Search results for: clinical nursing practice guideline

Authors: K. M. Anusha, R. Krishnaveni

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Crossing a decade of the 21st century, the paradigm of human resources can be seen evolving with the strategic gene induced into it. There seems to be a radical shift descending as the corporate sector calls on its HR team to become strategic rather than administrative. This transferal eventually requires the metrics employed by these HR teams not to be just operationally reactive but to be aligned to an evidence-based strategic thinking. Realizing the growing need for a prescriptive metric model for effective HR analytics, this study has designed a conceptual framework for a basic metric model that can assist IT-HRM professionals to transition to a practice of evidence-based decision-making to enhance organizational performance.

Keywords: metric model, evidence based HR, HR analytics, strategic HR practices, IT sector

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Authors: G. Battistoni, F. Collamati, E. De Lucia, R. Faccini, C. Mancini-Terracciano, M. Marafini, I. Mattei, S. Muraro, V. Patera, A. Sarti, A. Sciubba, E. Solfaroli Camillocci, M. Toppi, G. Traini, S. M. Valle, C. Voena

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Accelerated charged particles, mainly protons and carbon ions, are presently used in Particle Therapy (PT) to treat solid tumors. The precision of PT exploiting the charged particle high localized dose deposition in tissues and biological effectiveness in killing cancer cells demands for an online dose monitoring technique, crucial to improve the quality assurance of treatments: possible patient mis-positionings and biological changes with respect to the CT scan could negatively affect the therapy outcome. In PT the beam range confined in the irradiated target can be monitored thanks to the secondary radiation produced by the interaction of the projectiles with the patient tissue. The Dose Profiler (DP) is a novel device designed to track charged secondary particles and reconstruct their longitudinal emission distribution, correlated to the Bragg peak position. The feasibility of this approach has been demonstrated by dedicated experimental measurements. The DP has been developed in the framework of the INSIDE project, MIUR, INFN and Centro Fermi, Museo Storico della Fisica e Centro Studi e Ricerche 'E. Fermi', Roma, Italy and will be tested at the Proton Therapy center of Trento (Italy) within the end of 2017. The DP combines a tracker, made of six layers of two-view scintillating fibers with square cross section (0.5 x 0.5 mm2) with two layers of two-view scintillating bars (section 12.0 x 0.6 mm2). The electronic readout is performed by silicon photomultipliers. The sensitive area of the tracking planes is 20 x 20 cm2. To optimize the detector layout, a Monte Carlo (MC) simulation based on the FLUKA code has been developed. The complete DP geometry and the track reconstruction code have been fully implemented in the MC. In this contribution, the DP hardware will be described. The expected detector performance computed using a dedicated simulation of a 220 MeV/u carbon ion beam impinging on a PMMA target will be presented, and the result will be discussed in the standard clinical application framework. A possible procedure for real-time beam range monitoring is proposed, following the expectations in actual clinical operation.

Keywords: online range monitoring, particle therapy, quality assurance, tracking detector

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Authors: Sarah Misplon, Wim Marneffe, Johan Helling, Jana Missiaen, Inge Decock, Dries Myny, Steve Lervant, Koen Vaneygen

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The aim of this study was twofold. First, we investigated whether the current funding from the national health insurance (NHI) of home hospitalization (HH) for oncological patients is sufficient in Belgium. Second, we compared patient’s experiences and preferences of HH to the standard of care (SOC). Two HH models were examined in three Belgian hospitals and three home nursing organizations. In a first HH model, the blood draw and monitoring prior to intravenous therapy were performed by a trained home nurse at the patient’s home the day before the visit to the day hospital. In a second HH model, the administration of two subcutaneous treatments was partly provided at home instead of in the hospital. Therefore, we conducted (1) a bottom-up micro-costing study to compare the costs and revenues for the providers (hospitals and home care organizations), and (2) a cross-sectional survey to compare patient’s experiences and preferences of the SOC group and the HH group. Our results show that HH patients prefer HH and none of them wanted to return to SOC, although the satisfaction of patients was not significantly different between the two categories. At the same time, we find that costs associated to HH are higher overall. Comparing revenues with costs, we conclude that the current funding from NHI of HH for oncological patients is insufficient.

Keywords: cost analysis, health insurance, preference, home hospitalization

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Authors: Meng-Fei Cheng, Wei-Lun Chen, Han-Chang Ma, Chi-Che Tsai

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Recent K–12 Taiwan Science Education Curriculum Guideline emphasize the essential role of modeling curriculum in science learning; however, few modeling curricula have been designed and adopted in current science teaching. Therefore, this study aims to develop modeling curriculum on electric circuits to investigate any learning difficulties students have with modeling curriculum and further enhance modeling teaching. This study was conducted with 44 10th-grade students in Central Taiwan. Data collection included a students’ understanding of models in science (SUMS) survey that explored the students' epistemology of scientific models and modeling and a complex circuit problem to investigate the students’ modeling abilities. Data analysis included the following: (1) Paired sample t-tests were used to examine the improvement of students’ modeling abilities and conceptual understanding before and after the curriculum was taught. (2) Paired sample t-tests were also utilized to determine the students’ modeling abilities before and after the modeling activities, and a Pearson correlation was used to understand the relationship between students’ modeling abilities during the activities and on the posttest. (3) ANOVA analysis was used during different stages of the modeling curriculum to investigate the differences between the students’ who developed microscopic models and macroscopic models after the modeling curriculum was taught. (4) Independent sample t-tests were employed to determine whether the students who changed their models had significantly different understandings of scientific models than the students who did not change their models. The results revealed the following: (1) After the modeling curriculum was taught, the students had made significant progress in both their understanding of the science concept and their modeling abilities. In terms of science concepts, this modeling curriculum helped the students overcome the misconception that electric currents reduce after flowing through light bulbs. In terms of modeling abilities, this modeling curriculum helped students employ macroscopic or microscopic models to explain their observed phenomena. (2) Encouraging the students to explain scientific phenomena in different context prompts during the modeling process allowed them to convert their models to microscopic models, but it did not help them continuously employ microscopic models throughout the whole curriculum. The students finally consistently employed microscopic models when they had help visualizing the microscopic models. (3) During the modeling process, the students who revised their own models better understood that models can be changed than the students who did not revise their own models. Also, the students who revised their models to explain different scientific phenomena tended to regard models as explanatory tools. In short, this study explored different strategies to facilitate students’ modeling processes as well as their difficulties with the modeling process. The findings can be used to design and teach modeling curricula and help students enhance their modeling abilities.

Keywords: electric circuits, modeling curriculum, science learning, scientific model

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Authors: Ibrahim Aly, Manal Ahmed, Mahmoud M. El-Shall

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Filariasis is a parasitic disease caused by small roundworms. The filarial worms are transmitted and spread by blood-feeding black flies and mosquitoes. Lymphatic filariasis (Elephantiasis) is caused by Wuchereriabancrofti, Brugiamalayi, and Brugiatimori. Elimination of Lymphatic filariasis necessitates an increasing demand for valid, reliable, and rapid diagnostic kits. Nanodiagnostics involve the use of nanotechnology in clinical diagnosis to meet the demands for increased sensitivity, specificity, and early detection in less time. The aim of this study was to evaluate the nano-based enzymelinked immunosorbent assay (ELISA) and novel nano-chip card as a rapid test for detection of filarial antigen in serum samples of human filariasis in comparison with traditional -ELISA. Serum samples were collected from an infected human with filarial gathered across Egypt's governorates. After receiving informed consenta total of 45 blood samples of infected individuals residing in different villages in Gharbea governorate, which isa nonendemic region for bancroftianfilariasis, healthy persons living in nonendemic locations (20 persons), as well as sera from 20 other parasites, affected patients were collected. The microfilaria was checked in thick smears of 20 µl night blood samples collected during 20-22 hrs. All of these individuals underwent the following procedures: history taking, clinical examination, and laboratory investigations, which included examination of blood samples for microfilaria using thick blood film and serological tests for detection of the circulating filarial antigen using polyclonal antibody- ELISA, nano-based ELISA, and nano-chip card. In the present study, a recently reported polyoclonal antibody specific to tegumental filarial antigen was used in developing nano-chip card and nano-ELISA compared to traditional ELISA for the detection of circulating filarial antigen in sera of patients with bancroftianfilariasis. The performance of the ELISA was evaluated using 45 serum samples. The ELISA was positive with sera from microfilaremicbancroftianfilariasis patients (n = 36) with a sensitivity of 80 %. Circulating filarial antigen was detected in 39/45 patients who were positive for circulating filarial antigen using nano-ELISA with a sensitivity of 86.6 %. On the other hand, 42 out of 45 patients were positive for circulating filarial antigen using nano-chip card with a sensitivity of 93.3%.In conclusion, using a novel nano-chip assay could potentially be a promising alternative antigen detection test for bancroftianfilariasis.

Keywords: lymphatic filariasis, nanotechnology, rapid diagnosis, elisa technique

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Authors: Insook Lee, Heeseung Choi, Kyung-Sook Bang, Sungjae Kim, Minkyung Song, Buhyun Lee

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Backgrounds: A clearer and comprehensive understanding of the effects of forest therapy on depression is needed for further refinements of forest therapy programs. The purpose of this study was to review the literature on forest therapy programs designed to decrease the level of depression among adults to evaluate current forest therapy programs. Methods: This literature review was conducted using various databases including PubMed, EMBASE, CINAHL, PsycArticle, KISS, RISS, and DBpia to identify relevant studies published up to January 2016. The two authors independently screened the full text articles using the following criteria: 1) intervention studies assessing the effects of forest therapy on depression among healthy adults ages 18 and over; 2) including at least one control group or condition; 3) being peer-reviewed; and 4) being published either in English. The Scottish Intercollegiate Guideline Network (SIGN) measurement tool was used to assess the risk of bias in each trial. Results: After screening current literature, a total of 14 articles (English: 6, Korean: 8) were included in the present review. None of the studies used randomized controlled (RCT) study design and the sample size ranged from 11 to 300. Walking in the forest and experiencing the forest using the five senses was the key component of the forest therapy that was included in all studies. The majority of studies used one-time intervention that usually lasted a few hours or half-day. The most widely used measure for depression was Profile of Mood States (POMS). Most studies used self-reported, paper-and-pencil tests, and only 5 studies used both paper-and-pencil tests and physiological measures. Regarding the quality assessment based on the SIGN criteria, only 3 articles were rated ‘acceptable’ and the rest of the 14 articles were rated ‘low quality.’ Regardless of the diversity in format and contents of forest therapies, most studies showed a significant effect of forest therapy in curing depression. Discussions: This systematic review showed that forest therapy is one of the emerging and effective intervention approaches for decreasing the level of depression among adults. Limitations of the current programs identified from the review were as follows; 1) small sample size; 2) a lack of objective and comprehensive measures for depression; and 3) inadequate information about research process. Futures studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed.

Keywords: forest therapy, systematic review, depression, adult

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Authors: Melanie Schinnerl, Dorothea Greiling

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In the context of the 2020 strategy, poverty and its fight returned to the center of national political efforts. This served as motivation for an Austrian research grant-funded project to focus on the under-researched local government level with the aim to identify municipal best-practice cases and to derive policy implications for Austria. Designing effective poverty reduction strategies is a complex challenge which calls for an integrated multi-actor in approach. Cities are increasingly confronted to combat poverty, even in rich EU-member states. By doing so cities face substantial demographic, cultural, economic and social challenges as well as changing welfare state regimes. Furthermore, there is a low willingness of (right-wing) governments to support the poor. Against this background, the research questions are: 1. How do local governments define poverty? 2. Who are the main risk groups and what are the most pressing problems when fighting urban poverty? 3. What is regarded as successful anti-poverty initiatives? 4. What is the underlying welfare state concept? To address the research questions a multi-method approach was chosen, consisting of a systematic literature analysis, a comprehensive document analysis, and expert interviews. For interpreting the data the project follows the qualitative-interpretive paradigm. Municipal approaches for reducing poverty are compared based on deductive, as well as inductive identified criteria. In addition to an intensive literature analysis, interviews (40) were conducted in Austria since the project started in March 2018. From the other countries, 14 responses have been collected, providing a first insight. Regarding the definition of poverty the EU SILC-definition as well as counting the persons who receive need-based minimum social benefits, the Austrian form of social welfare, are the predominant approaches in Austria. In addition to homeless people, single-parent families, un-skilled persons, long-term unemployed persons, migrants (first and second generation), refugees and families with at least 3 children were frequently mentioned. The most pressing challenges for Austrian cities are: expected reductions of social budgets, a great insecurity of the central government's social policy reform plans, the growing number of homeless people and a lack of affordable housing. Together with affordable housing, old-age poverty will gain more importance in the future. The Austrian best practice examples, suggested by interviewees, focused primarily on homeless, children and young people (till 25). Central government’s policy changes have already negative effects on programs for refugees and elderly unemployed. Social Housing in Vienna was frequently mentioned as an international best practice case, other growing cities can learn from. The results from Austria indicate a change towards the social investment state, which primarily focuses on children and labour market integration. The first insights from the other countries indicate that affordable housing and labor market integration are cross-cutting issues. Inherited poverty and old-age poverty seems to be more pressing outside Austria.

Keywords: anti-poverty policies, European cities, empirical study, social investment

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Authors: Hedia Mhiri Sellami

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This case study used the principles of the flipped classroom (FC) in courses dealing with the use of the Information and Communication Technology (ICT) in three business curricula. The FC was used because our first goal is to devote more time to practice the theoretical concepts, so, before the class session, students had to watch videos introducing the concept they will learn. The videos weren't designed for our course, they are on Youtube and correspond to real cases of the ICT use in companies. This choice was also made in order to meet our second goal; it was to motivate students by showing them that the aspects covered by the course are very useful in the business. This case study reinforced the positive reputation of the FC as it was globally appreciated by our students. Beside, we managed to achieve our objectives relating to the motivation and application of concepts studied.

Keywords: flipped classroom, business, ICT, video, learning

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Authors: Maierhaba Mijiti

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Objective：The aim is to understand the relationship between the expression level of the long-non-coding RNA LINC AC008063 and the clinicopathological parameters of patients with head and neck squamous cell carcinoma (HNSCC), and to clarify the biological function of LINC AC008063 in HNSCC cells. Moreover, it provides a potential biomarker for the diagnosis, treatment, and prognosis evaluation of HNSCC. Methods: The expression level of LINC AC008063 in the HNSCC was analyzed using transcriptome sequencing data from the TCGA (The cancer genome atlas) database. The expression levels of LINC AC008063 in human embryonic lung diploid cells 2BS, human immortalized keratinocytes HACAT, HNSCC cell lines CAL-27, Detroit562, AMC-HN-8, FD-LSC-1, FaDu and WSU-HN30 were determined by real-time quantitative PCR (qPCR). RNAi (RNA interference) was introduced for LINC AC008063 knockdown in HNSCC cell lines, the localization and abundance analysis of LINC AC008063 was determined by RT-qPCR, and the biological functions were examined by CCK-8, clone formation, flow cytometry, transwell invasion and migration assays, Seahorse assay. Results: LINC AC008063 was upregulated in HNSCC tissue (P<0.001), and verified b CCK-8, clone formation, flow cytometry, transwell invasion and migration assays, Seahorse assayy qPCR in HNSCC cell lines. The survival analysis revealed that the overall survival rate (OS) of patients with high LINC AC008063 expression group was significantly lower than that in the LINC AC008063 expression group, the median survival times for the two groups were 33.10 months and 61.27 months, respectively (P=0.002). The clinical correlation analysis revealed that its expression was positively correlated with the age of patients with HNSCC (P<0.001) and positively correlated with pathological state (T3+T4＞T1+T2, P=0.03). The RT-qPCR results showed that LINC AC008063 was mainly enriched in cytoplasm (P=0.01). Knockdown of LINC AC008063 inhibited proliferation, colony formation, migration and invasion; the glycolytic capacity was significantly decreased in HNSCC cell lines (P＜0.05). Conclusion: High level of LINC AC008063 was associated with the malignant progression of HNSCC as well as promoting the important biological functions of proliferation, colony formation, migration and invasion; in particular, the glycolytic capacity was decreased in HNSCC cells. Therefore, LINC AC008063 may serve as a potential biomarker for HNSCC and a distinct molecular target to inhibit glycolysis.

Keywords: head and neck squamous cell carcinoma, oncogene, long non-coding RNA, LINC AC008063, invasion and metastasis

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Authors: Edgar Teixeira, Eurico Carrapatoso

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As 3D displays become increasingly affordable, while production techniques and computational resources to create stereoscopic content being ever more accessible, a new dimension is literally introduced along with new expressive and immersive potentialities in support of designing for the screen. Prospective design visionaries have already at the reach of their hands an innovative and powerful visualization technology, which enables them to actively envision future trends and vanguardist directions. This paper explores the aesthetic and informational potentialities of stereoscopic motion graphics, providing insight on the application of 3D displays in design practice, proposing strategies to investigate stereoscopic communication, discussing potential repercussions to extant theory and impacts on audience.

Keywords: design, visual communication, technology, stereoscopy, 3D media

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Authors: Norbert W. Paul

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In 1988, parts of the scientific community still heralded findings to support that AIDS was likely to remain largely a ‘gay disease’. The value-ladden terminology of some of the articles suggested that rectum and fragile urethra are not sufficiently robust to provide a barrier against infectious fluids, especially body fluids contaminated with HIV while the female vagina, would provide natural protection against injuries and trauma facilitating HIV-infection. Anal sexual intercourse was constituted not only as dangerous but also as unnatural practice, while penile-vaginal intercourse would follow natural design and thus be relatively safe practice minimizing the risk of HIV. Statements like the latter were not uncommon in the early times of HIV/AIDS and contributed to captious certainties and an underestimation of heterosexual risks. Pseudo-scientific discourses on the origin of HIV were linked to local and global health politics in the 1980ies. The pathways of infection were related to normative concepts like deviant, subcultural behavior, cultural otherness, and guilt used to target, tag and separate specific groups at risk from the ‘normal’ population. Controlling populations at risk became the top item on the agenda rather than controlling modes of transmission and the virus. Hence, the Thai strategy to cope with HIV/AIDS by acknowledging social and sexual practices as they were – not as they were imagined – has become a role model for successful prevention in the highly scandalized realm of sexually transmitted disease. By accepting the globalized character of local HIV-risk and projecting the risk onto populations which are neither particularly vocal groups nor vested with the means to strive for health and justice Thailand managed to culturally implement knowledge-based tools of prevention. This paper argues, that pertinent cultural collisions regarding our strategies to cope with HIV/AIDS are deeply rooted in misconceptions, misreadings and scandalizations brought about in the early history of HIV in the 1980ties. The Thai strategy is used to demonstrate how local values can be balanced against globalized health risk and used to effectuated prevention by which knowledge and norms are translated into local practices. Issues of global health and injustice will be addressed in the final part of the paper dealing with the achievability of health as a human right.

Keywords: bioethics, HIV, global health, justice

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Authors: Asadullah Sheikh, Kerry Barnett, Paul Ayres

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Despite significant progress in access, equity and public examination success, poor student performance in mathematics in secondary schools has become a major concern in Bangladesh. A substantial body of research has emphasised the important contribution of teaching practices to student achievement. However, this has not been investigated in Bangladesh. Therefore, the study sought to find out the effectiveness of mathematics teaching practices as a means of improving secondary school mathematics in Dhaka Municipality City (DMC) area, Bangladesh. The purpose of this study was twofold, first, to identify the 20 highest performing secondary schools in mathematics in DMC, and second, to investigate the teaching practices of mathematics teachers in these schools. A two-phase mixed method approach was adopted. In the first phase, secondary source data were obtained from the Board of Intermediate and Secondary Education (BISE), Dhaka and value-added measures used to identify the 20 highest performing secondary schools in mathematics. In the second phase, a concurrent mixed method design, where qualitative methods were embedded within a dominant quantitative approach was utilised. A purposive sampling strategy was used to select fifteen teachers from the 20 highest performing secondary schools. The main sources of data were classroom teaching observations, and teacher interviews. The data from teacher observations were analysed with descriptive and nonparametric statistics. The interview data were analysed qualitatively. The main findings showed teachers adopt a direct teaching approach which incorporates orientation, structuring, modelling, practice, questioning and teacher-student interaction that creates an individualistic learning environment. The variation in developmental levels of teaching skill indicate that teachers do not necessarily use the qualitative (i.e., focus, stage, quality and differentiation) aspects of teaching behaviours effectively. This is the first study to investigate teaching behaviours of effective secondary mathematics teachers within Dhaka, Bangladesh. It contributes in an international dimension to the field of educational effectiveness and raise questions about existing constructivist approaches. Further, it contributes to important insights about teaching behaviours that can be used to inform the development of evidence-based policy and practice on quality teaching in Bangladesh.

Keywords: effective teaching, mathematics, secondary schools, student achievement, value-added measures

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Authors: R. Korchiyne, A. Sbihi, S. M. Farssi, R. Touahni, M. Tahiri Alaoui

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Trabecular bone structure is important texture in the study of osteoporosis. Legendre multifractal spectrum can reflect the complex and self-similarity characteristic of structures. The main objective of this paper is to develop a new technique of medical image classification based on Legendre multifractal spectrum. Novel features have been developed from basic geometrical properties of this spectrum in a supervised image classification. The proposed method has been successfully used to classify medical images of bone trabeculations, and could be a useful supplement to the clinical observations for osteoporosis diagnosis. A comparative study with existing data reveals that the results of this approach are concordant.

Keywords: multifractal analysis, medical image, osteoporosis, fractal dimension, Legendre spectrum, supervised classification

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Authors: S. Sakhri

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Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.

Keywords: HER2+, RH+, breast cancer, tyrosine kinase

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Authors: Murat Sözen

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It is not at all difficult to estimate which level today’s technology reaches considering that humankinds space-faring in early 1950s. Technology is a means to help achieve goals and people can produce systems on their physical and mental abilities. Needed and used as tools in all areas of life and became a necessity and dependency, technology, widely used in the military field. To be a revolutionary change in the military matters, opportunities offered by technology should be put into practice. Tech makes weapons, sensors, platforms and soldiers carrying them more effective. To increase this efficiency in the battlefield defense industry is seeking every advantage of technology. In this study, the applicability of existing and on-going augmented reality applications for Armed Forces will be evaluated.

Keywords: augmented reality, battlefield, military, virtual reality

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Authors: Parastou Kharazmi

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Failure and leakage of metallic components because of corrosion in infrastructure structures is a considerably problematic and expensive issue and the traditional solution of replacing the component is costly and time-consuming. Rehabilitation techniques by using advanced polymeric materials are an alternative solution towards this problem. This paper provides a summary of analyses on relined rehabilitated metallic samples after exposure in practice and real condition to study the composite material performance when it is exposed to water, heat and chemicals in real condition. The study was carried out by using different test methods such as microscopy, thermal and chemical as well as mechanical analyses.

Keywords: composite, material, rehabilitation, structure

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

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The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

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Authors: Markéta Gregušová, Vladimíra Schindlerová, Ivana Šajdlerová, Petr Mohyla, Jan Kedroň

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Company managers are always looking for more and more opportunities to succeed in today's fiercely competitive market. To maintain your place among the successful companies on the market today or to come up with a revolutionary business idea is much more difficult than before. Each new or improved method, tool, or approach that can improve the functioning of business processes or even of the entire system is worth checking and verification. The use of simulation in the design of manufacturing systems and their management in practice is one of the ways without increased risk, which makes it possible to find the optimal parameters of manufacturing processes and systems. The paper presents an example of use of simulation for solution of the bottleneck problem in the concrete company.

Keywords: practical applications, business processes, systems, simulation

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Authors: Nuran Nur Aypar, Merlinda Alus Tokat

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The aim of the study is to determine the knowledge level of pregnant women with Gestational Diabetes Mellitus (GDM) about the disease and affecting factors. The data of this descriptive study were collected from 184 pregnant women who were followed up in Dokuz Eylul University Hospital (n=34), Izmir Ege Maternity Hospital, Gynecology Training and Research Hospital (n=133), and Egepol Private Hospital (n=17). Data collection forms were prepared by the researcher according to the literature. ANOVA test, Kruskal Wallis test, Mann-Whitney U test, Student’s t-test, and Pearson correlation test were used for statistical analyses. Average GDM knowledge score of pregnant women was 40.10±19.56. The GDM knowledge scores were affected by factors such as age, educational level, working status, income status, educational level of the spouse, and the GDM background. It has been shown in our study that the GDM knowledge scores were negatively affected by factors such as young age, low educational level, low-income level, unemployment, having a spouse with low educational level, the absence of the GDM story. It has been identified that 86.4% of the pregnant women were trained about GDM. The education provided in the antenatal period significantly increased GDM knowledge scores of pregnant women (p=0.000, U=515.0). It has been determined that GDM knowledge of the pregnant women with GDM is affected by various factors. These factors must be considered in order to determine new strategies.

Keywords: affecting factors, gestational diabetes mellitus (GDM), knowledge level, nursing, pregnancy

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Authors: Alexander K. Edwards

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Introduction: The moral dimension of teacher education globally has assumed a new paradigm of thinking based on the public gain (return-on-investments), value-creation (quality), professionalism (practice), and business strategies (innovations). Abundant literature reveals an interesting revolutionary trend in complimenting the raising of teachers and academic performances. Because of the global competition in the knowledge-creation and service areas, the C21st teacher at all levels is expected to be resourceful, strategic thinker, socially intelligent, relationship aptitude, and entrepreneur astute. This study is a significant contribution to practice and innovations to raise exemplary or primal teachers. In this study, the qualities needed were considered as ‘Quadrant Intelligence (Q-i)’ model for a primal teacher leadership beyond the classroom. The researcher started by examining the issue of the majority of teachers in Ghana Education Services (GES) in need of this Q-i to be effective and efficient. The conceptual framing became determinants of such Q-i. This is significant for global employability and versatility in teacher education to create premium and primal teacher leadership, which are again gaining high attention in scholarship due to failing schools. The moral aspect of teachers failing learners is a highly important discussion. In GES, some schools score zero percent at the basic education certificate examination (BECE). The question is what will make any professional teacher highly productive, marketable, and an entrepreneur? What will give teachers the moral consciousness of doing the best to succeed? Method: This study set out to develop a model for primal teachers in GES as an innovative way to highlight a premium development for the C21st business-education acumen through desk reviews. The study is conceptually framed by examining certain skill sets such as strategic thinking, social intelligence, relational and emotional intelligence and entrepreneurship to answer three main burning questions and other hypotheses. Then the study applied the causal comparative methodology with a purposive sampling technique (N=500) from CoE, GES, NTVI, and other teachers associations. Participants responded to a 30-items, researcher-developed questionnaire. Data is analyzed on the quadrant constructs and reported as ex post facto analyses of multi-variances and regressions. Multiple associations were established for statistical significance (p=0.05). Causes and effects are postulated for scientific discussions. Findings: It was found out that these quadrants are very significant in teacher development. There were significant variations in the demographic groups. However, most teachers lack considerable skills in entrepreneurship, leadership in teaching and learning, and business thinking strategies. These have significant effect on practices and outcomes. Conclusion and Recommendations: It is quite conclusive therefore that in GES teachers may need further instructions in innovations and creativity to transform knowledge-creation into business venture. In service training (INSET) has to be comprehensive. Teacher education curricula at Colleges may have to be re-visited. Teachers have the potential to raise their social capital, to be entrepreneur, and to exhibit professionalism beyond their community services. Their primal leadership focus will benefit many clienteles including students and social circles. Recommendations examined the policy implications for curriculum design, practice, innovations and educational leadership.

Keywords: emotional intelligence, entrepreneurship, leadership, quadrant intelligence (q-i), primal teacher leadership, strategic thinking, social intelligence

Procedia PDF Downloads 315

Authors: Sina Saadati, Mohammadreza Razzazi

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In this article, we have tried to present an agent-based model of human muscle. A suitable model of muscle is necessary for the analysis of mankind's movements. It can be used by clinical researchers who study the influence of motion sicknesses, like Parkinson's disease. It is also useful in the development of a prosthesis that receives the electromyography signals and generates force as a reaction. Since we have focused on computational efficiency in this research, the model can compute the calculations very fast. As far as it concerns prostheses, the model can be known as a charge-efficient method. In this paper, we are about to illustrate an agent-based model. Then, we will use it to simulate the human gait cycle. This method can also be done reversely in the analysis of gait in motion sicknesses.

Keywords: agent-based modeling and simulation, human muscle, gait cycle, motion sickness

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Authors: Kazuko Sakamoto, Keiichiro Kawarabayashi, Yoji Kitani

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Japanese sweets are one of the important elements of the Chur Japan strategy. In this research, we investigated what kind of sweets are liked to the Chinese tourist. What is generally eaten is influenced by culture, a sense of values, and business practice. Therefore, what was adapted there is sold. However, when traveling, what its country does not have is called for. Then, how far should we take in Chinese people's taste in a design?　This time, the design attribute (a color and a form) which leads to sweets "being delicious" was clarified by rough aggregate theory.As a result, the difference in the taste of Chinese people and Japanese people became clear.

Keywords: design attribute, international comparison, taste by appearance, design attribute

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Authors: Jana Soler Libran

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The primary aim of this paper is to analyze the relationship between power and knowledge suggested in Michel Foucault's theory. Taking into consideration the role of power in knowledge production, the goal is to evaluate to what extent genealogy can be presented as a practical method for epistemic resistance. To do so, the methodology used consists of a revision of Foucault’s literature concerning the topic discussed. In this sense, conceptual analysis is applied in order to understand the effect of the double dimension of power on knowledge production. In its negative dimension, power is conceived as an organ of repression, vetoing certain instances of knowledge considered deceitful. In opposition, in its positive dimension, power works as an organ of the production of truth by means of institutionalized discourses. This double declination of power leads to the first main findings of the present analysis: no truth or knowledge can lie outside power’s action, and power is constituted through accepted forms of knowledge. To second these statements, Foucaultian discourse formations are evaluated, presenting external exclusion procedures as paradigmatic practices to demonstrate how power creates and shapes the validity of certain epistemes. Thus, taking into consideration power’s mechanisms to produce and reproduce institutionalized truths, this paper accounts for the Foucaultian praxis of genealogy as a method to reveal power’s intention, instruments, and effects in the production of knowledge. In this sense, it is suggested to consider genealogy as a practice which, firstly, reveals what instances of knowledge are subjugated to power and, secondly, promotes aforementioned peripherical discourses as a form of epistemic resistance. In order to counterbalance these main theses, objections to Foucault’s work from Nancy Fraser, Linda Nicholson, Charles Taylor, Richard Rorty, Alvin Goldman, or Karen Barad are discussed. In essence, the understanding of the Foucaultian relationship between power and knowledge is essential to analyze how contemporary discourses are produced by both traditional institutions and new forms of institutionalized power, such as mass media or social networks. Therefore, Michel Foucault's practice of genealogy is relevant, not only for its philosophical contribution as a method to uncover the effects of power in knowledge production but also because it constitutes a valuable theoretical framework for political theory and sociological studies concerning the formation of societies and individuals in the contemporary world.

Keywords: epistemic resistance, Foucault’s genealogy, knowledge, power, truth

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

Procedia PDF Downloads 267

Authors: A. R. Bagirzade, A. Sh. Najafova, S. M. Yessirkepova, E. S. Albert

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This article describes a text recognition method based on Optical Character Recognition (OCR). The features of the OCR method were examined using the ABBYY FineReader program. It describes automatic text recognition in images. OCR is necessary because optical input devices can only transmit raster graphics as a result. Text recognition describes the task of recognizing letters shown as such, to identify and assign them an assigned numerical value in accordance with the usual text encoding (ASCII, Unicode). The peculiarity of this study conducted by the authors using the example of the ABBYY FineReader, was confirmed and shown in practice, the improvement of digital text recognition platforms developed by Electronic Publication.

Keywords: ABBYY FineReader system, algorithm symbol recognition, OCR/ICR techniques, recognition technologies

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

Procedia PDF Downloads 168

Authors: Nelson Ponce Jr., Jonas R. Gazoli, Alessandro Sete, Roberto M. G. Velásquez, Valério L. Borges, Moacir A. S. de Andrade

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The search for increased efficiency in generation systems has been of great importance in recent years to reduce the impact of greenhouse gas emissions and global warming. For clean energy sources, such as the generation systems that use concentrated solar power technology, this efficiency improvement impacts a lower investment per kW, improving the project’s viability. For the specific case of parabolic trough solar concentrators, their performance is strongly linked to their geometric precision of assembly and the individual efficiencies of their main components, such as parabolic mirrors and receiver tubes. Thus, for accurate efficiency analysis, it should be conducted empirically, looking for mounting and operating conditions like those observed in the field. The Brazilian power generation and distribution company Eletrobras Furnas, through the R&D program of the National Agency of Electrical Energy, has developed a plant for testing parabolic trough concentrators located in Aparecida de Goiânia, in the state of Goiás, Brazil. The main objective of this test plant is the characterization of the prototype concentrator that is being developed by the company itself in partnership with Eudora Energia, seeking to optimize it to obtain the same or better efficiency than the concentrators of this type already known commercially. This test plant is a closed pipe system where a pump circulates a heat transfer fluid, also calledHTF, in the concentrator that is being characterized. A flow meter and two temperature transmitters, installed at the inlet and outlet of the concentrator, record the parameters necessary to know the power absorbed by the system and then calculate its efficiency based on the direct solar irradiation available during the test period. After the HTF gains heat in the concentrator, it flows through heat exchangers that allow the acquired energy to be dissipated into the ambient. The goal is to keep the concentrator inlet temperature constant throughout the desired test period. The developed plant performs the tests in an autonomous way, where the operator must enter the HTF flow rate in the control system, the desired concentrator inlet temperature, and the test time. This paper presents the methodology employed for design and operation, as well as the instrumentation needed for the development of a parabolic trough test plant, being a guideline for standardization facilities.

Keywords: parabolic trough, concentrated solar power, CSP, solar power, test plant, energy efficiency, performance characterization, renewable energy

Procedia PDF Downloads 119

Authors: Mai Ali

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The abstract underscores the critical importance of junior paediatricians acquiring expertise in handling paediatric emergencies, with a particular focus on Diabetic Ketoacidosis (DKA). Existing literature reveals a wealth of research on healthcare professionals' knowledge regarding DKA, encompassing diverse cultural backgrounds and medical specialties. Consistently, challenges such as the absence of standardized protocols and inadequacies in training emerge as common issues across healthcare centres. This research proposal seeks to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom in managing DKA within various clinical contexts. The primary objective is to assess their level of competence and propose effective strategies to enhance DKA training comprehensively.

Keywords: DKA, knowledge, Junior paediatricians, local protocols

Procedia PDF Downloads 83