Search results for: clinical communication

Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

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Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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Authors: Stéfani T. A. Dantas, Laura T. S. Takume, Bruna F. Rossi, Érika R. Bonsaglia, Ivana G. Castilho, José C. F. Pantoja, Ary Fernandes Júnior, Juliano L. Gonçalves, Marcos V. Santos, Rinaldo A. Mota, Vera L. M. Rall

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Staphylococcus aureus is one of the main pathogens causing contagious bovine mastitis, being more frequently isolated from subclinical form, although the clinical form also occurs. Clinical mastitis cause visual signs, such as swelling, fever, hardening of the mammary gland, or any change in the characteristics of the milk. Considering the subclinical type, there are no visible signs in the animal nor changes in the milk. S. aureus has many important virulence factors for the establishment of its pathogenicity in animals, such as enterotoxins, which are also responsible for foodborne poisoning. Our objective is to perform a comparative analysis between 103 isolates of S. aureus, obtained from the milk of cows with clinical mastitis and 103 more, from subclinical type, in relation to the presence of these enterotoxins and verify if their presence plays an important role in the signs of illness. We will investigate all enterotoxins described till now, such as sea-see, seg-sez, sel26, sel 27, se01, and se02 (This study was approved by the Sao Paulo State University Animal Use Ethics Committee, No. 0136/2017). For the PCR assay, we used Illustra Bacteria Mini Spin Kit for bacterial DNA. At this moment, we have already tested sea-see, seg-ser, sew, and sex, and the results have already been submitted to Fisher Exact Probability Test or Chi-square Test. Considering the isolates obtained from clinical mastitis, the most frequent enterotoxins were selw (99%), selx (78%) and selh (50.5%), and sec, see, sej, sell, selp,and ser were absent. Among the subclinics, selw (82.5%) selm (15.5%) and selx (14.6%) were the most frequent, and sea-see, seg, sei-sel, sem-ser were absent. We have already observed statistically significant differences for seb, seg, seh, sei, selo, selu, selw and selx. Other interesting results were the low number of genes in each isolate from subclinical mastitis [0 genes: 14 (13.6%); 1 gene: 55 (53.4%); 2 genes: 33 (32%) or 3: 1 (0.97%)] compared to clinical isolates [1 gene: 5 (4.9%); 2 genes: 29 (28.1%); 3 genes: 38 (36.9%); 4 genes: 14 (13.6%); 5 genes: 5 (4.9%); 6 genes: 4 (3.9%); 7 genes: 5 (4.9%); 8 genes: 2 (1.9%) and 9 genes: 1 (1%)]. Based on these results, we can conclude that enterotoxins indeed play an important role in clinical signs in cattle with mastitis.

Keywords: mastitis, S. aureus, PCR, staphylococcal enterotoxin

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Authors: Peter Mayeso Jiyajiya

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This paper discusses how the teaching of English as a foreign language in Malawi can enhance intercultural communication competence in a multicultural society. It argues that incorporation of intercultural communication in the teaching of English as a foreign language would improve cultural awareness in communication in the multicultural Malawi. The teaching of English in Malawi is geared towards producing students who would communicate in the global world. This entails the use of proper pedagogical approaches and instructional materials that prepare the students toward intercultural awareness. In view of this, the language teachers were interviewed in order to determine their instructional approaches to intercultural communication. Instructional materials were further evaluated to assess how interculturality is incorporated. The study found out that teachers face perceptual and technical challenges that hinder them from exercising creativity to incorporate interculturality in their lessons. This is also compounded by lack of clear direction in the teaching materials on cultural elements. The paper, therefore, suggests a holistic approach to the teaching of English language in Malawian school in which the diversity of culture in classrooms must be considered an opportunity for addressing students’ cultural needs that may be lacking in the instructional materials.

Keywords: cultural awareness, grammar, foreign language, intercultural communication, language teaching

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Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla

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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.

Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management

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Authors: Aijing Luo, Zirui Xin, Yifeng Yuan

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Background: With the rapid development of the online health community, more and more patients or families are seeking health information on the Internet. Objective: This study aimed to discuss how to fully reveal the health information needs expressed by hypertensive patients in their questions in the online environment. Methods: This study randomly selected 1,000 text records from the question data of hypertensive patients from 2008 to 2018 collected from the website www.haodf.com and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning the intention of each hypertensive patient based on the patient’s question and used co-occurrence network analysis to explore the features of the health information needs of hypertensive patients. Results: The classification system for health information needs of patients with hypertension is composed of 9 parts: 355 kinds of drugs, 395 kinds of symptoms and signs, 545 kinds of tests and examinations , 526 kinds of demographic data, 80 kinds of diseases, 37 kinds of risk factors, 43 kinds of emotions, 6 kinds of lifestyles, 49 kinds of questions. The characteristics of the explored online health information needs of the hypertensive patients include: i)more than 49% of patients describe the features such as drugs, symptoms and signs, tests and examinations, demographic data, diseases, etc. ii) these groups are most concerned about treatment (77.8%), followed by diagnosis (32.3%); iii) 65.8% of hypertensive patients will ask doctors online several questions at the same time. 28.3% of the patients are very concerned about how to adjust the medication, and they will ask other treatment-related questions at the same time, including drug side effects, whether to take drugs, how to treat a disease, etc.; secondly, 17.6% of the patients will consult the doctors online about the causes of the clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, medication, and examinations. Conclusion: In the online environment, the health information needs expressed by Chinese hypertensive patients to doctors are personalized; that is, patients with different background features express their questioning intentions to doctors. The classification system constructed in this study can guide health information service providers in the construction of online health resources, to help solve the problem of information asymmetry in communication between doctors and patients.

Keywords: online health community, health information needs, hypertensive patients, doctor-patient communication

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Authors: Jonghoon Kim, Gilwon Yoon

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A wrist-band type biosignal measurement system and its data transfer through human body communication (HBC) were investigated. An HBC method based on pulses of ultra-wide band instead of using frequency or amplitude modulations was studied and implemented since the system became very compact and it was more suited for personal or mobile health monitoring. Our system measured photo-plethysmogram (PPG) and measured PPG signals were transmitted through a finger to a monitoring PC system. The device was compact and low-power consuming. HBC communication has very strong security measures since it does not use wireless network. Furthermore, biosignal monitoring system becomes handy because it does not need to have wire connections.

Keywords: biosignal, human body communication, mobile health, PPG, ultrawide band

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Authors: Tayaba Dastgeer, Farhan Rasheed, Muhammad Saeed, Maqsood Ahmad, Zia Ashraf, Abdul Waheed, Muhammad Kamran, Mohsin Khurshid

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Objectives: The study aimed to determine the efficacy of linezolid against clinical isolates of methicillin-resistant staphylococcus aureus (MRSA). Methodology: This cross-sectional study was conducted in the microbiology department of Allama Iqbal Medical College Lahore from August 2017 to September 2019. Isolates were confirmed as MRSA via the presence of the mec-A gene. Confirmed MRSA isolates were processed for susceptibility testing against different antimicrobials, especially linezolid, via the disc diffusion method. Zone sizes were interpreted according to CLSI guidelines. Results: Various types of clinical samples were included in the study; however, the highest frequency of MRSA isolates was found in pus samples, followed by other clinical samples. Among hospitalized patients, most MRSA isolates were obtained from patients in the surgical ward. Of 243 mec-A gene detected isolates, Vancomycin and linezolid showed 100% susceptibility, chloramphenicol showed declining resistance 78 (32.09%), and emerging sensitivity 165 (67.90%) against MRSA. Conclusion: Linezolid is a very efficient drug against MRSA, but the use of this novel drug must be conserved for vancomycin-resistant Staphylococcus aureus or when more resistant pathogens are suspected.

Keywords: MRSA, chloramphenicol, linezolid, nosocomial infections

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Authors: Ilma Robo, Manola Kelmendi, Kleves Elezi, Nevila Alliu

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The most important stage in deciding whether to re-treat or not endodontically is to find the reason for the clinical in-success. Therefore, endodontic re-treatment aims to eliminate the etiology of the pathology, where the main ones are the bacteria remaining in the inter-radicular spaces or the presence of other irritants that can be not only bacterial toxins but also the elements that keep the batteries fixed or extra-canal toxins such as extraction outside the apex of the canal filling. Shortcomings of endodontic treatment can be corrected, if possible, only with endodontic re-treatment that is initially attempted orthograde, and if clinical endodontic success is not achieved again, it can be performed retrograde or surgically. The elements that do not help in this direction are the anatomical deformations in the canal network of the tooth roots, in the presence of the delta at the apex of the tooth root, in the isthmuses present, all of which can be explained by the endodontic canal anatomical morphology. Actually, even if the causative endodontic bacteria remains isolated and without an exit in the healthy periodontal tissues, then this can also be a clinical endodontic success, regardless of the fact that the endodontic isolation occurred only in the exits such as the apex or the accessory canals. Clinical endodontic in-success occurs only when bacterial residues emerge or provide an exit in the healthy periradicular tissues or along the entire length of the canal where the accessory canals exit.

Keywords: endodontic success, E. foecalis, nanoparticles, laser diode, antibacterial, antiseptic

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Authors: Aakriti Lohiya

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Sigmund Freud’s clinical theories were deeply influenced by his childhood and his environment before his exile in England. In this article, the author illuminates his different works and the metaphors in them. The clinical relevance of Freud’s theories is much disputed and chatted but rarely has any psychoanalytic writing touched upon the way in which his theories are linked with life experiences. Exploring the metaphors in Freud’s theories will take us into the uncharted paths of how the experience of life events meets experience in the clinic. A sincere and critical reflection of the ideas proposed by Freud would certainly help us to locate its unfamiliar stages. Many of his theories and ideas attempted to create contact with his early childhood experiences. Freud was Jewish by birth but atheist by nature, which was reflected in many of his theories. The ways in which Freud theorizes the psychosexual development of a being and many of his mammoth theories are elucidated in this study. On the other hand, some of his ideas remain a challenge, which requires remembering, restating, and functioning through the clinical and mystical elements in his writing.

Keywords: sigmund freud, exile, psychoanalytic theory, metaphor, psychosexual theory

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Authors: Patrick David Chirilele

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There are growing interests in improving service delivery in the healthcare sector through the adoption of emerging digital technologies, including the Vocera B3000n communication system badge. As a result, understanding the factors that impact the adoption of such digital technologies is becoming important. This study investigates the determinants of task-technology fit through the adoption of Vocera B3000n communication system badge in healthcare sector in South Africa. Statistical analyses are performed on the data collected from 143 healthcare workers including registered nurses and personal care workers at three hospitals in South Africa through survey to test the relationship between task characteristics, technology characteristics and user characteristics for better understanding the task-technology fit and the adoption of Vocera communication systems in South African hospitals. The result reveals that all three factors have a significant impact on task-technology fit through the adoption of Vocera B3000n communication system badge. Such findings are useful for healthcare sector in their adoption of digital technologies for improving service delivery through effective communication in their workplace.

Keywords: adoption, communication systems, task-technology fit, user characteristics, Vocera

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Authors: Omar Mayyas

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Clinical decision-making (CDM) is essential to community health nursing (CHN) education. For this reason, nursing educators are responsible for developing these skills among nursing students because nursing students are exposed to highly critical conditions after graduation. However, due to limited exposure to real-world situations, many nursing students need help developing clinical decision-making skills in this area. Therefore, the impact of Virtual Simulation (VS) on community health nursing students' clinical decision-making in nursing education has to be investigated. This study aims to examine the difference in CDM ability among CHN students who received traditional education compared to those who received VS classes, to identify the factors that may influence CDM ability differences between CHN students who received a traditional education and VS classes, and to provide recommendations for educational programs that can enhance the CDM ability of CHN students and improve the quality of care provided in community settings. A mixed-method study will conduct. A randomized controlled trial will compare the CDM ability of CHN students who received 1hr traditional class with another group who received 1hr VS scenario about diabetic patient nursing care. Sixty-four students in each group will randomly select to be exposed to the intervention from undergraduate nursing students who completed the CHN course at York University. The participants will receive the same Clinical Decision Making in Nursing Scale (CDMNS) questionnaire. The study intervention will follow the Medical Research Council (MRC) approach. SPSS and content analysis will use for data analysis.

Keywords: clinical decision-making, virtual simulation, community health nursing students, community health nursing education

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Authors: B. S. Bamoallem, A. J. Wodehouse, G. M. Mair

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Communication takes place not only through speech, but also by means of gestures such as facial expressions, gaze, head movements, hand movements and body posture, and though there has been rapid development, communication platforms still lack this type of behavior. We believe communication platforms need to fully achieve this verbal and non-verbal behavior in order to make interactions more engaging and more efficient. In this study we decided to focus our research on the head rather than any other body part as it is a rich source of information for speech-related movement Thus we aim to investigate the value of incorporating head movements into the use of telepresence robots as communication platforms; this will be done by investigating a system that reproduces head movement manually as closely as possible.

Keywords: engagement, nonverbal behaviours, head movements, face-to-face interaction, telepresence robot

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Authors: Aristi Alopoudi, Sofia Beloka, Vassiliki Pliogou

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Autism is a complex neuro-developmental disorder with a variety of difficulties in many aspects such as social interaction, communication skills and verbal communication (speech). The aim of this study was to examine the impact of therapeutic horseback riding in improving the verbal and communication skills of children diagnosed with autism during 16 sessions. The researcher examined whether the expression of speech, the use of vocabulary, semantics, pragmatics, echolalia and communication skills were influenced by the therapeutic horseback riding when we increase the frequency of the sessions. The researcher observed two subjects of primary-school aged, in a two case observation design, with autism during 16 therapeutic horseback riding sessions (one riding session per week). Compared to baseline, at the end of the 16th therapeutic session, therapeutic horseback riding increased both verbal skills such as vocabulary, semantics, pragmatics, formation of sentences and communication skills such as eye contact, greeting, participation in dialogue and spontaneous speech. It was noticeable that echolalia remained stable. Increased frequency of therapeutic horseback riding was beneficial for significant improvement in verbal and communication skills. More specifically, from the first to the last riding session there was a great increase of vocabulary, semantics, and formation of sentences. Pragmatics reached a lower level than semantics but the same as the right usage of the first person (for example, I make a hug) and echolalia used for that. A great increase of spontaneous speech was noticed. The eye contact was presented in a lower level, and there was a slow but important raise at the greeting as well as the participation in dialogue. Last but not least; this is a first study conducted in therapeutic horseback riding studying the verbal communication and communication skills in autistic children. According to the references, therapeutic horseback riding is a therapy with a variety of benefits, thus; this research made clear that in the benefits of this therapy there should be included the improvement of verbal speech and communication.

Keywords: Autism, communication skills, speech, therapeutic horseback riding

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Authors: Lily Parm, Irma Nool, Liina Männiksaar, Mare Tupits, Ivi Prits, Merilin Kuhi, Valentina Raudsepp

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Background: The results of previous clinical satisfaction surveys show that nursing students swhounderw entinternships in the pediatricwardhadthelowestsatisfactioncomparedtootherwards, but the quality of students' practicaltrainingexperienceisanimportant determinant in nursing education. The aim of theresearchwastodescribenursingstudents` assessment to the clinical learning environment and supervision in pediatric wards Method: Theresearchisquantitative. All studentswhohadpracticaltraining in the pediatric ward participated in the study (N = 39). FordatacollectionClinicalLearningEnvironment, Supervision, and NurseTeacher (CLES + T) evaluationscalewasused, wherethescalewasanswered on a 5-point Likert scale. In addition, 10 backgroundvariableswereused in the questionnaire. IBM SPSS Statistics 28.0 wasusedfordataanalysis. Descriptive statistics and Spearmanncorrelationanalysiswasusedtofindcorrelatinsbetweenbackgroundvariables and satisfaction with supervision.Permissiontoconductthestudy (No 695) hasbeenobtainedbytheEthicsCommittee of theInstituteforHealthDevelopment. Results: Of therespondents, 28 (71.8%) werefirst-year, 9 (23.1%) second-year and 2 (5.1%) fourth-yearstudents. Thelargestshare of the last practicaltrainigwas in nursing, with 27 (69.2%) respondents. Mainlythementorswerenursesfor 32 (82,1%) of students.Satisfactionwiththementoring (4.4 ± 0.83) and wardnursemanager`sleaderhiostyle (4.4 ± 0.7), ratedthehighest and therole of thenurseteacherwasratedthelowest (3,7 ± 0.83.In Spearmann'scorrelationanalysis, therewas a statisticallystrongcorrelationbetween a positiveattitudetowardsthesupervisor'ssupervision and receivingfeedbackfromthesupervisor (r =0.755; p <0.001), studentsatisfactionwithsupervision (r = 0.742; p <0.001), supervisionbased on cooperation (r = 0.77) and instructionbased on theprinciple of equalitythatpromotedlearning (r = 0.755; p <0.001). Conclusions: Theresults of theresearchshowedhighsatisfactionwiththesupervisionand therole of wardmanager. Stillbettercooperationisneededbetweenpracticalplacement and nursingschooltoenhancethestudents`satisfactionwithsupervision.

Keywords: CLES+T, clinical environment, nurse teacher, statisfaction, pediatric ward, mentorship

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Authors: Atif Mahmood, Mohammad Inayatullah Khan Babar

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Communication infrastructure has been installed, operated, and maintained all over the world according to defined electrical safety standards for separate or joint structures. These safety standards have been set for the safeguard of public, utility workers (employees and contractors), utility facilities, electrical communication equipment’s connected to the utility facilities and other facilities or premise adjacent to utility facilities. Different communication utilities in Pakistan use standards of different countries due to the absence of Common National Electrical Safety Standards of Pakistan. It is really important to devise a framework for implementation of a uniform standard for strict compliance. In this context, it is important to explore the compliance of safety standards for communication conductors and equipment for separate or joint structures for which NESC standards are taken as reference. Specific reference to grounding techniques including grounding AC/DC systems and its frames, leaving Fences, Messenger wires and special circuits used for the protection for lightning etc, ungrounded so recommendations are also given after in-depth analysis of current technical practices for the installation and maintenance of communication infrastructure.

Keywords: utility facilities, grounding electrodes, special circuits, grounding conductor

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Authors: Jiyeon Kang, Yeon Jin Jeong, Hoon Heo

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Purpose: Bullying in nursing workplace has been a serious problem that increases the turnover of nurses. Few studies have examined the effects of communication training on workplace bullying for nurses, and all used a single-group design and a small sample size. Thus, more rigorous research has been needed to evaluate the effects properly. This research was aimed to identify the effects of the mobile type communication training of responses on bullying behaviors among nurses. Methods: A randomized controlled trial was performed. Subjects were 62 critical care nurses working in university hospitals in Busan, South Korea. We developed a mobile phone application to train nurses to deal with bullying situation. This application includes 6 common bullying situations and appropriate empathetic communication (non-violent communication) samples in the form of webtoons. The experimental group used this application for 4 weeks, and we measured interpersonal relationship, workplace bullying, symptom experience, and intention to leave before, post, and 8 weeks after the intervention from both experimental and control groups. The effect of the intervention was analyzed using repeated measures ANOVA. Results: The mobile type communication training developed in this study was effective for decreasing nurses’ intention to leave workplace (F = 5.11, p = .027). However, it had no effect on interpersonal relationship (F = 2.54, p = .116), workplace bullying (F = 2.99, p = .089) or symptom experience (F = 2.81, p = .099). The beneficial effects on intention to leave lasted at least up to 4 weeks after the training. Conclusion: The mobile type communication training can be utilized as an effective personal coping strategy for workplace bullying among nurses. Further studies on the long-term effects of the communication training are necessary.

Keywords: bullying, communication, mobile applications, nurses, training, workplace

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Authors: K. Grigoryan, T. Jurcik

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Interpersonal and school-related factors, along with individual characteristics, can predict non-suicidal self-injures (NSSI). The objective of this review is to describe psychosocial variables associated with NSSI among adolescents. A better understanding of this phenomenon may facilitate the identification of potentially effective interventions for adolescents. Relevant empirical studies and reviews from clinical, cross-cultural, and social psychology, as well as cognitive psychology literature, were synthesized into two broad topics: social/interpersonal and individual factors. Variables related to the occurrence of NSSI are discussed, including social support, peer modeling, abuse, personality traits, sense of belongingness, self-compassion, and others. Based on these findings, specific clinical recommendations were identified that need to be further evaluated empirically. The systemic interventions recommended in this review may further promote research in circumventing this social and clinical problem.

Keywords: non-suicidal self-injury, psychosocial factors, mental health, adolescence

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Authors: Timothy Kephart

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Many law enforcement officials believe that gangs communicate messages to both the community and to rival gangs through graffiti. Some social scientists have documented this as well, however no recent research has examined gang graffiti for its underlying meaning. Empirical research on gang graffiti and gang communication through graffiti is limited. This research can be described as an exploratory effort to better understand how, and perhaps why, gangs employ this medium for communication. Furthermore this research showcases how law enforcement agencies can utilize this hidden form of communication to better direct resources and impact gang violence.

Keywords: gangs, graffiti, juvenile justice, policing

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Authors: Mehrdad Hosseinishakib, Mozhgan Chakani, Gholamreza Babaei

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This study aims to investigate the relationship between the bilateral communication channels, communication technologies with effective communications and communication technologies, employee participation in motivated decision-making of employees using the EFQM excellence model in Education Organization of Area 4 in Karaj. This research is an applied research in terms of the purpose and is a descriptive survey research in terms of nature and method and assesses the current situation using field studies. The statistical population consists of all employees and managers of Education Organization of Area 4 in Karaj including 5442 persons and random sampling was used and sample size is 359 using Cochran formula. Measurement tool is a researcher-made questionnaire with 20 questions including two categories of expertise and general questions. The first category includes general questions about respondents' personal characteristics such as gender and level of education, work experience and courses of study. The second category includes expertise questions of the questionnaire that have been designed to test research hypotheses that its reliability was approved by Cronbach's alpha coefficient 0.916 and its validity was approved according to the vies of teachers and some senior managers of Education Organization of Area 4 in Karaj. The results of the analysis of the findings show that there is a significant relationship between mutual communication channels, communication technologies with effective communication between employees and management. There is also a significant relationship between communication technologies and employee motivation and employee participation in their motivated decision-making in Education Organization of Area 4 in Karaj.

Keywords: communication channels, effective communication, EFQM model, ANOVA

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Authors: Yang Wei, Xueyan Wang, Hui Zou

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Objective: Investigation the prevalence of menopausal symptoms in patients with allergic symptoms, evaluation of the effect of sex hormones combined with anti-allergic therapy in these patients. Method: Age of 45-65 years old women with allergic symptoms at the same time in gynecological-endocrinology clinic in our hospital were selected from Feb 1 to May 31, 2010, randomly. The patients were given oral estradiol valerate plus progestin pills combined with anti-allergy treatment and then evaluated twice a week and one month later. Evaluation criterion: Menopause Rating Scale (MRS) and the degree of clinical symptoms were used to evaluate menopause and allergy separately. Results: 1) There were 195 cases of patients with menopausal symptoms at the age. Their MRS were all over 15. 2) Among them 45 patients were with allergic symptom accounted for 23% which were diagnosed by allergic department. 3) Evaluated after one week: the menopausal symptoms were improved and MRS were less than or equal to 5 in all these patients; the skin symptom of allergic symptoms vanished completely. 4) Evaluated after one month: Menopause symptoms were improved steadily; other clinical symptoms of allergy were also improved or without recurrence. Conclusion: The incidence rate of menopausal women with clinical symptoms of allergic diseases is high and it needs attention. The effect of sex hormones combined with anti-allergic therapy is obvious.

Keywords: menopausal, allergy, sex hormone, anti-allergy treatment

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Authors: Komathy Thiagarajan, Mohd. Azizuddin Mohd. Yussof, Hasnoorina Husin, Noor Azreena Abd Aziz, Faezah Shekh Abdullah, Abdul Wahaf Abdul Wahid

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Polycystic Ovary Syndrome (PCOS) presents with a plethora of clinical features owing to the multifaceted underlying pathophysiology. This study was conducted to determine the clinical features unique to the sub fertile women attending the Sub fertility Clinic of the National Population and Family Development Board (NPFDB) so that a more holistic approach can be adopted to further enhance the pregnancy outcome in those women. This was a case-control study conducted over a span of three years (from January 2014 until December 2016), whereby women who fulfilled the Rotterdam Criteria 2004 were classified as PCOS (n=79) and women who did not fulfill the Rotterdam Criteria were classified as controls (n=88). The mean age of the women was 30.1 years and the mean duration of marriage was 3.93 years. The majority of women suffered from primary sub fertility (82.6%). The median age was lower among PCOS women (29.0 years) compared to the controls (30.0 years), p<0.05. The majority of PCOS women (43.0%) were obese (BMI > 30 kg/m2) compared to only 19.3% who were obese in the control group, p<0.05. Hypertension was present in 59.5% of PCOS women and only in 36.4% of the control group, p<0.05. There were significantly more women who presented with hirsutism in PCOS group (27.8%) as compared to the control group (5.7%), p<0.05. The findings of this study elucidate that the clinical features of significance among sub fertile women suffering from PCOS, if detected early, are amenable to lifestyle modifications and timely interventions can potentially improve the fertility outcomes in this group of women.

Keywords: clinical features, fertility, lifestyle modification, PCOS

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Authors: Neeraj Malhotra, Ramya Shenoy

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Objective: To assess the effect of clinical parameters (bonding agent, preparation design & storage media) on the strength of reattached anterior tooth fragment. Methodology: This is a systematic review and meta-analysis for articles referred from MEDLINE, PUBMED, and GOOGLE SCHOLAR. The articles on tooth reattachment and clinical factors affecting fracture strength/bond strength/fracture resistance of the reattached tooth fragment in anterior teeth and published in English from 1999 to 2016 were included for final review. Results: Out of 120 shortlisted articles, 28 articles were included for the systematic review and meta-analysis based on 3 clinical parameters i.e. bonding agent, tooth preparation design & storage media. Forest plot & funnel plots were generated based on individual clinical parameter and their effect on strength of reattached anterior tooth fragment. Results based on analysis suggest combination of both conclusive evidence favoring the experimental group as well as in-conclusive evidence for individual parameter. Conclusion: There is limited evidence as there are fewer articles supporting each parameter in human teeth. Bonding agent had showed better outcome in selected studies.

Keywords: bonding agent, bond strength, fracture strength, preparation design, reattachment, storage media

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Authors: Asima Mehaboob Khan, Rizwan Taj

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Purpose: This study aims to estimate the knowledge, attitude and practices of medical ethics among young healthcare professionals. Method: A qualitative descriptive study was conducted among young healthcare professionals from both public and private sector medical institutions. Using the convenience sampling technique, 272 healthcare professionals participated in this study. A pre-structured modified questionnaire was used to collect the data. Descriptive analyses were executed for each variable. Result: About 76.47% of healthcare professional considers the importance of adequate knowledge of medical ethics, and 82.24% declared lecture, seminars and clinical discussion as the source of their medical knowledge of biomedical ethics. About 42.44% of healthcare professionals exhibited a negative attitude toward medical ethics, 57.72% showed a mildly positive attitude, whereas 1.10% and 0.74% indicated a moderately positive attitude and a highly positive attitude towards medical ethics. Similarly, the level of practice according to medical ethics is also very poor among young healthcare professionals. 34.56% of healthcare professionals deviated from medical ethics during their clinical practices, whereas 0.74% showed a good level of medical practice according to medical ethics. Conclusion: It is concluded in this research study that young healthcare professionals have adequate theoretical knowledge of medical ethics but are not properly trained to perform their clinical practices according to the guidelines of medical ethics. Furthermore, their professional attitude is poorly developed to maintain medical ethics during their clinical practices.

Keywords: knowledge, attitude, practices, medical ethics

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Authors: Oksana Mykytyuk

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Chronic desynchronosis is an important factor of progression of osteoarthritis in shift workers. 80 patients with primary osteoarthritis (female:male ratio = 3:1, average age: 57.6 years, average disease duration: 6.4 years, radiological stage: II-III) were examined, 42% reported systematic night shift-work for more than two years. Full clinical examination was performed, all patients filled in SF-36, WOMAC questonnaries, marked visual analog scales for estimation of pain intensity and general well-being. Patients who had been exposed to night work had significantly worse clinical course of osteoarthritis marked by more (27.5%, p < 0.05) extensive pain syndrome, especially at night hours, (10.00 pm-2.00 am period) and estimated life quality as poorer comparing those working at day time. Osteoarthritis initiation occurred at earlier age in them comparing those who worked in non-shifted regimen. They showed a trend to generalized affliction of bigger quantity of joint groups, higher frequency of synovitis as well. Shift-workers administered higher doses of non-steroid anti-inflammatory drugs (NSAIDs) and estimated their effect as lower (39.6% average daily relief vs 62.5% in non-shift workers after 10 days of regular application of therapy). Frequency of chronic NSAID-induced gastropathy was 25% higher among night-workers. Shift-workers are predisposed to worse course of osteoarthritis with marked clinical symptoms, requiring higher doses on NSAIDs and with inclination towards bigger frequency of complication. That should be kept in mind while developing individual treatment and secondary prophylaxis strategy.

Keywords: desynchronosis, osteoarthritis, questionnaries, shift-work

Procedia PDF Downloads 114

Authors: Douglas Rossi Ramos

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The current digital conjuncture, called by some authors as 'Internet of Things' (IoT), 'Web 2.0' or even 'Web 3.0', consists of a network that encompasses any communication of objects and entities, such as data, information, technologies, and people. At this juncture, especially characterized by an "object socialization," communication can no longer be represented as a simple informational flow of messages from a sender, crossing a channel or medium, reaching a receiver. The idea of communication must, therefore, be thought of more broadly in which it is possible to analyze the process communicative from interactions between humans and nonhumans. To think about this complexity, a communicative process that encompasses both humans and other beings or entities communicating (objects and things), it is necessary to constitute a new epistemology of communication to rethink concepts and notions commonly attributed to humans such as 'memory.' This research aims to contribute to this epistemological constitution from the discussion about the notion of memory according to the complex ontology of Henri Bergson. Among the results (the notion of memory in Bergson presents itself as a conceptual tool for the analysis of posthumanism and the anthropomorphic conjuncture of the new advent of digital), there was the need to think about an ontological memory, analyzed as a being itself (being itself of memory), as a strategy for understanding the forms of interaction and communication that constitute the new digital conjuncture, in which communicating beings or entities tend to interact with each other. Rethinking the idea of communication beyond the dimension of transmission in informative sequences paves the way for an ecological perspective of the digital dwelling condition.

Keywords: communication, digital, Henri Bergson, memory

Procedia PDF Downloads 139

Authors: Muthana Saleh Alalaki, Michael Opoku Agyeman

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The growth in the number of Intellectual Properties (IPs) or the number of cores on the same chip becomes a critical issue in System-on-Chip (SoC) due to the intra-communication problem between the chip elements. As a result, Network-on-Chip (NoC) has emerged as a system architecture to overcome intra-communication issues. This paper presents a study of recent contributions on simulation tools for NoC. Furthermore, an overview of NoC is covered as well as a comparison between some NoC simulators to help facilitate research in on-chip communication.

Keywords: WiNoC, simulation tool, network-on-chip, SoC

Procedia PDF Downloads 475

Authors: Nititorn Ounpipat

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The objective of this study was to find the relationship between internal communication and job satisfaction, and to find out the best communication channel to contact employees for a quality working within the operation or organizational rules. The sample size of 100% who were working as a shop floor level employee in the company. The study used the quantitative research method by distributing a structured questionnaire to collect data from 150 employees as the sample size. Inferential statistics and forward multiple regression analysis were used to analyze the results of this research. The result shows that communication channel correlated with job satisfaction. Each channel has a correlation with the satisfaction of working with the Department Board Information and All Employee / Weekly Meeting Relevance high. Since there is a correlation coefficient equal. 851 and. 840, respectively. Company Board Information, Memo, Letter, Leader, Supervisor, Friends and Email Relevance moderate as well.

Keywords: internal communication channels, job satisfaction, personal feedback, Rayong province

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Authors: Teerapong Chaisen, Pornpan Puttaraksa, Chayanit Chitchai, Peeraya Somsak, Rinyaphat Kecharananta

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This paper aims to study integrated marketing communication (IMC) of department store in Chiang Mai with the object to understand how department stores manage communication in order to inform customer and how customers react to the received information. We study the example of 300 customers both Thai and foreigners who received the given information from the department stores and the reactions of these customers. This paper shows Central festival is the top destination to visit for Thai customers. On the other hand, Central Plaza is favored by foreign customers. However, all department stores need to use more IMC to make awareness for customer.

Keywords: integrated marketing communication, satisfaction, department store, consumer

Procedia PDF Downloads 302

Authors: A. M. Almujalli, G. M. Al-Ghamdi

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Mycobacterium avium subspecies paratuberculosis causes paratuberculosis, a chronic debilitating granulomatous enteritis, in camels as well as domestic and wild ruminants. The clinical manifestation of the disease in camel is not well characterized, therefore this study was aimed to investigate the clinical and pathological pictures of camels that are suffering from partuberculosis. Twelve young camels that were presented to the Veterinary Teaching Hospital, King Faisal University were investigated. Clinical and pathological examination were performed. The results revealed highly significant increase in creatinine, blood urea nitrogen, magnesium, AST and ALT in diseased camels, while glucose, total protein and albumin were highly significantly decreased in diseased camels when compared to healthy ones. Post-mortem testing indicated thickening, corrugation of the intestinal wall, folded mucosa, enlarged and oedemated ileocaecal and mesenteric lymph nodes. The microscopic findings detected short, blunt and distorted intestinal villi with hyperactive goblet cells of the villi and the crypts of lieberkuhn contained mucin droplets. The lamina propria was heavily infiltrated with mononuclear cells mostly macrophages. This clinical picture of paratuberculosis may be used to initiate control strategy to limit the spread of the disease in camel herds.

Keywords: camel, partuberclosis, control, Saudi Arabia

Procedia PDF Downloads 180

Authors: Olumide Simeon Ogunnusi, Shukor Abd Razak, Michael Kolade Adu

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Inter-agent communication manager facilitates communication among mobile agents via message passing mechanism. Until now, all Foundation for Intelligent Physical Agents (FIPA) compliant agent systems are capable of exchanging messages following the standard format of sending and receiving messages. Previous works tend to secure messages to be exchanged among a community of collaborative agents commissioned to perform specific tasks using cryptosystems. However, the approach is characterized by computational complexity due to the encryption and decryption processes required at the two ends. The proposed approach to secure agent communication allows only agents that are created by the host agent server to communicate via the agent communication channel provided by the host agent platform. These agents are assumed to be harmless. Therefore, to secure communication of legitimate agents from intrusion by external agents, a 2-phase policy enforcement system was developed. The first phase constrains the external agent to run only on the network server while the second phase confines the activities of the external agent to its execution environment. To implement the proposed policy, a controller agent was charged with the task of screening any external agent entering the local area network and preventing it from migrating to the agent execution host where the legitimate agents are running. On arrival of the external agent at the host network server, an introspector agent was charged to monitor and restrain its activities. This approach secures legitimate agent communication from Man-in-the Middle and Replay attacks.

Keywords: agent communication, introspective agent, isolation of agent, policy enforcement system

Procedia PDF Downloads 282