glove: Case Study of Soft Robotic Hand Exoskeleton

Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

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Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

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1622 Preparedness of Health System in Providing Continuous Health Care: A Case Study From Sri Lanka

Authors: Samantha Ramachandra, Avanthi Rupasinghe

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Demographic transition from lower to higher percentage of elderly population eventually coupled with epidemiological transition from communicable to non-communicable diseases (NCD). Higher percentage of NCD overload the health system as NCD survivors claims continuous health care. The demands are challenging to a resource constrained setting but reorganizing the system may find solutions. The study focused on the facilities available and their utilization at outpatient department (OPD) setting of the public hospitals of Sri Lanka for continuous medical care. This will help in identifying steps of reorganizing the system to provide better care with the maximum utilization of available facilities. The study was conducted as a situation analysis with secondary data at hospital planning units. Variable were identified according to the world health organization (WHO) recommendation on continuous health care for elders in “age-friendly primary health care toolkit”. Data were collected from secondary and tertiary care hospitals of Sri Lanka where most of the continuous care services are available. Out of 58 secondary and tertiary care hospitals, 16 were included in the study to represent each hospital categories. Average number of patient attending for episodic treatment at OPD and Clinical follow-up of chronic conditions shows vast disparity according to the category of the hospital ranging from 3750 – 800 per day at OPD and 1250 – 200 per clinic session. Average time spent per person at OPD session is low, range from 1.54 - 2.28 minutes, the time was increasing as the hospital category goes down. 93.7% hospitals had special arrangements for providing acute care on chronic conditions such as catheter, feeding tube and wound care. 25% hospitals had special clinics for elders, 81.2% hospitals had healthy lifestyle clinics (HLC), 75% hospitals had physical rehabilitation facilities and 68.8% hospitals had facilities for counselling. Elderly clinics and HLC were mostly available at lower grade hospitals where as rehabilitation and counselling facilities were mostly available at bigger hospitals. HLC are providing health education for both patients and their family members, refer patients for screening of complication but not provide medical examinations, investigations or treatments even though they operate in the hospital setting. Physical rehabilitation is basically offered for patients with rheumatological conditions but utilization of centers for injury rehabilitation and rehabilitation of survivors following major illness such as myocardial infarctions, stroke, cancer is not satisfactory (12.5%). Human Resource distribution within hospital shows vast disparity and there are 103 physiotherapists in the biggest hospital where only 36 physiotherapists available at the next level hospital. Counselling facilities also provided mainly for the patient with psychological conditions (100%) but they were not providing counselling for newly diagnosed patients with major illnesses (0%). According to results, most of the public-sector hospitals in Sri Lanka have basic facilities required in providing continuous care but the utilization of services need more focus. Hospital administration or the government need to have initial steps in proper utilization of them in improving continuous health care incorporating team approach of rehabilitation. The author wishes to acknowledge that this paper was made possible by the support and guidance given by the “Australia Awards Fellowships Program for Sri Lanka – 2017,” which was funded by the Department of Foreign Affairs and Trade, Australia, and co-hosted by Monash University, Australia and the Sri Lanka Institute of Development Administration.

Keywords: continuous care, outpatient department, non communicable diseases, rehabilitation

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1621 Crime Victim Support Services in Bangladesh: An Analysis

Authors: Mohammad Shahjahan, Md. Monoarul Haque

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In the research work information and data were collected from both types of sources, direct and indirect. Numerological, qualitative and participatory analysis methods have been followed. There were two principal sources of collecting information and data. Firstly, the data provided by the service recipients (300 nos. of women and children victims) in the Victim Support Centre and service providing policemen, executives and staffs (60 nos.). Secondly, data collected from Specialists, Criminologists and Sociologists involved in victim support services through Consultative Interview, KII, Case Study and FGD etc. The initial data collection has been completed with the help of questionnaires as per strategic variations and with the help of guidelines. It is to be noted that the main objective of this research was to determine whether services provided to the victims for their facilities, treatment/medication and rehabilitation by different government/non-government organizations was veritable at all. At the same time socio-economic background and demographic characteristics of the victims have also been revealed through this research. The results of the study show that although the number of victims has increased gradually due to socio-economic, political and cultural realities in Bangladesh, the number of victim support centers has not increased as expected. Awareness among the victims about the effectiveness of the 8 centers working in this regard is also not up to the mark. Two thirds of the victims coming to get service were not cognizant regarding the victim support services at all before getting the service. Most of those who have finally been able to come under the services of the Victim Support Center through various means, have received sheltering (15.5%), medical services (13.32%), counseling services (13.10%) and legal aid (12.66%). The opportunity to stay in security custody and psycho-physical services were also notable. Usually, women and children from relatively poor and marginalized families of the society come to victim support center for getting services. Among the women, young unmarried women are the biggest victims of crime. Again, women and children employed as domestic workers are more affected. A number of serious negative impacts fall on the lives of the victims. Being deprived of employment opportunities (26.62%), suffering from psycho-somatic disorder (20.27%), carrying sexually transmitted diseases (13.92%) are among them. It seems apparent to urgently enact distinct legislation, increase the number of Victim Support Centers, expand the area and purview of services and take initiative to increase public awareness and to create mass movement.

Keywords: crime, victim, support, Bangladesh

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1620 Exploring the Number, Type and Level of Disability among Victims of Nepal Earthquake 2015

Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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1619 A Novel Method For Non-Invasive Diagnosis Of Hepatitis C Virus Using Electromagnetic Signal Detection: A Multicenter International Study

Authors: Gamal Shiha, Waleed Samir, Zahid Azam, Premashis Kar, Saeed Hamid, Shiv Sarin

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A simple, rapid and non-invasive electromagnetic sensor (C-FAST device) was- patented; for diagnosis of HCV RNA. Aim: To test the validity of the device compared to standard HCV PCR. Subjects and Methods: The first phase was done as pilot in Egypt on 79 participants; the second phase was done in five centers: one center from Egypt, two centers from Pakistan and two centers from India (800, 92 and 113 subjects respectively). The third phase was done nationally as multicenter study on (1600) participants for ensuring its representativeness. Results: When compared to PCR technique, C-FAST device revealed sensitivity 95% to 100%, specificity 95.5% to 100%, PPV 89.5% to 100%, NPV 95% to 100% and positive likelihood ratios 21.8% to 38.5%. Conclusion: It is practical evidence that HCV nucleotides emit electromagnetic signals that can be used for its identification. As compared to PCR, C-FAST is an accurate, valid and non-invasive device.

Keywords: C-FAST- a valid and reliable device, distant cellular interaction, electromagnetic signal detection, non-invasive diagnosis of HCV

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1618 Foot Recognition Using Deep Learning for Knee Rehabilitation

Authors: Rakkrit Duangsoithong, Jermphiphut Jaruenpunyasak, Alba Garcia

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The use of foot recognition can be applied in many medical fields such as the gait pattern analysis and the knee exercises of patients in rehabilitation. Generally, a camera-based foot recognition system is intended to capture a patient image in a controlled room and background to recognize the foot in the limited views. However, this system can be inconvenient to monitor the knee exercises at home. In order to overcome these problems, this paper proposes to use the deep learning method using Convolutional Neural Networks (CNNs) for foot recognition. The results are compared with the traditional classification method using LBP and HOG features with kNN and SVM classifiers. According to the results, deep learning method provides better accuracy but with higher complexity to recognize the foot images from online databases than the traditional classification method.

Keywords: foot recognition, deep learning, knee rehabilitation, convolutional neural network

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1617 Effect of Pulmonary Rehabilitation towards Length of Stay and IL-6 Level on Community-Acquired Pneumonia Patients

Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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1616 Renovation of Pipeline in Residential Buildings by Polymeric Composites

Authors: Parastou Kharazmi

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In this paper, rehabilitation methods for pipeline by advanced polymeric coating such as relining are reviewed. A number of diverse methods which are globally used are described and a brief summary of advances in technology, methods and materials is provided. The paper explains why it is claimed that sewerage rehabilitation with relining in residential buildings is environmentally friendly and economical, the importance of the quality control procedure is discussed and several quality tests are proposed.

Keywords: buildings, composite, material, renovation

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1615 Data Collection Techniques for Robotics to Identify the Facial Expressions of Traumatic Brain Injured Patients

Authors: Chaudhary Muhammad Aqdus Ilyas, Matthias Rehm, Kamal Nasrollahi, Thomas B. Moeslund

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This paper presents the investigation of data collection procedures, associated with robots when placed with traumatic brain injured (TBI) patients for rehabilitation purposes through facial expression and mood analysis. Rehabilitation after TBI is very crucial due to nature of injury and variation in recovery time. It is advantageous to analyze these emotional signals in a contactless manner, due to the non-supportive behavior of patients, limited muscle movements and increase in negative emotional expressions. This work aims at the development of framework where robots can recognize TBI emotions through facial expressions to perform rehabilitation tasks by physical, cognitive or interactive activities. The result of these studies shows that with customized data collection strategies, proposed framework identify facial and emotional expressions more accurately that can be utilized in enhancing recovery treatment and social interaction in robotic context.

Keywords: computer vision, convolution neural network- long short term memory network (CNN-LSTM), facial expression and mood recognition, multimodal (RGB-thermal) analysis, rehabilitation, robots, traumatic brain injured patients

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1614 Women as Catalysts for the Rehabilitation of the Traditional System of Governance in Nigeria

Authors: Inalegwu Stephany Akipu

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Before the advent of Colonialists on the shores of Nigeria between the 16th and 17th Centuries, there existed the traditional systems of governance which was successful with Women as active participants. However, the current state of politics in Nigeria reveals an obvious absence of women in the Country’s governance. Being that the economy rests on the quality of leaders and their constructive contribution to the plight of the masses, it becomes pertinent to exhaust all the avenues that may be open to good governance-women inclusive. It is against this backdrop that this paper attempts to compare the machinery that were in place in pre-colonial Nigerian governance that aided the womenfolk to successfully reign or assist in leadership with the seeming lack of interest by women in present times. Factors that militate against the women will also be highlighted. Furthermore, suggestions are made on how to revive these successful traditional systems of governance. The paper concludes by emphasising the role of women as the needed catalysts for this aforementioned rehabilitation of traditional systems and the impact of media in achieving this feat.

Keywords: catalysts, governance, media, rehabilitation

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1613 The Major Challenge of the Health System Health Management Services in Kosovo and Impact on Satisfaction

Authors: Nevruz Zogu, Shpetim Rezniqi

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In the framework of transformational economic development social pluralism and the free, market health systems operating in the countries of our region are naturally involved in a process of profound change and reform. Health systems actually represent complex ensembles centers and public and private institutions (domestic and foreign), who administer substantial amounts of human, technological, material, financial, information and scientific facts • The goal of health systems is much more than medical care. It includes the promotion, protection, treatment and rehabilitation of health of the population. • Meeting the needs of increasingly diverse broader health services efficient, secure the quality and affordability of their increasing cost of unstoppable, requires the necessary reform of health systems and implementing policies and new management methods, to ensure effectiveness and health benefits as higher population.

Keywords: health, management, economy, finance

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1612 Development of Thermal Insulation Materials Based on Silicate Using Non-Traditional Binders and Fillers

Authors: J. Hroudova, J. Zach, L. Vodova

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When insulation and rehabilitation of structures is important to use quality building materials with high utility value. One potentially interesting and promising groups of construction materials in this area are advanced, thermally insulating plaster silicate based. With the present trend reduction of energy consumption of building structures and reducing CO2 emissions to be developed capillary-active materials that are characterized by their low density, low thermal conductivity while maintaining good mechanical properties. The paper describes the results of research activities aimed at the development of thermal insulating and rehabilitation material ongoing at the Technical University in Brno, Faculty of Civil Engineering. The achieved results of this development will be the basis for subsequent experimental analysis of the influence of thermal and moisture loads developed on these materials.

Keywords: insulation materials, rehabilitation materials, lightweight aggregate, fly ash, slag, hemp fibers, glass fibers, metakaolin

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1611 Neuropsychiatric Outcomes of Intensive Music Therapy in Stroke Rehabilitation A Premilitary Investigation

Authors: Honey Bryant, Elvina Chu

Abstract:

Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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1610 Divulging Discursive Constructions On Alcohol Consumption Among Filipino Men Who Are Recovering From Alcoholism: A Foucauldian Approach

Authors: Quervin Zacary M. Roldan, Gwyneth Gabrielle M. Fajardo, Carmela M. Maciar

Abstract:

Alcohol in the Philippines is regarded as a part of their culture however, it is also stigmatized, as alcohol addiction is prevalent among Filipino Males leading them to develop Alcohol Use Disorder. With this, Discourses of alcohol consumption from Individuals recovering from AUD from different rehabilitation centers in the Philippines were analyzed in the study to explore how they ‘talk’ about their alcohol consumption. By utilizing the Foucauldian Discourse Analysis following the six steps by Carla Willig, four (4) major discourses were major construed by the recovering individuals of AUD which are: (1) Being alcohol-free was a dream, (2) Drinking alcohol turns you into a demon that will destroy your life, (3) Drinking alcohol as ‘doing’ drugs and (4) Alcohol is a temporary solution. These discourses construct alcohol consumption as something that is being referred to as a 'bad' substance which is both normalized and stigmatized in Philippine society.

Keywords: alcohol, alcohol consumption, alcohol-based beverages, psychological effects, discourse, alcohol use disorder, stigma

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1609 Classification of Small Towns: Three Methodological Approaches and Their Results

Authors: Jerzy Banski

Abstract:

Small towns represent a key element of settlement structure and serve a number of important functions associated with the servicing of rural areas that surround them. It is in light of this that scientific studies have paid considerable attention to the functional structure of centers of this kind, as well as the relationships with both surrounding rural areas and other urban centers. But a preliminary to such research has typically involved attempts at classifying the urban centers themselves, with this also assisting with the planning and shaping of development policy on different spatial scales. The purpose of the work is to test out the methods underpinning three different classifications of small urban centers, as well as to offer a preliminary interpretation of the outcomes obtained. Research took in 722 settlement units in Poland, granted town rights and populated by fewer than 20,000 inhabitants. A morphologically-based classification making reference to the database of topographic objects as regards land cover within the administrative boundaries of towns and cities was carried out, and it proved possible to distinguish the categories of “housing-estate”, industrial and R&R towns, as well as towns characterized by dichotomy. Equally, a functional/morphological approach taken with the same database allowed for the identification – via an alternative method – of three main categories of small towns (i.e., the monofunctional, multifunctional or oligo functional), which could then be described in far greater detail. A third, multi-criterion classification made simultaneous reference to the conditioning of a structural, a location-related, and an administrative hierarchy-related nature, allowing for distinctions to be drawn between small towns in 9 different categories. The results obtained allow for multifaceted analysis and interpretation of the geographical differentiation characterizing the distribution of Poland’s urban centers across space in the country.

Keywords: small towns, classification, local planning, Poland

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1608 Quantification of Learned Non-Use of the Upper-Limb After a Stroke

Authors: K. K. A. Bakhti, D. Mottet, J. Froger, I. Laffont

Abstract:

Background: After a cerebrovascular accident (or stroke), many patients use excessive trunk movements to move their paretic hand towards a target (while the elbow is maintained flexed) even though they can use the upper-limb when the trunk is restrained. This phenomenon is labelled learned non-use and is known to be detrimental to neuroplasticity and recovery. Objective: The aim of this study is to quantify learned non-use of the paretic upper limb during a hand reaching task using 3D movement analysis. Methods: Thirty-four participants post supratentorial stroke were asked to reach a cone placed in front of them at 80% of their arm length. The reaching movement was repeated 5 times with the paretic hand, and then 5 times with the less-impaired hand. This sequence was first performed with the trunk free, then with the trunk restrained. Learned non-use of the upper-limb (LNUUL) was obtained from the difference of the amount of trunk compensation between the free trunk condition and the restrained trunk condition. Results: LNUUL was significantly higher for the paretic hand, with individual values ranging from 1% to 43%, and one-half of the patients with an LNUUL higher than 15%. Conclusions: Quantification of LNUUL can be used to objectively diagnose patients who need trunk rehabilitation. It can be also used for monitoring the rehabilitation progress. Quantification of LNUUL may guide upper-limb rehabilitation towards more optimal motor recovery avoiding maladaptive trunk compensation and its consequences on neuroplasticity.

Keywords: learned non-use, rehabilitation, stroke, upper limb

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1607 Energy Intensity of a Historical Downtown: Estimating the Energy Demand of a Budapest District

Authors: Viktória Sugár, Attila Talamon, András Horkai, Michihiro Kita

Abstract:

The dense urban fabric of the 7th district of Budapest -known as the former Jewish Quarter-, contains mainly historical style, multi-story tenement houses with courtyards. The high population density and the unsatisfactory energetic state of the buildings result high energy consumption. As a preliminary survey of a complex rehabilitation plan, the authors aim to determine the energy demand of the area. The energy demand was calculated by analyzing the structure and the energy consumption of each building by using Geographic Information System (GIS) methods. The carbon dioxide emission was also calculated, to assess the potential of reducing the present state value by complex structural and energetic rehabilitation. As a main focus of the survey, an energy intensity map has been created about the area.

Keywords: CO₂, energy intensity map, geographic information system (GIS), Hungary, Jewish quarter, rehabilitation

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1606 Analysis of Tools for Revitalization and Rehabilitation of Brownfields

Authors: Jiří Kugl

Abstract:

Typology and specific opportunities of brownfield revitalization are already largely described. Challenges and opportunities that brownfields represent have been adequately studied and presented, as well as specific ways in which these areas can be used or how they are used abroad. In other words, the questions why (revitalize brownfields) and what (we should do with them) are satisfactorily answered, but the question how (we can work with them) is not. This work will focus on answering this question, which will deal with tools that enable the revitalization and rehabilitation projects in the area. Tools can be divided, for example in terms of spatial planning and urban design, from an environmental perspective, from the perspective of cultural heritage protection and from the perspective of investment opportunities. The result is that the issue of brownfields is handled by numerous institutions and instruments. The aim of this paper is to identify, classify and analyze these instruments. Paper will study instruments from other countries with long-term experience with this issue (eg. France, Great Britain, USA, Germany, Denmark, Czech Republic) and analyse their contribution and the feasibility of their implementation in other countries.

Keywords: brownfields, revitalization, rehabilitation, tools, urban planning

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1605 Rehabilitation Approach for Cancer Patients: Indication, Management and Outcome

Authors: Juliani Rianto, Emma Lumby, Tracey Smith

Abstract:

Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.

Keywords: cancer, exercises, benefit, mental health

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