Effect of Psycho-Educational Program on Psychological Distress and Post-Traumatic Stress Disorder among Stroke Survivors' Patients

Context: A stroke is a brain attack, and a major global health problem not merely affects a person physically but also emotionally. Psychosocial well-being is frequently threatened following a stroke. The improvement of the psychological status of stroke patients is essential to stroke management and recovery.Aim: The study aimed to evaluate the effect of the psychoeducational program on psychological distress and posttraumatic stress disorder among stroke survivors' patients. Methods: A quasi-experimental study design (one group pre/posttest) was utilized to achieve the aim of the study in the neurology department at Benha University Hospital at Benha City, Kaluobia Governorate. A convenient sample of 40 stroke survivor's patients was included in the study as a single study group. Three tools were utilized for data collection, structured interview questionnaire, Hospital Anxiety, and Depression Scale, and Post Traumatic Stress Disorder Scale. Results: Reveals that there was a highly statistically significant reduction in the severity of total anxiety and depression and also total posttraumatic stress disorder post-program implementation than before. Also, there was a highly statistically significant positive correlation between total posttraumatic stress, total anxiety, and total depression among studied patients pre and post-program implementation at p-value <0.001. Conclusion: Psycho-educational program had a positive effect on reducing psychological distress and posttraumatic stress disorder among stroke survivors' patients. The study recommended that psychological nursing intervention should be continuously integrated as a part of routine nursing care provided for stroke survivors' patients in the neurology and rehabilitation unit

Behavior of Hexagonal Concrete-Filled Double-Skin Steel Short Columns under the Effect of Axial Compression

Concrete-filled double skin tubular (CFDST) columns involve a tube-‌in-‌tube arrangement, where the steel sections can be round, square or rectangular hollow sections, with the annulus between the hollow sections filled with concrete. To date there have been no significant applications of hexagonal concrete-filled double skin tubular columns (HCFDST) with inner circular tubes worldwide, partly due to the lack of design provisions. This paper addresses the compressive performance of these columns. To obtain the structural behavior of HCFDST columns, a finite element analysis was conducted. To indicate the accuracy and the reliability of the model, the proposed FEM model was verified by the available experimental data for HCFDST. Columns were employed to conduct parametric studies, the effects of various parameters on the load-displacement response of HCFDST short columns are studied by using the validated FE model. A new formula to determine ultimate load for regular HCFDST short columns in compression has been proposed in this study

Paracetamol versus meperidine for relief of labour pain in primiparous women: a randomized controlled trial

Background: Most parturient women request analgesia, of which, there are two types; opioids and non-opioids. Opioids include morphine and meperidine, while non-opioids, which are milder forms of painkillers, include acetaminophen (paracetamol) and non-steroid anti-inflammatory drugs. The major concerns associated with opioids are the risk of neonatal respiratory depression, the cost and availability.Methods: The aim of this study was to compare the efficacy and safety of paracetamol versus meperidine for intra-partum pain relief. A total of 92 primiparous singleton term pregnant women were randomly allocated to receive intravenous paracetamol (1000 mg), or intramuscular meperidine (50 mg), at the beginning of the active phase of labor. The primary outcome was the labor pain perception, assessed using the visual analogue scale (VAS), at baseline, 15, 30, 60 and 120 minutes after administration of the drug.Results: Women of both groups showed significant reduction of the VAS after administration of the medication. There were no differences between both groups regarding the mode of delivery and the durations of the first or second stages of labor. However, meperidine was associated with higher rates of dizziness and nausea/vomiting. The 1-min Apgar scores were significantly lower in meperidine group. However, there were no differences in the 5-min Apgar score, need for neonatal resuscitation or neonatal respiratory distress.Conclusions: intravenous paracetamol as analgesia during labor is effective with no fetal or maternal adverse effects. Its use should have more chance for intrapartum pain relief. Additionally, it can be used as adjuvant with other types of analgesics

Association between Serum Adiponectin and Insulin Resistance in Children and Adolescents with Type 1 Diabetes: A Cross-Sectional, Single Center Study from Egypt

Objective: To determine the serum level of adiponectin and its relation to insulin resistance (IR) in children andadolescents with type 1 diabetes (T1D). Materials and methods: Over a 3-month period, 65 children diagnosed with T1D who were followed up at the Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU) at Cairo University Children’s Hospital. Demographics, clinical data, investigations, and management details were collected from the patient’s medical records and evaluated for the serum level of adiponectin. Results: Mean age of the study population was 12.6 ± 2 years. About 40% of participants had low serum adiponectin, with a mean value of 2.4 ± 3.6. Sixty-one (93.8%) of participants had dyslipidemia. The mean estimated glucose disposal rate (eGDR) was 6.9 ± 2.1. Multivariate linear regression was performed to adjust for possible confounders in correlation between serum adiponectin and eGDR; it wasn’t significant asp-value = 0.875. There was a statistically significant difference between patients with normal and low adiponectin regarding the age of diagnosis of diabetes, body mass index, the occurrence of microalbuminuria, and LDL level, with p-values of 0.04, 0.015, 0.022, and 0.011, respectively. Conclusions: There was also an association between lower adiponectin levels in children with type 1 diabetes and the occurrence of microalbuminuria and dyslipidemia. However, there is no reported association between its level and IR

Impact of Coronavirus Disease-19 Lockdown on Egyptian Children and Adolescents: Dietary Pattern Changes Health Risk

BACKGROUND: Lockdown and school closure related to the coronavirus disease 2019 (COVID-19) have unfavorable effects on children and adolescents. AIM: This study was conducted to survey the changes in dietary pattern and related health factors in Egyptian children and adolescents during the COVID-19 outbreak closure. MATERIALS AND METHODS: Data were collected through a dietary pattern, eating behavior, and physical activity electronic questionnaire conducted through social media sites, targeting parents of children and adolescents after two whole months of lockdown and school closure in Egypt. RESULTS: This study included 765 participants, 31.8% noted increased appetite, 45.6% reported increased sweets and unhealthy food consumption, and 37.6% showed increased frequent snacking between meals. Alongside 53.1% showed increase in late snacks during night after COVID-19 closure. The majority of our participants 82.0% noted associative change in eating behavior with boring and 94.6% revealed increased usage of electronics and screen time. This study showed significant positive correlation between increased appetite and mobile screen time, laptop screen time, and video gaming. Increased sweets and unhealthy food consumption was positively correlated with TV watching and mobile screen time. A significant positive correlation was revealed between uncaring about eating fruits and vegetables and increase screen time for each of mobile, and laptop and remote learning. Furthermore, there was positive correlation between decreased protein serving intake and each of mobile screen time and remote learning. TV watching and laptop screen times showed positively significantly association with frequent snacking between meals. Mobile screen time, TV screen time, and video gaming were positively significantly correlated with late night snacking. CONCLUSIONS: The present study concluded prolonged lockdown leads to changes in eating patterns, related to contributing factors of physical inactivity and prolonged screen time

Adaptive Fuzzy Supplementary Controller for SSR Damping in a Series-Compensated DFIG-Based Wind Farm

Although using a series compensation technique in a long transmission line effectively increases the transmittable power; it may cause a sub-synchronous resonance (SSR) phenomenon. Gate-controlled series capacitor (GCSC) is an effective method for SSR damping by controlling the turn-off angle. In the previous studies, a constant supplementary damping controller (SDC) was used for controlling the turn-off angle, which can mitigate the SSR phenomenon. However, these methods can not capture the maximum transmittable power at different operating points. In this paper, a fuzzy logic controller (FLC) is proposed to compute the gain of SDC based on the wind speed and the error between the measured and reference line currents for transferring as much power as possible and damping the SSR phenomenon simultaneously. Using the MATLAB/SIMULINK program, the proposed method is tested at different operating points to validate its effectiveness and robustness. Compared to the traditional method (constant SDC), the maximum transmittable power, as well as SSR damping, is achieved in all studied cases by the proposed method (variable SDC)

Statistical inference for the Nadarajah-Haghighi distribution based on ranked set sampling with applications

In this article, the maximum likelihood and Bayes inference methods are discussed for determining the two unknown parameters and specific lifetime parameters of the Nadarajah-Haghighi distribution, such as the survival and hazard rate functions, with the inclusion of ranked set sampling and simple random sampling. The estimated confidence intervals for the two parameters and any function of them are developed based on the Fisher-information matrix. Metropolis-Hastings algorithm and Lindley-approximation are used for generating the Bayes estimates and related highest posterior density credible ranges for the unknown parameters and reliability parameters under the presumption of conjugate gamma priors. A Monte-Carlo simulation study and a real-life data set have been used to assess the efficacy of the proposed methods

Protein Energy Wasting in a Sample of Egyptian Children on Regular Hemodialysis: Relation to Anorexigenic Hormones

BACKGROUND: Increased incidence of pediatric end-stage renal disease (ESRD) with associated serious consequences indicating a major public health problem. Malnutrition and uremic wasting are leading causes of growth impairment and increasing morbidity and mortality of pediatric ESRD patients, predominantly those on regular hemodialysis (HD). Ghrelin and obestatin, which are known appetite regulatory hormones, might have a pivotal role in uremic wasting and growth impairment in hemodialyzed children. AIM: The aim of the present study was to measure serum unacylated ghrelin (UAG) and obestatin and to investigate their roles in the growth impairment of Egyptian hemodialyzed children. SUBJECTS AND METHODS: The study included 50 hemodialyzed and 40 healthy children recruited from the Department of Nephrology, Pediatric Hospital, Ain Shams University. Full clinical examination and measurement of anthropometric indices were done. Routine labs were done as well, with an assessment of serum levels of obestatin, UAG, and insulin by enzyme linked immunosorbent assay. Furthermore, we determined fasting serum glucose and lipid profile with the calculation of homeostasis model assessment for insulin resistance (HOMA-IR). RESULTS: Anthropometric measurements were statistically significantly decreased in the hemodialyzed group than that of the control group (p < 0.05). Weight z-score was the most affected anthropometric parameter (37 patients = 74% with underweight and 13 patients = 26% with normal weight). The hemodialyzed children showed a significant increase of UAG, obestatin, insulin, glucose, HOMA-IR, and TG, while a significant decrease of HDL-cholesterol and albumin (p < 0.01). UAG had a negative correlation with Wt-z score, Ht z-score, fat mass %, albumin, and TG while obestatin was inversely correlated to Wt-z score, BMI z-score, waist circumference, and waist-height ratio (W/H). CONCLUSION: UAG and obestatin hormones were elevated in a group of Egyptian children on regular HD. These hormones were strongly related to the impairment of renal functions, and anthropometric parameters, dyslipidemia, hypoalbuminemia, and insulin resistance in these pediatric hemodialyzed patients

Microgrid energy management and monitoring systems: A comprehensive review

Microgrid (MG) technologies offer users attractive characteristics such as enhanced power quality, stability, sustainability, and environmentally friendly energy through a control and Energy Management System (EMS). Microgrids are enabled by integrating such distributed energy sources into the utility grid. The microgrid concept is proposed to create a self-contained system composed of distributed energy resources capable of operating in an isolated mode during grid disruptions. With the Internet of Things (IoT) daily technological advancements and updates, intelligent microgrids, the critical components of the future smart grid, are integrating an increasing number of IoT architectures and technologies for applications aimed at developing, controlling, monitoring, and protecting microgrids. Microgrids are composed of various distributed generators (DG), which may include renewable and non-renewable energy sources. As a result, a proper control strategy and monitoring system must guarantee that MG power is transferred efficiently to sensitive loads and the primary grid. This paper evaluates MG control strategies in detail and classifies them according to their level of protection, energy conversion, integration, benefits, and drawbacks. This paper also shows the role of the IoT and monitoring systems for energy management and data analysis in the microgrid. Additionally, this analysis highlights numerous elements, obstacles, and issues regarding the long-term development of MG control technologies in next-generation intelligent grid applications. This paper can be used as a reference for all new microgrid energy management and monitoring research

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London