A Multidisciplinary Approach to the Assessment and Management of Pre-school Age Neuro-developmental Disorders: A Local Experience
Published on: 8th January, 2017
OCLC Number/Unique Identifier: 7317600168
Background: Early and effective identification of childhood neurodevelopmental disorders remains a critical task of all pediatric healthcare professionals, which is critical to the well-being of children and their families.
Methods: A retrospective review of medical records of all preschool children referred to a Child Development Centre (CDC) in North-West England, over a six-month period between Sept 2014 and Feb 2015 was conducted. The local multi-professional approach to the clinical assessment and management of preschool children was described and the published literature on this topic was reviewed.
Results: Twenty four different categories of professionals spanning the whole range of primary, secondary, and tertiary healthcare, social care and educational services were involved in the management of the patients. The largest group of professionals was the primary healthcare specialists. The ten different primary care professionals managed an average of 42% of the patients.
The secondary healthcare providers were involved in the care of an average of 17%, tertiary care providers 10%, educational specialists 25% and social care professionals were involved with 5% of all the patients.
The commonest diagnostic disorders were Speech/Language delay (56%), Global developmental delay (33%), Behavior difficulties (26%), Social communication concerns (21%) and Autistic spectrum disorder (19%).
Conclusion: The high number and specialties of various healthcare professionals at all levels of care indicates the high social and economic investment required in managing the affected preschool children in the region. Childhood neurodevelopmental disorders in the preschool age represents a high level of public health significance.
The place of health innovation in space to improve the lives of earthlings
Published on: 27th August, 2019
OCLC Number/Unique Identifier: 8264378479
For over twenty years, following the creation of space stations, MIR first and then the ISS (International Space Station) men (3 to 6) live and succeed each other continuously about 300 - 400 km of altitude to make scientific experiments. For this reason sending men into space has become an activity “almost banal or regular “but this remains potentially a very dangerous environment for the adapted manon Earth and thus requires medical monitoring to ensure the health of astronauts and the persistence of their ability during their mission. In general, the medical benefits on Earth of space conquest go far beyond envy and the need for man to discover the cosmos but to develop many tools medicines to also offer solutions for all living beings on Earth!
Alps and climate
Published on: 15th April, 2020
OCLC Number/Unique Identifier: 8595218781
Pines have been discovered to die in the Alps. In any place of skiing, you can find dried pine trees from 2x to 20 meters high. In each zone of visibility of the forest mass of such pines, there are from 1 to 90%. I wonder if science deals with this issue
Dealing with Depression in Family Caregivers
Published on: 27th March, 2017
OCLC Number/Unique Identifier: 7317595274
Aims and objectives: By reporting the use of therapeutic nursing interventions to facilitate the process of change in a depressive elderly caregiver, this paper seeks to underline the importance of fitting interventions to individual clients.
Background: In assisting families of chronic illness sufferers, it must be remembered that the perceptions and functions of both clients and families are determined by family members, and that changes, if any, are made by those clients and families, rather than by nurses. However, nurses do play an important role in facilitating the process of change.
Design: This is a case report.
Methods: A case study of a depressive elderly caregiver is used to examine the use of therapeutic nursing interventions to facilitate the process of change with problem analysis, case conceptualisation and specific skills employed documented.
Results: The change from one therapeutic approach (Cognitive-behavioural therapy) to another (Narrative Therapy) facilitates enlisting the caregiver’s unique strengths, resources and competence to overcome the difficulties and challenges identified during the process of change. In dealing with depression in family caregivers, nurses should not only be flexible but also remain sceptical in using different approaches, with heightened awareness of the client’s circumstances.
Risk evaluation and modeling of soils contaminated with Polycyclic Aromatic Hydrocarbons (PAHs) in parts of Bonny Island, Niger Delta, Nigeria
Published on: 27th May, 2020
OCLC Number/Unique Identifier: 8609740211
Environmental impact of a recent oil spill incident in Bonny terminal using soil media was studied using a risk-based modeling approach. The establishment of the presence of contaminants of concern (CoC), evaluation/assessment, modeling spilled volume and ascertaining potential health risk associated with the spill incident was carried out. The Contaminant of Concern (CoC) included Total Petroleum Hydrocarbons (TPH) and Polycyclic Aromatic Hydrocarbons (PAHs). Soils and groundwater were sampled in the vicinity of the spill incident and further away into the surrounding communities. Soils were sampled into the depths (0.1 m, 0.5 m,1.0 m, 1.5 m), and the results of sieve analysis revealed that the area is predominantly silty sand in composition. This study also revealed that TPH concentration at all locations and depths exceeded DPR target value of 50 mg/kg. The TPH model revealed that a total volume of 222,500m3 of the spill area exceeded DPR intervention value of 5000 mg/kg. The results of PAH showed that only BS-1, BS-6, BS-8, BS-9 and BS-10 exceeded DPR target value of 1.0 mg/kg at some depths. All other sample depths and locations were within the target limit. The 3-D grid generated for PAH showed that 563,000m3 of the study area exceeded the DPR target value. The 3-D block models generated for TPH and PAH, along with the cross-sections and extracted time slices all showed that the concentration of the Contaminant of Concern (CoC) generally decreased with depth, and the centre of the spill located at the south-eastern part of the survey area. Based on these models, three spill zones were identified; Zone 1-highly contaminated areas (BS-8, BS-9, BS-10); Zone 2 - moderately contaminated areas (BS-1, BS-2, BS-6, BS-7); and low contaminated areas (BS-3, BS-4, BS-5). The entire soil in the area were contaminated with TPH and 47% of the area contaminated with PAH. This study has shown the effectiveness of the use of a model-based approach in quantifying hydrocarbon contamination volumes in the area. There is therefore the need for continuous monitoring of hydrocarbon spills in the area.
Caring Difficulties of Parents’ Towards Children with Cerebral Palsy
Published on: 16th May, 2017
OCLC Number/Unique Identifier: 7317593954
Children with cerebral palsy may have one or more of mental, psychomotor, visual, audio or speech problems. Not being a well-defined disease with clear boundaries, it is regarded as a set of conditions caused by various reasons. In this regard, children with CP have to depend on their families or caregivers and cope with physical, mental, social and economic problems due to their condition. Therefore, it turns out to be crucial to determine the needs of the family with children with CP so that the programs that will assist them during this process can be developed. The study further revealed that the parents of the children with cerebral palsy needed information about controlling their children’s behaviors and teaching them certain behaviors; they needed to talk to the teacher and/or therapist of the child; they needed support about making time for themselves; they needed community services about finding a care center or a nursery suitable for their children’s needs.
A Case-Study of the Anatomy of a Miscommunication: Why colleagues as patients develop complications?
Published on: 17th August, 2018
OCLC Number/Unique Identifier: 7844581704
This is an anatomy of a miscommunication, written by the patient, a medical school professor and his orthopaedic consultant, who was also a colleague leading to a series of misunderstandings. This raises the practical question of who is responsible for effective communication with the patient who is also a colleague. At the pre-operative assessment a combination of the diffidence of an inexperienced nurse and the patient’s wrong assumptions about his post-operative mobility and his keenness to maintain his independence and identity nearly led to a delayed discharge. The miscommunication was due to the patient’s assumptions about previous orthopaedic and recent cardiac surgery hospital experience. Neither he nor the nurse checked these assumptions and we speculate might this possibly account for why senior colleagues who become patients sometimes have unexpected complications. There are lessons to be learned from this frank exploration of the colleague patient’s experience of a miscommunication.
Impact of mineralformation on restoration of the soil structure in nakhchivan AR and geographical spreading legitimacy
Published on: 3rd June, 2020
OCLC Number/Unique Identifier: 8628623679
The silt fractions have a great impact in soil structural formation. If the soil forming rocks don’t disturb, crush and weather, the soil forming processes on them occur weakly, the organic substances cause formation of the loamy stratums without completely turning. This mostly influences the initial soil forming layers. The reproduction minerals in these soils cause initial minerals majority by occurring weakly. If these processes occur quickly then they cause a gradual increase of the reproduction minerals and reduction of the initial minerals.
The heights of the zones where the geographical spreading of such stratums is situated depend on levels.
Biodegradation of gold and platinum implants in rats studied by electron microscopy
Published on: 27th November, 2019
OCLC Number/Unique Identifier: 8452128684
Graphical abstract
Biodegradation of implanted gold in human tissue. TEM images reveal markedly biodegradation of implanted gold and re-crystallization of dissolved gold as nanoparticle of different size, shape and crystallinity. Highly crystalline icosahedral Au nanoparticle and the corresponding power spectrum are shown on top.
Background: Despite the importance of biodegradation for the durability of metal prosthesis and the widely use of gold implants, there exist a lack of knowledge regarding the stability of pure gold in tissue.
Methods: We studied biodegradation of grids of pure gold, nickel, and copper as well as middle ear prosthesis of gold, platinum or titanium. Metals were implanted into rat skin and humans. Dissolution and re-crystallization process of the metals was analysed using SEM, TEM, power spectra as well as elemental analysis by EDX and EELS/ESI.
Results: Biodegradation of gold was detected, presumably by solving and re-precipitation of gold around implants. Gold cluster, nanoparticles, and mesostructures were detected, formed by dissolution and re-crystallization process. This process results into a migration of gold into the farer off tissue. Cellular filaments as biomolecular templates facilitate the formation of mesostructures. Loss of function of middle ear prosthesis by biodegradation is caused by chronic inflammation and fibrosis. Indeed, similar processes were detected with platinum, but in a very lower level.
Conclusion: Noble metal implants undergo biodegradation in oxidative environment in tissue. The dissolution – recrystallization process can be explained by enzyme catalysed redox processes comprising reactive oxygen species and reduction agents as ascorbic acid present in cells and body tissue. Enymes like myeloperoxidase inside lysosomes of inflammatory cells produce hypochloride ions and H2O2 which can dissolve the gold.
General significance: The crucial role of the specific chemical environments of gold implants in tissue for their chemical stability and durability of function has been demonstrated. Due to widely use and importance of gold implants, this finding is of general interes.
Bio-moleculear thermal oscillator and constant heat current source
Published on: 4th December, 2019
OCLC Number/Unique Identifier: 8452126491
The demand for materials and devices that are capable of controlling heat flux has attracted many interests due to desire to attain new sources of energy and on-chip cooling. Excellent properties of DNA make it as an interesting nanomaterial in future technologies. In this paper, we aim to investigate the thermal flow through two sequence combinations of DNA, e.g, (AT)4 (CG)4 (AT)4 (CG)4 and (CG)8 (AT)8. Two interesting phenomena have been observed respectively. In the first configuration, an oscillatory thermal flux is observed. In this way, an oscillating heat flux from a stationary spatial thermal gradient is provided by varying the gate temperature. In the second configuration, the system behaves as a constant heat current source. The physical mechanism behind each phenomenon is identified. In the first case, it was shown that the transition between thermal positive conductance and negative differential conductance implies oscillatory heat current. In the latter, the discordance between the phonon bands of the two coupled sequences results in constant thermal flow despite of increasing in temperature gradient.
Efficacy of transcranial direct current stimulation and over-ground walking task on functional mobility and quality of life of stroke survivors
Published on: 3rd December, 2020
OCLC Number/Unique Identifier: 8873217355
Introduction: High proportion of stroke survivors have impaired functional mobility and decrease in overall quality of life (QoL). Transcranial direct current stimulation (tDCS) (non-invasive brain stimulation) and over-ground walking task (OGWT) (functional task-oriented training) have been suggested to improve functional mobility and QoL of stroke survivors. Hence, this study determined the efficacy of tDCS (anodal and cathodal) with OGWT on functional mobility and QoL of stroke survivors.
Materials and methods: Seventy eight (78) stroke survivors were randomised into three groups: anodal group (anodal tDCS with OGWT); cathodal group (cathodal tDCS with OGWT) and control group (OGWT only). Participants had two sessions of intervention per week for six weeks. Functional mobility was assessed using 10 meter walk test (10MWT) measuring steps, time and velocity while QoL was measured using Stroke Specific QoL (SSQoL) scale. Significance level was set at p < 0.05.
Results: Participants (46 males) were aged 56.78 ± 10.24 years. The groups were matched for functional mobility and QoL at baseline and only work/productivity domain of SSQoL showed statistically significant difference (p = 0.028). Each group showed statistically significant improvement between baseline and post-intervention scores of items in functional mobility (p ≤ 0.001) and total SSQoL (p ≤ 0.001). Anodal group showed better statistically significant improvement in step (p = 0.008), time (p = 0.024), velocity (p = 0.001) and total SSQoL (p = 0.016) among the groups when the mean differences were compared.
Conclusion: tDCS with OGWT is efficacious in improving functional mobility and QoL of stroke survivors. Specifically anodal tDCS with OGWT showed better clinical improvement in step, time, velocity and QoL in stroke survivors.
Knowledge, attitude, practice and associated factors towards nursing care documentation among nurses in West Gojjam Zone public hospitals, Amhara Ethiopia, 2018
Published on: 2nd April, 2019
OCLC Number/Unique Identifier: 8080746628
Background: In health care systems nursing care documentation is a vital and powerful tool that ensures continuity of care and communication between health personnel for better patient outcomes. Knowledge, attitude and practice of nurses’ towards nursing care documentation affect the quality and coordination of patients’ care. Hence, this study aimed to assess knowledge, attitude, practice and associated factors towards nursing care documentation among nurses in West Gojjam Zone public hospitals, Amhara Ethiopia.
Method: Institutional based cross sectional study was conducted among 246 nurses in West Gojjam Zone public hospitals from February to March 8, 2018. The study participants were selected by simple random sampling technique. Data were collected by using pre-tested and validated self-administered structured questionnaire with internal reliability of Cronbach’s Alpha values 0.912, 0.784 and 0.713 for knowledge, attitude and practice questions respectively. Epi data version 3.1 and SPSS version 20 was used for data entry and analysis respectively. Descriptive statistics and binary logistic regression model were used.
Result: The overall response rate was 97.56%. Among 240 respondents 54.6% of them had good knowledge, 50% of study participants had favorable attitude and 47.5% of study participants had good nursing care documentation practice. Sex and monthly salary were found to be statistically significant with knowledge of nurses. Work setting, work experiences and knowledge of nurses had significant association with nurses’ attitude towards nursing care documentation. Availability of operational standards, knowledge and attitude of nurses had significant association with nursing care documentation practice.
Conclusions and Recommendation: Results of this study showed that knowledge, attitude and practice of West Gojjam zone public hospital nurses on nursing care documentation were poor. Therefore; in order to solve this problem each hospital should recruit nurses until hospitals are saturated enough. It is recommended to avail nursing care documentation standards/guidelines in each hospital and to give training about it and also it is recommended to conduct multisite studies especially qualitative type to increase its quality.
Handwashing in healthcare today: Why haven’t we gotten better?
Published on: 25th April, 2019
OCLC Number/Unique Identifier: 8163900187
In 2010, a study identified that only about 40% of doctors and other health care providers comply with proper hand hygiene techniques in hospitals and other healthcare facilities. These statistics are alarming as healthcare professionals are the ones who set the gold standard for hygiene and sterility, but they continue to find it difficult to demonstrate this standard in every practice [1]. Even with The Joint Commission supporting that hand hygiene as the most critical intervention for preventing healthcare-associated infections (HCAIs), the compliance rate for hand hygiene has not drastically improved [2]. The goal of this article brief is to answer the question why hasn’t handwashing improved even with the evidence to support that proper hand hygiene decreases HCAIs?
Lower-body negative pressure/ergometer exercise in bed rest: Effects on female orthostatic tolerance
Published on: 21st October, 2020
OCLC Number/Unique Identifier: 8689024101
Introduction: Alternatively using gradient lower-body negative pressure (LBNP) and ergometer exercise (LBNP + ergo) under a flight schedule framework was explored to detect its orthostatic capacity maintenance effects in female subjects after 15 days of -6° head-down bed rest (HDBR).
Methods: Twenty-two female university students were divided into a control group (n = 8), an LBNP group (n = 7), and an LBNP + ergo group (n = 7). Ergometer exercise consisted of an interval exercise protocol with 2 min intervals alternating between 41% and 70% VO2max. Gradient LBNP was decompressed in 10 mm Hg intervals to -40 mmHg every 5 min. intermittent ergometer exercise and LBNP were alternatively performed. Tilt test was performed 2 days before HDBR (R-2), on the day of HDBR termination (R+1), and 5 days after HDBR (R+5).
Results: Fifty percent of the participants (11/22) did not pass the tilt test on R+1. The orthostatic tolerance time decreased from 20 to 16.1 ± 2.1 min in the control group, to 10.0 ± 2.7 min in the LBNP group (p = 0.01) and to 16.3 ± 2.0 min in the LBNP + ergo group. The HRs and BPs were at similar level among three groups during tilt test on different test days. Compared with the control group, the LBNP + ergo group had higher SV and CO percentage changes at R+1(p < 0.023) and R+5 (p < 0.00001) during the tilt test.
Conclusion: LBNP combined with ergometer exercises fails to prevent orthostatic intolerance but it induced some positive hemodynamic changes during tilt test after 15 days HDBR.
Knowledge and views about coordinated individual planning from the perspective of active older adults
Published on: 5th June, 2019
OCLC Number/Unique Identifier: 8165631605
Background: Today’s older adults are often well informed and want to participate in decision-making processes. The coordinated individual planning process offers them active involvement in deciding and owning how their care will be managed.
Aim: The aim of the study was to explore active older adults’ knowledge and views regarding coordinated individual planning.
Methods: The study has an exploratory inductive approach. Five focus-group discussions were conducted with 40 participants from different organizations and associations. A qualitative interpretive description framework was used, and the analysis resulted in four unique themes.
Results: The four themes resulting from the analysis are collaboration and continuity, participation and involvement in decision, individual need for support, and access to information and service. Collaboration between different levels of the healthcare system and between professionals is crucial. Older adults wanted to be participating actors in their healthcare. They worried about the lack of continuity and thought that services were not responsive or did not meet individuals’ needs.
Conclusion: Older adults want their views and preferences to be taken into consideration, and they want to be actively engaged in the decision-making process regarding their care.
Raw materials criticalities in material selection & design
Published on: 19th February, 2020
OCLC Number/Unique Identifier: 8554447253
Circular Economy, Sustainability, Design for Environment are some of the keywords that identify new formidable challenges to be faced in the next years. Raw materials have a dominant role in reaching that goal. Green energy, electric vehicles, communication, etc. depends on raw materials labeled as critical because of their economic importance coupled with high supply risk. For this reason, mitigating actions need to be used in materials selection and design such as material substitution, improved materials efficiency and recycling. In this technical communication, a method to implement raw materials criticality issues in materials selection is described according to the recent literature. The strategy is based on Ashby’s approach and the definition of the alloy criticality index quantifying the criticality per unit of mass of the material.
A quantum mechanical model for hole transport through DNA: predicting conditions for oscillatory/non-oscillatory behavior
Published on: 9th March, 2020
OCLC Number/Unique Identifier: 8558600875
A quantum mechanical model that considers tunneling and inelastic scattering has been applied to explain the hole transfer reaction from a G (Guanine) base to a GGG base cluster through a barrier of Adenine bases, (A)n (n = 1-16). For n = 1, the ratio of tunneling to inelastic scattering is about 6, which is sharply decreased to around 0.23 and 5.23 × 10-8 for n = 4 and 16 respectively, suggesting dominance of inelastic scattering for n ≥ 4. As in experiment, the calculated product yield ratios (PGGG) exhibit a strong distance dependence for n < 4, and a weak distance dependence for n ≥ 4. We also predict conditions under which oscillatory or non-oscillatory charge transfer (CT) yield are expected.
Comparison of muscle activation of 3 different hip belt squat techniques
Published on: 15th September, 2020
OCLC Number/Unique Identifier: 8669246407
The purpose of this study was to differentiate between muscular activity of three different types of belt squats (SquatMax-MD, Pit Shark and Monster Rhino) and the muscle activation of the rectus femoris, vastus medialis oblique, gluteus maximus, and gluteus medius. Fourteen healthy, male athletes, over the age of 18 years, performed 2 sets of 5 repetitions on each of the three belt squat machines with a weight equivalent to each participant’s body weight. Athletes were given at least 2 minutes of rest between each set and condition. Electromyographic data were collected from four muscles: rectus femoris, vastus medialis oblique, gluteus maximus, and gluteus medius muscles. ANOVA revealed the SquatMax-MD belt squat resulted in the highest muscle activation in every muscle, with significantly higher activity in the rectus femoris, vastus medialis oblique, and gluteus medius muscles. The Monster Rhino belt squat produced the second highest muscle activation with the Pit Shark belt squat creating the lowest muscle activation. In totality, the SquatMax-MD produced 38.7% greater muscle activation than the Monster Rhino and 12.2% greater activation than the Pit Shark. The belt squat can be an advantageous exercise because it can effectively load the lower body while de-loading the spine and upper body. The difference in activation between the SquatMax-MD and other belt squats may be due, in part, to the design of the machines. The additional activation produced by the SquatMax-MD belt squat may be useful for individuals seeking hypertrophy, strength, or a reduction in injury risk.
The effects of a clinical ladder program on professional development and job satisfaction of acute care nurses
Published on: 26th July, 2019
OCLC Number/Unique Identifier: 8207891872
Nurses play a vital role in acute care hospitals and health care delivery. The purpose of this research study is to identify the nurse’s perception of the Clinical Ladder Program at their hospital and the correlation it has on the nurse’s job satisfaction and their professional development. A quantitative study will be conducted using two convenience samples from Alexian Brothers Hospital and Saint Anthony’s hospital with a total of 52 nurses who are currently participating in the clinical ladder program.
Detection limit of a lutetium based non-paralizable PET-like detector
Published on: 16th April, 2020
OCLC Number/Unique Identifier: 8586063433
The effect of the intrinsic lutetium radioactivity on the detection performances of a LYSO based in-beam PET-like prototype used for quality control of hadrontherapy treatments is studied. This radioactivity leads to a background that degrades the measurement of the β+ signal. In particular, it prevents the measurement of faint signals originating from low activity β+ sources. This paper presents a method to estimate the minimum β+ activity that can be measured for any acquisition time taking into account the non-extensible dead time of the detector. This method is illustrated with experimental data collected with the in-beam PET-like prototype. The results presented in this paper are therefore specific to this detector. The method can however be applied in other contexts, either to other lutetium based PET detectors or even to non-PET detectors affected by lutetium radioactivity. The dead time correction formalism can also be used generally to scale signal and background yields in any non-paralizable detector, even those in which the background is not due to the presence of intrinsic radioactivity.
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