Search results for: Clinical Practice Guideline
7315 E-Learning Network Support Services: A Comparative Case Study of Australian and United States Universities
Authors: Sayed Hadi Sadeghi
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This research study examines the current state of support services for e-network practice in an Australian and an American university. It identifies information that will be of assistance to Australian and American universities to improve their existing online programs. The study investigated the two universities using a quantitative methodological approach. Participants were students, lecturers and admins of universities engaged with online courses and learning management systems. The support services for e-network practice variables, namely academic support services, administrative support and technical support, were investigated for e-practice. Evaluations of e-network support service and its sub factors were above average and excellent in both countries, although the American admins and lecturers tended to evaluate this factor higher than others did. Support practice was evaluated higher by all participants of an American university than by Australians. One explanation for the results may be that most suppliers of the Australian university e-learning system were from eastern Asian cultural backgrounds with a western networking support perspective about e-learning.Keywords: support services, e-Network practice, Australian universities, United States universities
Procedia PDF Downloads 1607314 Unpacking the Summarising Event in Trauma Emergencies: The Case of Pre-briefings
Authors: Professor Jo Angouri, Polina Mesinioti, Chris Turner
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In order for a group of ad-hoc professional to perform as a team, a shared understanding of the problem at hand and an agreed action plan are necessary components. This is particularly significant in complex, time sensitive professional settings such as in trauma emergencies. In this context, team briefings prior to the patient arrival (pre-briefings) constitute a critical event for the performance of the team; they provide the necessary space for co-constructing a shared understanding of the situation through summarising information available to the team: yet the act of summarising is widely assumed in medical practice but not systematically researched. In the vast teamwork literature, terms such as ‘shared mental model’, ‘mental space’ and ‘cognate labelling’ are used extensively, and loosely, to denote the outcome of the summarising process, but how exactly this is done interactionally remains under researched. This paper reports on the forms and functions of pre-briefings in a major trauma centre in the UK. Taking an interactional approach, we draw on 30 simulated and real-life trauma emergencies (15 from each dataset) and zoom in on the use of pre-briefings, which we consider focal points in the management of trauma emergencies. We show how ad hoc teams negotiate sharedness of future orientation through summarising, synthesising information, and establishing common understanding of the situation. We illustrate the role, characteristics, and structure of pre-briefing sequences that have been evaluated as ‘efficient’ in our data and the impact (in)effective pre-briefings have on teamwork. Our work shows that the key roles in the event own the act of summarising and we problematise the implications for leadership in trauma emergencies. We close the paper with a model for pre-briefing and provide recommendations for clinical practice, arguing that effective pre-briefing practice is teachable.Keywords: summarising, medical emergencies, interaction analysis, shared/mental models
Procedia PDF Downloads 867313 Development a Fine Motor and Executive Function Assessment (FiM&EF) for Assessing School Aged Children with Attention Deficit/Hyperactivity Disorder (AD/HD)
Authors: Negar Miri-Lavasani
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Background: Children with Attention-deficit/hyperactivity disorder (ADHD) show fine motor skills difficulties, and it is controversial whether this difficulty is based on problems in their fine motor skills or their executive function impairments. Objectives of Study: The Fine Motor and Executive Function assessment tool (FiM&EF) was developed to answer the question, ‘Do the fine motor skill deficits in children with ADHD come from their fine motor problems or is it caused by their executive function problems?’. This paper describes the development of a new assessment of Fine Motor and Executive Function (FiM &EF) needed by primary school students with ADHD aged 6-12 years with ADHD. Methods: A study on the content validity established through a survey of a panel of nine experts is explained in detail. Findings: Most the experts agreed such an assessment was needed and two items were deleted as a result of experts’ feedback. Relevance to Clinical Practice: Distinguishing the main reason of fine motor problem in these children could help the clinician for their therapy plans. Knowledge on the influence of executive functioning on fine motor ability in selected age children with ADHD would provide a clearer clinical picture of the fine motor capabilities and executive function for these children.Keywords: children with ADHD, executive function, fine motor, test
Procedia PDF Downloads 2857312 Awareness regarding Radiation Protection among the Technicians Practicing in Bharatpur, Chitwan, Nepal
Authors: Jayanti Gyawali, Deepak Adhikari, Mukesh Mallik, Sanjay Sah
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Radiation is defined as an emission or transmission of energy in form of waves or particles through space or material medium. The major imaging tools used in diagnostic radiology is based on the use of ionizing radiation. A cross-sectional study was carried out during July- August, 2015 among technicians in 15 different hospitals of Bharatpur, Chitwan, Nepal to assess awareness regarding radiation protection and their current practice. The researcher was directly engaged for data collection using self-administered semi-structured questionnaire. The findings of the study are presented in socio-demographic characteristics of respondents, current practice of respondents and knowledge regarding radiation protection. The result of this study demonstrated that despite the importance of radiation and its consequent hazards, the level of knowledge among technicians is only 60.23% and their current practice is 76.84%. The difference in the mean score of knowledge and practice might have resulted due to technicians’s regular work and lack of updates. The study also revealed that there is no significant (p>0.05) difference in knowledge level of technicians practicing in different hospitals. But the mean difference in practice scores of different hospital is significant (p<0.05) i.e. i.e. the cancer hospital with large volumes of regular radiological cases and radiation therapies for cancer treatment has better practice in comparison to other hospitals. The deficiency in knowledge of technicians might alter the expected benefits, compared to the risk involved, and can cause erroneous medical diagnosis and radiation hazard. Therefore, this study emphasizes the need for all technicians to update themselves with the appropriate knowledge and current practice about ionizing and non-ionizing radiation.Keywords: technicians, knowledge, Nepal, radiation
Procedia PDF Downloads 3197311 The Art and Science of Trauma-Informed Psychotherapy: Guidelines for Inter-Disciplinary Clinicians
Authors: Daphne Alroy-Thiberge
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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care
Procedia PDF Downloads 967310 Qualitative Analysis of Current Child Custody Evaluation Practices
Authors: Carolyn J. Ortega, Stephen E. Berger
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The role of the custody evaluator is perhaps one of the most controversial and risky endeavors in clinical practice. Complaints filed with licensing boards regarding a child-custody evaluation constitute the second most common reason for such an event. Although the evaluator is expected to answer for the family-law court what is in the “best interest of the child,” there is a lack of clarity on how to establish this in any empirically validated manner. Hence, practitioners must contend with a nebulous framework in formulating their methodological procedures that inherently places them at risk in an already litigious context. This study sought to qualitatively investigate patterns of practice among doctoral practitioners conducting child custody evaluations in the area of Southern California. Ten psychologists were interviewed who devoted between 25 and 100% of their California private practice to custody work. All held Ph.D. degrees with a range of eight to 36 years of experience in custody work. Semi-structured interviews were used to investigate assessment practices, ensure adherence to guidelines, risk management, and qualities of evaluators. Forty-three Specific Themes were identified using Interpretive Phenomenological Analysis (IPA). Seven Higher Order Themes clustered on salient factors such as use of Ethics, Law, Guidelines; Parent Variables; Child Variables; Psychologist Variables; Testing; Literature; and Trends. Evaluators were aware of the ever-present reality of a licensure complaint and thus presented idiosyncratic descriptions of risk management considerations. Ambiguity about quantifying and validly tapping parenting abilities was also reviewed. Findings from this study suggested a high reliance on unstructured and observational methods in child custody practices.Keywords: forensic psychology, psychological testing, assessment methodology, child custody
Procedia PDF Downloads 2797309 The Clinical Manifestations of Myocardial Bridging in Patients with Coronary Artery Disease
Authors: Alexey Yu. Martynov, Sulejman Bayramov
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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina
Procedia PDF Downloads 1187308 Alpha Lipoic Acid: An Antioxidant for Infertility
Authors: Chiara Di Tucci, Giulia Galati, Giulia Mattei, Valentina Bonanni, Oriana Capri, Renzo D'Amelio, Ludovico Muzii, Pierluigi Benedetti Panici
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Objective: Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. Methods: We performed a search from English literature using the PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies, and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After the primary and secondary screening, 28 articles were selected. Results: The available literature demonstrates the positive effects of ALA in multiple processes, from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men has been shown to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01), and improve sperm quality (p < .001). Conclusions: ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.Keywords: alpha lipoic acid, endometriosis, infertility, male factor, polycystic ovary syndrome
Procedia PDF Downloads 787307 Inter-Departmental Survey to Check the Impact of Bio-Safety Training Sessions among Lab Employees
Authors: Noorulaine Maqsood, Saeed Khan
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Background: Concern regarding incident reporting and bio-safety training in clinical laboratories in Pakistan has increased remarkably in the last few years due to rapid increase in diagnosis and research on infectious organisms. In order to ensure the safety of employees, this issue needs to be addressed immediately. Bio-safety training sessions and lectures are necessary for the protection of laboratory workers in order to ensure safe practices and minimize the count of incident reporting in the lab. Objective: To carry out an inter-departmental survey in lab regarding the awareness of bio-safety practices among lab employees before and after conducting bio-safety training sessions. Methodology: We conducted a 30 questions survey of laboratory workers in June 2013 (before training session) to gather information related to bio-safety awareness. Afterwards, we conducted another survey after training sessions and workshops related to bio-safety. Result: The survey regarding bio-safety level showed that before the training session 32% of the participants were aware of bio-safety level being used in their lab whereas after the session this percentage increased to 72%. 48% of the participants had information about the proper usage of PPE which increased to 76%. Awareness regarding proper management of hazardous waste increased from 32% to 64%. The incident reporting practice, sample handling and hand hygiene awareness was previously reported to be 40%, 65%, and 52% that increased to 80%, 85% and 88% respectively after the training session was completed. Conclusion: The first survey results showed lack of awareness that suggest nearly all senior scientists, faculty, medical technologist, lab attendant and housekeeping staff working in laboratories are required to have bio-safety training, and required inspection at least twice a year by a bio-safety officer and also required to renew their bio-safety training. After the training session, significant changes in awareness level and attitude of the participants regarding biosafety practices were observed. Therefore, such bio-safety sessions should be carried out regularly in clinical laboratories.Keywords: biosafety practices, clinical laboratory, Pakistan, survey
Procedia PDF Downloads 4237306 Scenario-Based Learning Using Virtual Optometrist Applications
Authors: J. S. M. Yang, G. E. T. Chua
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Diploma in Optometry (OPT) course is a three-year program offered by Ngee Ann Polytechnic (NP) to train students to provide primary eye care. Students are equipped with foundational conceptual knowledge and practical skills in the first three semesters before clinical modules in fourth to six semesters. In the clinical modules, students typically have difficulties in integrating the acquired knowledge and skills from the past semesters to perform general eye examinations on public patients at NP Optometry Centre (NPOC). To help the students overcome the challenge, a web-based game Virtual Optometrist (VO) was developed to help students apply their skills and knowledge through scenario-based learning. It consisted of two interfaces, Optical Practice Counter (OPC) and Optometric Consultation Room (OCR), to provide two simulated settings for authentic learning experiences. In OPC, students would recommend and provide appropriate frame and lens selection based on virtual patient’s case history. In OCR, students would diagnose and manage virtual patients with common ocular conditions. Simulated scenarios provided real-world clinical situations that required contextual application of integrated knowledge from relevant modules. The stages in OPC and OCR are of increasing complexity to align to expected students’ clinical competency as they progress to more senior semesters. This prevented gameplay fatigue as VO was used over the semesters to achieve different learning outcomes. Numerous feedback opportunities were provided to students based on their decisions to allow individualized learning to take place. The game-based learning element in VO was achieved through the scoreboard and leader board to enhance students' motivation to perform. Scores were based on the speed and accuracy of students’ responses to the questions posed in the simulated scenarios, preparing the students to perform accurately and effectively under time pressure in a realistic optometric environment. Learning analytics was generated in VO’s backend office based on students’ responses, offering real-time data on distinctive and observable learners’ behavior to monitor students’ engagement and learning progress. The backend office allowed versatility to add, edit, and delete scenarios for different intended learning outcomes. Likert Scale was used to measure students’ learning experience with VO for OPT Year 2 and 3 students. The survey results highlighted the learning benefits of implementing VO in the different modules, such as enhancing recall and reinforcement of clinical knowledge for contextual application to develop higher-order thinking skills, increasing efficiency in clinical decision-making, facilitating learning through immediate feedback and second attempts, providing exposure to common and significant ocular conditions, and training effective communication skills. The results showed that VO has been useful in reinforcing optometry students’ learning and supporting the development of higher-order thinking, increasing efficiency in clinical decision-making, and allowing students to learn from their mistakes with immediate feedback and second attempts. VO also exposed the students to diverse ocular conditions through simulated real-world clinical scenarios, which may otherwise not be encountered in NPOC, and promoted effective communication skills.Keywords: authentic learning, game-based learning, scenario-based learning, simulated clinical scenarios
Procedia PDF Downloads 1127305 Computational Modeling of Thermal Comfort and CO2 Distribution in Common Room-Lecture Room by Using Hybrid Air Ventilation System, Thermoelectric-PV-Silica Gel under IAQ Standard
Authors: Jirod Chaisan, Somchai Maneewan, Chantana Punlek, Ninnart Rachapradit, Surapong Chirarattananon, Pattana Rakkwamsuk
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In this paper, simulation modeling of heat transfer, air flow and distribution emitted from CO2 was performed in a regenerated air. The study room was divided in 3 types: common room, small lecture room and large lecture room under evaluated condition in two case: released and unreleased CO2 including of used hybrid air ventilation system for regenerated air under Thailand climate conditions. The carbon dioxide was located on the center of the room and released rate approximately 900-1200 ppm corresponded with indoor air quality standard (IAQs). The indoor air in the thermal comfort zone was calculated and simulated with the numerical method that using real data from the handbook guideline. The results of the study showed that in the case of hybrid air ventilation system explained thermal and CO2 distribution due to the system was adapted significantly in the comfort zone. The results showed that when CO2 released on the center of the other room, the CO2 high concentration in comfort zone so used hybrid air ventilation that decreased CO2 with regeneration air including of reduced temperature indoor. However, the study is simulation modeling and guideline only so the future should be the experiment of hybrid air ventilation system for evaluated comparison of the systems.Keywords: air ventilation, indoor air quality, thermal comfort, thermoelectric, photovoltaic, dehumidify
Procedia PDF Downloads 4797304 Efficacy of Nasya in Alcohol Withdrawal Syndrome
Authors: Sandip Tambare, Revati Ghadge
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Alcohol withdrawal syndrome continue to be concerning health issue worldwide in alcoholics. Many current option for treating alcohol withdrawal signs are habit forming causing dependency of sedatives. The divine science of Ayurveda recommends Nasya for improvement of alcohol withdrawal signs. As per the latest reports 1/3 of the Indian population is using alcohol in an unhealthy manner, the complication being wide and varied among which, the Alcohol Withdrawal Syndrome is the dominant one. The presentation varies from mild sleep loss or anxiety to delirium. Ayurveda has given utmost in the context of Madatyaya(Alcoholism). Various protocols based on the identification of the status of tridoshas are explained which includes sodhana, samana and satwavachaya chikitsa. Various medications are being used, with appreciated effects in the clinical practice. As per reports, the panchakarma procedure nasya seems highly effective, in managing of the alcohol withdrawal syndrome. Nasya with Ksheerabala Taila is given for 7 days in the condition of Alcohol Withdrawal syndrome and it was the non Randomized trial with 30 subjects satisfying the DSM V criteria for alcohol withdrawl and the assessment was done using the Clinical Institute Withdrawal Assessment for Alcohol Scale revised (CIWA-Ar). Conclusion: Among the symptoms which were studied after the interventions, it was found that there was high significant response in almost all the symptoms in the given subjects. The eternal science of Ayurveda is able to answer the existing problem of alcohol and its abuse in the society.Keywords: nasya, alcohol withdrawal, madatyaya, ksheerabala taila
Procedia PDF Downloads 1337303 Clinical Staff Perceptions of the Quality of End-of-Life Care in an Acute Private Hospital: A Mixed Methods Design
Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray
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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.
Procedia PDF Downloads 1437302 A Review of Methods for Handling Missing Data in the Formof Dropouts in Longitudinal Clinical Trials
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Much clinical trials data-based research are characterized by the unavoidable problem of dropout as a result of missing or erroneous values. This paper aims to review some of the various techniques to address the dropout problems in longitudinal clinical trials. The fundamental concepts of the patterns and mechanisms of dropout are discussed. This study presents five general techniques for handling dropout: (1) Deletion methods; (2) Imputation-based methods; (3) Data augmentation methods; (4) Likelihood-based methods; and (5) MNAR-based methods. Under each technique, several methods that are commonly used to deal with dropout are presented, including a review of the existing literature in which we examine the effectiveness of these methods in the analysis of incomplete data. Two application examples are presented to study the potential strengths or weaknesses of some of the methods under certain dropout mechanisms as well as to assess the sensitivity of the modelling assumptions.Keywords: incomplete longitudinal clinical trials, missing at random (MAR), imputation, weighting methods, sensitivity analysis
Procedia PDF Downloads 4087301 A Saudi Woman with Tokophobia: A Case Report
Authors: Wid Kattan, Rahaf Albarraq
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Background: Tokophobia is a pathological fear of pregnancy that can lead to the avoidance of childbirth. It is classified as primary or secondary. This report describes a patient with tokophobia, as well as her presentation, risk factors, comorbidities, and treatment. Case Presentation: A 43-year-old Saudi woman experienced tokophobia upon becoming pregnant for the fifth time. She was assessed in two clinical interviews by a consultant psychiatrist specializing in women’s mental health. In addition, she completed several questionnaires for assessment of different aspects of her mental health: overall depression, perinatal depression, generalized anxiety, maternal functioning, and fear of childbirth (FOC). Several risk factors and comorbidities that may have contributed to the development of tokophobia in this patient were discussed, including traumatic experiences in previous deliveries, the unplanned nature of the pregnancy, perinatal depression, and pronounced symptoms of anxiety. A collaborative decision to perform a C-section was made, in line with obstetric guidelines and good mental health practice. Full symptomatic recovery was achieved immediately after delivery. Conclusions: We hope to increase clinical awareness of the assessment and management of tokophobia, which is a relatively new concept and, as yet, understudied.Keywords: tokophobia, fear of childbirth, mental health, anxiety, case report, depression, fear of delivery, psychiatry, cesarean section, perinatal depression
Procedia PDF Downloads 1397300 Proposing Problem-Based Learning as an Effective Pedagogical Technique for Social Work Education
Authors: Christine K. Fulmer
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Social work education is competency based in nature. There is an expectation that graduates of social work programs throughout the world are to be prepared to practice at a level of competence, which is beneficial to both the well-being of individuals and community. Experiential learning is one way to prepare students for competent practice. The use of Problem-Based Learning (PBL) is a form experiential education that has been successful in a number of disciplines to bridge the gap between the theoretical concepts in the classroom to the real world. PBL aligns with the constructivist theoretical approach to learning, which emphasizes the integration of new knowledge with the beliefs students already hold. In addition, the basic tenants of PBL correspond well with the practice behaviors associated with social work practice including multi-disciplinary collaboration and critical thinking. This paper makes an argument for utilizing PBL in social work education.Keywords: social work education, problem-based learning, pedagogy, experiential learning, constructivist theoretical approach
Procedia PDF Downloads 3017299 Effect of Reflective Practices on the Performance of Prospective Teachers
Authors: Madiha Zahid, Afifa Khanam
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The present study aims to investigate the effect of reflective teaching practices on prospective teachers’ performance. Reflective teaching practice helps teachers to plan, implement and improve their performance by rethinking about their strengths and weaknesses. An action research was conducted by the researcher. All prospective teachers of sixth semester in a women university’s teacher education program were the population of the study. From 40 students, 20 students were taken as experimental group, and the rest of 20 students were taken as control group. During the action research a cyclic process of producing a module, training teachers for the reflective practices and then observing them during their class for reflective practice was done by the researchers. The research used a set of rubrics and checklists for assessing prospective teachers’ performance during their class. Finally, the module was modified with the help of findings. It was found that the training has improved the performance of teachers as they revised and modified their teaching strategies through reflective practice. However, they were not able to train their students for reflective practice as per expectation. The study has implications for teacher training programs to include reflective practice modules as part of their course work for making them better teachers.Keywords: reflective practices, prospective teacher, effect, performance
Procedia PDF Downloads 1727298 A Phenomenological Method Based on Professional Descriptions of Community-of-Practice Members to Scientifically Determine the Level of Child Psycho-Social-Emotional Development
Authors: Gianni Jacucci
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Alfred Schutz (1932), at the very turning towards phenomenology, of the attention for the social sciences, stated that successful communication of meanings requires the sharing of “sedimenta-tions “ of previous meanings. Börje Langefors (1966), at the very beginning of the social studies of information systems, stated that a common professional basis is required for a correct sharing of meanings, e. g., “standardised accounting data among accountants”. Harold Garfinkel (1967), at the very beginning of ethnomethodology, stated that the accounting of social events must be carried out in the same language used by the actors of those events in managing their practice. Community of practice: we advocate professional descriptions of the community of practice members to scientifically determine the level of child psycho social emotional development. Our approach consists of an application to Human Sciences of Husserl’s Phenomenological Philosophy using a method reminder of Giorgi’s DPM in Psychology. Husserl’s requirement of "Epoché," which involves eliminating prejudices from the minds of observers, is met through "concept cleaning," achieved by consistently sharing disciplinary concepts within their community of practice. Mean-while, the absence of subjective bias is ensured by the meticulous attention to detail in their professional expertise. Our approach shows promise in accurately assessing many other properties through detailed professional descriptions of the community of practice members.Keywords: scientific rigour, descriptive phenomenological method, sedimentation of meanings, community of practice
Procedia PDF Downloads 357297 Liberation as a Method for Monument Valorisation: The Case of the Defence Heritage Restoration
Authors: Donatella R. Fiorino, Marzia Loddo
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The practice of freeing monuments from subsequent additions crosses the entire history of conservation and it is traditionally connected to the aim of valorisation, both for cultural and educational purpose and recently even for touristic exploitation. Defence heritage has been widely interested by these cultural and technical moods from philological restoration to critic innovations. A renovated critical analysis of Italian episodes and in particular the Sardinian case of the area of San Pancrazio in Cagliari, constitute an important lesson about the limits of this practice and the uncertainty in terms of results, towards the definition of a sustainable good practice in the restoration of military architectures.Keywords: defensive architecture, liberation, Valorisation for tourism, historical restoration
Procedia PDF Downloads 3377296 Glioblastoma: Prognostic Value of Clinical, Histopathological and Immunohistochemical (p53, EGFR, VEGF, MDM2, Ki67) Parameters
Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi
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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67
Procedia PDF Downloads 2827295 Integrating Practice-Based Learning in Accounting Education: Bolstering Students Engagement and Learning
Authors: Humayun Murshed, Shibly Abdullah
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This paper focuses on sharing experience gained through a pilot project undertaken to teach an introductory accounting subject linking real-life ground realities with the fundamental concepts of accounting. In view of the practical dimensions of Accounting it has been observed that adopting a teaching approach based on practical illustrations help students to motivate and generate interests to take accounting profession as their career. The paper reports that students’ perception about accounting as ‘dreary’ has been changed to ‘interesting’ due to adoption of practice based approach in teaching. The authors argue that ‘concept mapping’ can play a vital role in facilitating practice based education in accounting which promotes a rewarding learning experience among the students. The paper considers taking into account generic skills development, student centric learning, development of innovative assessment tasks, making students aware of the potential benefits of practice based education primarily through concept mapping, and engaging them both inside and outside of the class rooms are critical for ensuring success of this approach.Keywords: accounting education, pedagogy, practice-based education, concept mapping
Procedia PDF Downloads 3407294 Empowering Persons with Disabilities in Indonesia: Translating the Disability Law into Practice
Authors: Marthella Rivera Roidatua
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Since the release of Convention on the Rights of Persons with Disabilities in 2006, disability became a mainstreamed global issue. Many developed countries have shown the continuous effort to improve their disability employment policy, for example, the US and the UK with their integrated support system through disability benefits. Relative little recent research on developing country is available. Surprisingly, Indonesia, just enacted the Law No.8/2016 on Disability that bravely highlighted on integrating disabled people into the workforce. It shows a positive progress shifting traditional perspective to what Tom Shakespeare’s concept of a social model of disability. But, the main question is how can this law support the disabled people to access and maintain paid work. Thus, besides the earlier literature reviews, interviews with leading sectors, Ministry of Social Affairs and Ministry of Manpower, was conducted to examine government’s attitude towards the disabled worker. Insights from two local social enterprises on disability were also engaged in building better perspective. The various source of data was triangulated then analysed with a thematic approach. Results were encouraging the Indonesian government to have a better collaboration with other impactful local organisations in promoting the disability employment. In the end, this paper also recommends the government to make a reasonable adjustment and practical guideline for companies in hiring disabled.Keywords: disability, employment, policy, Indonesia, collaboration, guidelines
Procedia PDF Downloads 2387293 Resilient Environments vs. Resilient Architects: Creativity, Practice and Education
Authors: Y. Perera, M. Pathiraja
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Within the paradigm of 'Resilient Built-environments,' in order for architecture to be resilient, 'Resilience' should be identified as an essential component of the architect’s notion of creativity. In much simpler terms, 'Resilient Built-Environment' should necessarily be a by-product of the 'Resilient Architect.' The inherent influence of individualistic notions of creativity upon the practice had intensified the dichotomy between theory and practice unless the notion of 'Resilience' is identified as an integral component of the architect’s notion of creativity. Analysing the architectural position is an ideal way of understanding the architect’s notion of creativity, therefore, in exploring the notion of 'Resilience' and the 'Resilient Architect' within the Sri Lankan platform, the architectural positions of two renowned architects; Geoffrey Bawa and Valentine Gunasekara were explored and analysed. The architectural positions of both the architects asserted specific rules and methodologies adopted within the process of problem solving that had subsequently led to a traceable language / pattern within their architecture. The dominance of such rules within the practice could be detrimental to adaptation of theories / notions, such as 'Resilience' and the formation of the 'Resilient Architect', unless methodologies itself are flexible, robust, despite rigidity, or else the notion of 'Resilience' exist in the form of a methodological rule.Keywords: architectural position, creativity, education, practice, resilience, theory
Procedia PDF Downloads 3107292 Management Tools for Assessment of Adverse Reactions Caused by Contrast Media at the Hospital
Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya
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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media
Procedia PDF Downloads 2947291 Effect of Implementing a Teaching Module about Diet and Exercises on Clinical Outcomes of Patients with Gout
Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed
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The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.Keywords: clinical outcomes, diet, exercises, teaching module
Procedia PDF Downloads 3447290 Characteristics of Patients Undergoing Subclavian Artery Revascularization in Latvia: A Retrospective Analysis
Authors: Majid Shahbazi
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Subclavian artery stenosis (SAS) is a common vascular disease that can cause a range of symptoms, from arm fatigue and weakness to ischemic stroke. Revascularization procedures, such as percutaneous transluminal angioplasty and stenting, are widely used to treat SAS and improve blood flow to the affected arm. However, the optimal management of patients with SAS is still unclear, and further research is needed to evaluate the safety and efficacy of different treatment options. This study aims to investigate the characteristics of patients with SAS who underwent revascularization procedures in Latvia (Specifically RAKUS). The research part of this paper aims to describe and analyze the demographics, comorbidities, diagnostic methods, types of revascularization procedures, and antiaggregant therapy used. The goal of this study is to provide insights into the current clinical practice in Latvia and help future treatment decision-makers. To achieve this aim, a retrospective study of 76 patients with SAS who underwent revascularization procedures was performed. After statistical analysis of the data, the study provided insights into the characteristics and management of patients with SAS in Latvia, highlighting the most observed comorbidities in these patients, the preferred diagnostic methods, and the most performed procedures. These findings can inform clinical decision-making and may have implications for the management of patients with subclavian artery stenosis in Latvia.Keywords: subclavian artery stenosis, revascularization, characteristics of patients, comorbidities, retrospective analysis
Procedia PDF Downloads 907289 Nurses’ Views on ‘Effective Nurse Leader’ Characteristics in Iraq
Authors: S. Abed, S. O’Neill
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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.Keywords: health care, nurse education, nursing in Iraq, nurse leadership
Procedia PDF Downloads 2687288 Articulations of Teacher Quality Discourse through Practice Teaching
Authors: Marlon B. Espedillon
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This qualitative study examines practice teaching as an important component of teacher education and its entanglement with the teacher quality discourse. How the key actors -student teachers, supervising instructors, cooperating teachers, and school principals- construe teacher quality is essential in understanding how the student teachers articulate their voices and challenge the cultural myths in teacher education. The ethnographic method of research was used to provide an ecological picture of field experiences. Three cultural myths were uncovered based on the thematic analysis of the interview transcripts, observations, and documents.Keywords: teacher quality, practice teaching, student teacher agency, cultural myths
Procedia PDF Downloads 937287 Predicting Resistance of Commonly Used Antimicrobials in Urinary Tract Infections: A Decision Tree Analysis
Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga
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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree
Procedia PDF Downloads 2487286 Clinical Outcome after in Vitro Fertilization in Women Aged 40 Years and Above: Reasonable Cut-Off Age for Successful Pregnancy
Authors: Eun Jeong Yu, Inn Soo Kang, Tae Ki Yoon, Mi Kyoung Koong
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Advanced female age is associated with higher cycle cancelation rates, lower clinical pregnancy rate, increased miscarriage and aneuploidy rates in IVF (In Vitro Fertilization) cycles. This retrospective cohort study was conducted at a Cha Fertility Center, Seoul Station. All fresh non-donor IVF cycles performed in women aged 40 years and above from January 2016 to December 2016 were reviewed. Donor/recipient treatment, PGD/PGS (Preimplantation Genetic Diagnosis/ Preimplantation Genetic Screening) were excluded from analysis. Of the 1,166 cycles from 753 women who completed ovulation induction, 1,047 were appropriate for the evaluation according to inclusion and exclusion criterion. IVF cycles were categorized according to age and grouped into the following 1-year age groups: 40, 41, 42, 43, 44, 45 and > 46. The mean age of patients was 42.4 ± 1.8 years. The median AMH (Anti-Mullerian Hormone) level was 1.2 ± 1.5 ng/mL. The mean number of retrieved oocytes was 4.9 ± 4.3. The clinical pregnancy rate and live birth rate in women > 40 years significantly decreased with each year of advancing age (p < 0.001). The clinical pregnancy rate decreased from 21% at the age of 40 years to 0% at ages above 45 years. Live birth rate decreased from 12.3% to 0%, respectively. There were no clinical pregnancy outcomes among 95 patients aged above 45 years of age. The overall miscarriage rate was 40.7% (range, 36.7%-70%). The transfer of at least one good quality embryo was associated with about 4-9% increased chance of a clinical pregnancy rate. Therefore, IVF in old age women less than 46 had a reasonable chance for successful pregnancy outcomes especially when good quality embryo is transferred.Keywords: advanced maternal age, in vitro fertilization, pregnancy rate, live birth rate
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