Search results for: workplace injuries
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1048

Search results for: workplace injuries

748 Human Quality Treatment and Organizational Growth: The Principle of Respect at Nestle Nigeria

Authors: Rose Ogbechie, Nicholas Anakwue

Abstract:

In recent times, research has centered, in the area of Business Ethics, on the issue of human quality treatment (HQT), regarding the way people are dealt with, in organizations, taking into cognizance, respect for the dignity of the human person, as well as, the rights and responsibilities of the corporate individual. As such, the principle of respect is an essential ethical principle that should govern professional relationships in the workplace. There is a prevailing myth in the Nigerian business space, that to drive business success, business leadership must coerce and drive people, oftentimes, beyond comfort to meet work expectations. This has, most times, necessitated abuses and insults on subordinates in the workplace, and instituted a rigid hierarchy of management in business relationships. Nestlé Nigeria, one of the largest foods and beverage companies in Africa, provides a contrast to this myth in their success heuristic. Over the years in Nigeria, the company has registered significant successes in the Nigerian Fast-Moving Consumer Goods (FMCG) Market, with stellar performances year-on-year, and a high-penetration rate of its products in the Nigerian consumer space. At the heart of the FMCG giant’s success and culture is the principle of respect—respect for stakeholders, respect for all peoples, respect for cultures, respect for the environment. Utilizing qualitative research methods, through interviews and focus group discussions with Nestlé’s stakeholders, this paper explores the ethical principle of respect, and how, through it, human quality treatment influences positively organizational growth.

Keywords: human quality treatment, respect, Nestlé Nigeria, FMCG, organizational growth

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747 Future Prospects of Female Journalists in Mass Media of Bangladesh

Authors: M. Nurus Safa, Jiang Jinzhang, Akter Tahera

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This study explores the female are overcoming the odds and doing well as journalist during the last decade in Bangladesh. Female journalists are contributing to the society for economic prosperity and changing the attitude towards the development concept and process. But the path is not smooth for involving women in journalism. The findings are female journalist facing many barriers like family pressure, Society problem, pay-allowances, gender discrimination, sexual harassment and even lack of workplace. According to their skill and merit, they face problems in getting maternity leave and assignments. But their role in this sector cannot be neglected. It is possible to survive if have the passion, professionalism, and love on this profession. Day by day, the female participation in journalism sector is increasing in Bangladesh. Despite the barriers, female journalists are showing strong interest in journalism as a career. As much gender balance in Mass media as the women's freedom and scope will increase. As a result, the spread of female’s workplace in the media will spread. Good number of female journalists is working in different policy making positions of the organization. In future, experienced female journalists will be more because now day's they taking challenges and working religiously according to the company and public need. In recent time Bangladesh is encouraging her women to work outside of home. Currently, a significant change has come into the social attitude which represents by women’s advancement in journalism sector of Bangladesh. This study uses the survey method and 6 depth interview to find out a fruitful result. As a sampling, the study uses purposive sampling technique to collect the data from the 120 female respondents of television, online and print media journalists.

Keywords: attitude, Bangladesh, challenges, female journalists, prospects

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746 Research the Causes of Defects and Injuries of Reinforced Concrete and Stone Construction

Authors: Akaki Qatamidze

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Implementation of the project will be a step forward in terms of reliability in Georgia and the improvement of the construction and the development of construction. Completion of the project is expected to result in a complete knowledge, which is expressed in concrete and stone structures of assessing the technical condition of the processing. This method is based on a detailed examination of the structure, in order to establish the injuries and the elimination of the possibility of changing the structural scheme of the new requirements and architectural preservationists. Reinforced concrete and stone structures research project carried out in a systematic analysis of the important approach is to optimize the process of research and development of new knowledge in the neighboring areas. In addition, the problem of physical and mathematical models of rational consent, the main pillar of the physical (in-situ) data and mathematical calculation models and physical experiments are used only for the calculation model specification and verification. Reinforced concrete and stone construction defects and failures the causes of the proposed research to enhance the effectiveness of their maximum automation capabilities and expenditure of resources to reduce the recommended system analysis of the methodological concept-based approach, as modern science and technology major particularity of one, it will allow all family structures to be identified for the same work stages and procedures, which makes it possible to exclude subjectivity and addresses the problem of the optimal direction. It discussed the methodology of the project and to establish a major step forward in the construction trades and practical assistance to engineers, supervisors, and technical experts in the construction of the settlement of the problem.

Keywords: building, reinforced concrete, expertise, stone structures

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745 A Deep Learning Approach to Detect Complete Safety Equipment for Construction Workers Based on YOLOv7

Authors: Shariful Islam, Sharun Akter Khushbu, S. M. Shaqib, Shahriar Sultan Ramit

Abstract:

In the construction sector, ensuring worker safety is of the utmost significance. In this study, a deep learning-based technique is presented for identifying safety gear worn by construction workers, such as helmets, goggles, jackets, gloves, and footwear. The suggested method precisely locates these safety items by using the YOLO v7 (You Only Look Once) object detection algorithm. The dataset utilized in this work consists of labeled images split into training, testing and validation sets. Each image has bounding box labels that indicate where the safety equipment is located within the image. The model is trained to identify and categorize the safety equipment based on the labeled dataset through an iterative training approach. We used custom dataset to train this model. Our trained model performed admirably well, with good precision, recall, and F1-score for safety equipment recognition. Also, the model's evaluation produced encouraging results, with a [email protected] score of 87.7%. The model performs effectively, making it possible to quickly identify safety equipment violations on building sites. A thorough evaluation of the outcomes reveals the model's advantages and points up potential areas for development. By offering an automatic and trustworthy method for safety equipment detection, this research contributes to the fields of computer vision and workplace safety. The proposed deep learning-based approach will increase safety compliance and reduce the risk of accidents in the construction industry.

Keywords: deep learning, safety equipment detection, YOLOv7, computer vision, workplace safety

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744 The Effectiveness of Kinesiotaping Methods in Rehabilitation Therapy

Authors: Ana-Katarina Nikich

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Background: The kinesiotaping method is often used in physiotherapy and rehabilitation. The purpose of this study was to evaluate the effectiveness of taping in the rehabilitation process of patients. Materials and methods: The study involved 90 male and female patients (the average age was 40-50 years) with various conditions requiring rehabilitation, such as injuries of the musculoskeletal system, sports injuries and other ailments. All patients were divided into two groups: experimental (n=40) and control (n=50). Both groups received 20 days of standard rehabilitation. In the experimental group, kinesiotaping methods were used, taking into account the individual characteristics of each patient. The control group performed regular exercises and physical therapy, but without using kinesiotape. During the study, physical parameters were monitored, interviews were conducted and the conditions of patients from both groups were compared. Results and discussion: The use of the kinesiotaping method in the rehabilitation process led to a significant improvement in physical parameters and pain reduction in patients. Significant improvement (p <0.005) was observed in all evaluated parameters among the patients of the experimental group. The control group also showed sufficient improvement (p <0.005), but the percentage of the experimental group was higher. As a result of the observation, the patients of the experimental group showed faster and more complete rehabilitation compared to the control group. The use of the kinesiotaping method allows to reduce the load on the damaged areas, improve blood circulation and lymphatic drainage, as well as increase stability and coordination of movements. Conclusions: Kinesiotaping as one of the modern therapeutic methods has shown its effectiveness in the rehabilitation process, contributing to the optimal recovery of patients with various conditions requiring rehabilitation. The use of tapes should be included in a comprehensive rehabilitation program to achieve the best results and reduce recovery time.

Keywords: kinesiotaping, rehabilitation, therapy, pain

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743 Exploring the Number, Type and Level of Disability among Victims of Nepal Earthquake 2015

Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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742 Wearable Devices Could Reduce the Risk of Injury in Parasomnias Phenotypes

Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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741 Transmission of Intergenerational Trauma: Protecting Those who Still Suffer from Pain of their Ancestors’ Trauma

Authors: Bonnie Pollak

Abstract:

As the world continues to suffer grievous injuries, future generations will suffer from trauma that was inflicted on innocent victims. Trauma can result from refugees fleeing their homes, exposure to warfare, loss of loved ones, and lack of shelter and basic necessities. The Holocaust continues to cause pain even though WWII ended nearly 80 years ago. One cannot forget the inhumane treatment and murder of relatives. The pain and trauma may continue for generations. The purpose of the Final Solution was to eliminate Jews in totality. Though Hitler’s plan was not successful, he managed to cause trauma that will continue with no end date in sight. “The Effects of Trauma and Secondary Trauma,” Trauma can cause life-long challenges, eating disorders, cardiovascular disease, cancer, sleeping difficulties, fear of going outside, guilt, separation problems, and epigenetic changes. Secondary Trauma, witnessing a loved one in danger or hearing about the danger, can cause similar symptoms as seen in primary trauma. The transmission of trauma was demonstrated in children of Holocaust survivors and in communities where oppression was commonplace. We are witnessing a repeat of widescale death and horrific injuries today in Ukraine and in other parts of the world, where concern for pain and trauma is not acknowledged by perpetrators. Lessons from the Holocaust can be applied to help others who have been traumatized by widescale terrorism resulting in death of loved ones, loss of home and shelter, food and other life-sustaining measures. The world must help victims by providing basic necessities but also by using trauma-informed care, focusing on strength and resilience, and helping individuals to feel pride in their identity.

Keywords: transmission of intergenerational trauma, impact on religious beliefs and practices, 2nd generation, identity

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740 The Issue of Pedagogical Approaches in Higher Education: Public Universities as an Example

Authors: Majda El Moufarej

Abstract:

Higher education plays a central role in socio-economic development. However, with the wave of change mainly due to the extensive use of technology in the workplace, the rate of unemployment among graduates rises because they lack the appropriate competencies and skills currently required in professional life. This situation has led higher education institutions worldwide to reconsider their missions, strategic planning, and curricula, among other elements to redress the image of the university as expected. When it comes to practice, there are many obstacles that hinder the achievement of the expected objectives, especially in public universities with free access, as in the case of Morocco. Nevertheless, huge efforts have been made by educational managers to improve the quality of education by focusing on the issue of pedagogical approaches, where university teachers assume more responsibility to save the situation. In this paper, the focus will be placed on the issue of pedagogical approaches to be adopted, depending on the nature of the subject, the size of the class, the available equipment, the students’ level and degree of motivation. Before elaborating on this idea, it may be more insightful to begin by addressing another variable, which concerns the new role of university teachers and their qualification in pedagogical competence. Then, the discussion will revolve around five pedagogical approaches currently adopted in western universities and the focus will be exclusively placed on the one which is called “the Systematic Approach to course Design”, due to its crucial relevance in the teaching of subjects in the schools of humanities, as it can guide the teacher in the development of an explicit program for purposeful teaching and learning. The study is based on a qualitative method, and the findings will be analyzed and followed by some recommendations about how to overcome difficulties in teaching large groups, while transmitting the relevant knowledge and skills on demand in the workplace.

Keywords: higher education, public universities, pedagogical approaches, pedagogical competence

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739 Attitudes of Young Adults with Physical Disabilities towards Occupational Preferences

Authors: Limor Gadot, Orly Sarid

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Integration of young adults with disabilities (YAWD) into workplaces provides an opportunity for social and occupational mobility, enabling them to financial independence. To enhance integration, it is important to understand their occupational preferences as well as the factors that influencing it such as demographic variables, self-assessed health, beliefs about work, subjective norms, and self-efficacy. Planned behavior theory was chosen as a basis for this study. A cross-sectional study, based on preliminary sample of 37 YAWD who have been recognized by the National Insurance Institute and are engaged in a year of national service. The finding shows that most of the participants were single (97%) women (60%); average age was 22(+ 2) years, approximately half were secular. Most of the participants had disabilities resulting from CP (96%). Self-assessed health was correlated positively and significantly with behavioral intentions to work in the free market (r = .33, p = .05), and significant negative correlation with behavioral intentions to work in supported settings (r =.-40, p = .01), and sheltered settings (r =-.36, p = .03): individuals who perceived themselves as having more severe disabilities showed a greater tendency to choose a workplace with more rehabilitative inputs. Furthermore, women showed a greater tendency than men to perceive their disability as impairing their future intention to work: t (36) = 2.23, p < .05. Beliefs about work were positively associated with normative beliefs (r = .308, p = .06). The findings indicate that, especially with women, perceptions of health are related to occupational preferences. Moreover, the findings indicate that the relationship between subjective norms about work and normative beliefs about integrating in a workplace that prevail in the individual's environment affects occupational preferences. The contribution of the study lies in the development of new responses and interventions to encourage adults with disabilities to work.

Keywords: young adults, disabilities, work preferences, occupational preferences

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738 Factors Affecting At-Grade Railway Level Crossing Accidents in Bangladesh

Authors: Armana Huq

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Railway networks have a significant role in the economy of any country. Similar to other transportation modes, many lives suffer from fatalities or injuries caused by accidents related to the railway. Railway accidents are not as common as roadway accidents yet they are more devastating and damaging than other roadway accidents. Despite that, issues related to railway accidents are not taken into consideration with significant attention as a major threat because of their less frequency compared to other accident categories perhaps. However, the Federal Railroad Administration reported nearly twelve thousand train accidents related to the railroad in the year 2014, resulting in more than eight hundred fatalities and thousands of injuries in the United States alone of which nearly one third fatalities resulted from railway crossing accidents. From an analysis of railway accident data of six years (2005-2010), it has been revealed that 344 numbers of the collision were occurred resulting 200 people dead and 443 people injured in Bangladesh. This paper includes a comprehensive overview of the railway safety situation in Bangladesh from 1998 to 2015. Each year on average, eight fatalities are reported in at-grade level crossings due to railway accidents in Bangladesh. In this paper, the number of railway accidents that occurred in Bangladesh has been presented and a fatality rate of 58.62% has been estimated as the percentage of total at-grade railway level crossing accidents. For this study, analysis of railway accidents in Bangladesh for the period 1998 to 2015 was obtained from the police reported accident database using MAAP (Microcomputer Accident Analysis Package). Investigation of the major contributing factors to the railway accidents has been performed using the Multinomial Logit model. Furthermore, hotspot analysis has been conducted using ArcGIS. Eventually, some suggestions have been provided to mitigate those accidents.

Keywords: safety, human factors, multinomial logit model, railway

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737 Working From Home: On the Relationship Between Place Attachment to Work Place, Extraversion and Segmentation Preference to Burnout

Authors: Diamant Irene, Shklarnik Batya

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In on to its widespread effects on health and economic issues, Covid-19 shook the work and employment world. Among the prominent changes during the pandemic is the work-from-home trend, complete or partial, as part of social distancing. In fact, these changes accelerated an existing tendency of work flexibility already underway before the pandemic. Technology and means of advanced communications led to a re-assessment of “place of work” as a physical space in which work takes place. Today workers can remotely carry out meetings, manage projects, work in groups, and different research studies point to the fact that this type of work has no adverse effect on productivity. However, from the worker’s perspective, despite numerous advantages associated with work from home, such as convenience, flexibility, and autonomy, various drawbacks have been identified such as loneliness, reduction of commitment, home-work boundary erosion, all risk factors relating to the quality of life and burnout. Thus, a real need has arisen in exploring differences in work-from-home experiences and understanding the relationship between psychological characteristics and the prevalence of burnout. This understanding may be of significant value to organizations considering a future hybrid work model combining in-office and remote working. Based on Hobfoll’s Theory of Conservation of Resources, we hypothesized that burnout would mainly be found among workers whose physical remoteness from the workplace threatens or hinders their ability to retain significant individual resources. In the present study, we compared fully remote and partially remote workers (hybrid work), and we examined psychological characteristics and their connection to the formation of burnout. Based on the conceptualization of Place Attachment as the cognitive-emotional bond of an individual to a meaningful place and the need to maintain closeness to it, we assumed that individuals characterized with Place Attachment to the workplace would suffer more from burnout when working from home. We also assumed that extrovert individuals, characterized by the need of social interaction at the workplace and individuals with segmentationpreference – a need for separation between different life domains, would suffer more from burnout, especially among fully remote workers relative to partially remote workers. 194 workers, of which 111 worked from home in full and 83 worked partially from home, aged 19-53, from different sectors, were tested using an online questionnaire through social media. The results of the study supported our assumptions. The repercussions of these findings are discussed, relating to future occupational experience, with an emphasis on suitable occupational adjustment according to the psychological characteristics and needs of workers.

Keywords: working from home, burnout, place attachment, extraversion, segmentation preference, Covid-19

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736 Smart Coating for Enhanced Corneal Healing via Delivering Progranulin

Authors: Dan Yan, Yunuo Zhang, Yuhan Huang, Weijie Ouyang

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The cornea serves as a vital protective barrier for the eye; however, it is prone to injury and damage that can disrupt corneal epithelium and nerves, triggering inflammation. Therefore, understanding the biological effects and molecular mechanisms involved in corneal wound healing and identifying drugs targeting these pathways is crucial for researchers in this field. This study aimed to investigate the therapeutic potential of progranulin (PGRN) in treating corneal injuries. Our findings demonstrated that PGRN significantly enhanced corneal wound repair by accelerating corneal re-epithelialization and re-innervation. In vitro experiments with cultured epithelial cells and trigeminal ganglion cells further revealed that PGRN stimulated corneal epithelial cell proliferation and promoted axon growth in trigeminal ganglion cells. Through RNA-sequencing (RNA-seq) analysis and other experimental techniques, we discovered that PGRN exerted its healing effects by modulating the Wnt signaling pathway, which played a critical role in repairing epithelial cells and promoting axon regeneration in trigeminal neurons. Importantly, our study highlighted the anti-inflammatory properties of PGRN by inhibiting the NF-κB signaling pathway, leading to decreased infiltration of macrophages. In conclusion, our findings underscored the potential of PGRN in facilitating corneal wound healing by promoting corneal epithelial cell proliferation, trigeminal ganglion cell axon regeneration, and suppressing ocular inflammation. These results suggest that PGRN could potentially expedite the healing process and improve visual outcomes in patients with corneal injuries.

Keywords: cornea, wound healing, progranulin, corneal epithelial cells, trigeminal ganglion cells

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735 Psychopathic Manager Behavior and the Employee Workplace Deviance: The Mediating Role of Revenge Motive, the Moderating Roles of Core Self-Evaluations and Attitude Importance

Authors: Sinem Bulkan

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This study introduces the construct of psychopathic manager behaviour and aims for the development of psychopathic manager behaviour (Psycho-Man B) measure. The study also aims for the understanding of the relationship between psychopathic manager behaviour and workplace deviance while investigating the mediating role of a revenge motive and the moderating roles of the core self-evaluations and the attitude importance. Data were collected from 519 employees from a wide variety of jobs and industries who currently work for or previously worked for a manager in a collectivist culture, Turkey. Psycho-Man B Measure was developed resulting in five dimensions as opposed to the proposed ten dimensions. Simple linear and hierarchical regression analyses were conducted to test the hypotheses. The results of simple linear regression analyses showed that psychopathic manager behaviour was positively significantly related to supervisor-directed and organisation-directed deviance. Revenge motive towards the manager partially mediated the relationship between psychopathic manager behaviour and supervisor-directed deviance. Similarly, revenge motive towards the organisation partially mediated the relationship between psychopathic manager behaviour and organisation-directed deviance. Furthermore, no support was found for the expected moderating role of core self-evaluations in the revenge motive towards the manager-supervisor-directed deviance and revenge motive towards the organisation-organisation-directed deviance relationships. Attitude importance moderated the relationship between revenge motive towards the manager and supervisor-directed deviance; revenge motive towards the organisation and organisation-directed deviance. Moderated-mediation hypotheses were not supported for core self-evaluations but were supported for the attitude importance. Additional analyses for sub-dimensions were conducted to further examine the hypotheses. Demographic variables were examined through independent samples t-tests, and one way ANOVA. Finally, findings are discussed; limitations, suggestions and implications are presented. The major contribution of this study is that ‘psychopathic manager behaviour’ construct was introduced to the literature and a scale for the reliable identification of psychopathic manager behaviour was developed in to evaluate managers’ level of sub-clinical psychopathy in the workforce. The study introduced that employees engage in different forms of supervisor-directed deviance and organisation-directed deviance depending on the level of the emotions and personal goals. Supervisor-directed deviant behaviours and organisation-directed deviant behaviours became distinct in a way as impulsive and premeditated, active or passive, direct and indirect actions. Accordingly, it is important for organisations to notice that employees’ level of affective state and attitude importance for psychopathic manager behaviours predetermine the certain type of employee deviant behaviours.

Keywords: attitude importance, core self evaluations, psychopathic manager behaviour, revenge motive, workplace deviance

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734 Effect on Occupational Health Safety and Environment at Work from Metal Handicraft Using Rattanakosin Local Wisdom

Authors: Witthaya Mekhum, Waleerak Sittisom

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This research investigated the effect on occupational health safety and environment at work from metal handicraft using Rattanakosin local wisdom focusing on pollution, accidents, and injuries from work. The sample group in this study included 48 metal handicraft workers in 5 communities by using questionnaires and interview to collect data. The evaluation form TISI 18001 was used to analyze job safety analysis (JSA). The results showed that risk at work reduced after applying the developed model. Banbu Community produces alloy bowl rubbed with stone. The high risk process is melting and hitting process. Before the application, the work risk was 82.71%. After the application of the developed model, the work risk was reduced to 50.61%. Banbart Community produces monk’s food bowl. The high risk process is blow pipe welding. Before the application, the work risk was 93.59%. After the application of the developed model, the work risk was reduced to 48.14%. Bannoen Community produces circle gong. The high risk process is milling process. Before the application, the work risk was 85.18%. After the application of the developed model, the work risk was reduced to 46.91%. Teethong Community produces gold leaf. The high risk process is hitting and spreading process. Before the application, the work risk was 86.42%. After the application of the developed model, the work risk was reduced to 64.19%. Ban Changthong Community produces gold ornament. The high risk process is gold melting process. Before the application, the work risk was 67.90%. After the application of the developed model, the work risk was reduced to 37.03%. It can be concluded that with the application of the developed model, the work risk of 5 communities was reduced in the 3 main groups: (1) Work illness reduced by 16.77%; (2) Pollution from work reduced by 10.31%; (3) Accidents and injuries from work reduced by 15.62%.

Keywords: occupational health, safety, local wisdom, Rattanakosin

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733 The Impact of Working Environment Condition and Lifestyle Factors in Male Infertility in South of Iran

Authors: Shabnam Etemadi

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Background: Infertility is one of the most important issues in any society due to its psychological, medical and economic consequences that can greatly influence overall health and life. This study aims to assess the relationship between inhalation or exposing workplace pollution and dysfunction of the male reproductive system. Semen samples are male employees in south of Iran who exposed to work environmental pollutants for long hours. Method: Due to descriptive-analytical, the analysis of all interviews of all male patients of Bu Ali Medical Center and Pasteur Laboratory are conducted within 6 months. Random sampling numbered and patients signed informed consent. To analyze the data, Miller's fertility motivation questionnaires and the Miller-Smith lifestyle assessment inventory are used and Working Conditions Survey is developed. For analyzing the collecting data SPSS is used. Findings: Although sperm motility and volume had no statistically significant relationship with any of the lifestyle components, the weak relationship between sperm movement and work environment conditions (P = 0.07) lead to other factors to be investigated. * Among the factors of Working Environment Condition, smoking, work in the open environment and presence of more than 6 hours in the work environment with sperm mobility, smoking, contact with chemicals and radioactive with sperm volume at a level less than 0.05 had a statistically significant relationship. Conclusion: Finding revealed the environment pollution is one of the important factors in male infertility and strengthens this hypothesis. Working Environmental pollutants in the field of metropolitan pollution should be considered as a unifying hypothesis, possibly could interfere with male reproductive function.

Keywords: infertility, lifestyle, workplace pollution, male infertility

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732 Competing Discourses of Masculinity and Seeking Mental Health Assistance among Male Police Officers in Canada

Authors: Maria T. Cruz, Scott N. Thompson

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In recent years, Canadian federal and provincial law enforcement organizations have implemented numerous mental health strategies in an attempt to address officers’ mental health and wellness needs. Despite these reforms, however, mental illness continues to persist in these populations. Whereas workplace stressors continue to be factored into the development of mental health initiatives, it is proposed that aspects of masculine culture have been overlooked as contributing to the prevalence of mental illness among Canadian officers. By drawing on Michel Foucault’s theory of discourse, this study was conducted to determine if elements of masculine discourse exist as a socio-cultural barrier for officers seeking mental health assistance. This research supported the above hypothesis, and furthermore, identified how masculine discourse works in competition with mental health-related help-seeking discourses. To answer the research question, semi-structured phone interviews with active and retired male officers from Western provincial and municipal policing organizations, and the Royal Canadian Mounted Police were employed. Through thematic analysis of the transcripts, the data revealed three themes: i) masculinity in law enforcement is a determinant of workplace competency; ii) the dominance of masculine culture in law enforcement is problematic for mental health, and iii) improved help-seeking policies complicate how masculinity is expressed in law enforcement organizations. These findings suggest that within the reviewed Canadian law enforcement organizations, aspects of masculinity act as a socio-cultural barrier to officers seeking mental health services, and that the two conflicting discourses of masculinity and mental health-related help-seeking appear to be in competition with each other.

Keywords: competing discourses, dominant discourses, Foucault’s theory of discourse, law enforcement, masculinity, mental health, police officers

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731 A Comparative Study of Indoor Radon Concentrations between Dwellings and Workplaces in the Ko Samui District, Surat Thani Province, Southern Thailand

Authors: Kanokkan Titipornpun, Tripob Bhongsuwan, Jan Gimsa

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The Ko Samui district of Surat Thani province is located in the high amounts of equivalent uranium in the ground surface that is the source of radon. Our research in the Ko Samui district aimed at comparing the indoor radon concentrations between dwellings and workplaces. Measurements of indoor radon concentrations were carried out in 46 dwellings and 127 workplaces, using CR-39 alpha-track detectors in closed-cup. A total of 173 detectors were distributed in 7 sub-districts. The detectors were placed in bedrooms of dwellings and workrooms of workplaces. All detectors were exposed to airborne radon for 90 days. After exposure, the alpha tracks were made visible by chemical etching before they were manually counted under an optical microscope. The track densities were assumed to be correlated with the radon concentration levels. We found that the radon concentrations could be well described by a log-normal distribution. Most concentrations (37%) were found in the range between 16 and 30 Bq.m-3. The radon concentrations in dwellings and workplaces varied from a minimum of 11 Bq.m-3 to a maximum of 305 Bq.m-3. The minimum (11 Bq.m-3) and maximum (305 Bq.m-3) values of indoor radon concentrations were found in a workplace and a dwelling, respectively. Only for four samples (3%), the indoor radon concentrations were found to be higher than the reference level recommended by the WHO (100 Bq.m-3). The overall geometric mean in the surveyed area was 32.6±1.65 Bq.m-3, which was lower than the worldwide average (39 Bq.m-3). The statistic comparison of the geometric mean indoor radon concentrations between dwellings and workplaces showed that the geometric mean in dwellings (46.0±1.55 Bq.m-3) was significantly higher than in workplaces (28.8±1.58 Bq.m-3) at the 0.05 level. Moreover, our study found that the majority of the bedrooms in dwellings had a closed atmosphere, resulting in poorer ventilation than in most of the workplaces that had access to air flow through open doors and windows at daytime. We consider this to be the main reason for the higher geometric mean indoor radon concentration in dwellings compared to workplaces.

Keywords: CR-39 detector, indoor radon, radon in dwelling, radon in workplace

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730 Evolution of Bombings against Transportation Infrastructure

Authors: Jonathan K. Hill

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The transportation networks throughout Africa remain the only transportation infrastructure system in the world that is attacked by terrorists at a high frequency, so the international community can learn from each attack. The targeting of transportation should be recognized as a direct attack against a civilian population, so the international community should work to better understand the types of attacks utilized, the types of improvised explosive device designs adapted to transportation targets, and the ways the various modes of transportation have been attacked throughout the continent. Some countries have seen grenade attacks that have resulted in only injuries, while some countries have experienced large vehicle bombings that have resulted in hundreds of injuries and numerous deaths. With insurgencies, explosive devices have been small, complex, and generally target an enemy of the insurgency. With terrorist bombings, the explosive devices have been large, brazen, and targeted at civilian populations. And, these civilian populations are easily targeted within the transportation system. The presentation provided by Assess Africa LLC is titled ‘Evolution of Bombings Against Transportation Infrastructure’ and covers improvised explosive device characteristics, how improvised explosive devices have been adapted to transportation targets in Africa, analyses recent incidents, and provides some advice for effective protective measures. A main component of the improvised explosive device characteristics portion of the presentation focuses on the link between explosive device components, the intelligence network, and the bomb-builder’s network. By understanding the components, how the use of various components can be linked to a terrorist group’s capabilities, and how the bomb-builder acquires materials, the analysis of improvised explosive device attacks takes on a new direction – one that focuses on defeating the network instead of merely reviewing incidents of the past.

Keywords: Africa, bombings, critical infrastructure protection, transportation security

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729 Base Deficit Profiling in Patients with Isolated Blunt Traumatic Brain Injury – Correlation with Severity and Outcomes

Authors: Shahan Waheed, Muhammad Waqas, Asher Feroz

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Objectives: To determine the utility of base deficit in traumatic brain injury in assessing the severity and to correlate with the conventional computed tomography scales in grading the severity of head injury. Methodology: Observational cross-sectional study conducted in a tertiary care facility from 1st January 2010 to 31st December 2012. All patients with isolated traumatic brain injury presenting within 24 hours of the injury to the emergency department were included in the study. Initial Glasgow Coma Scale and base deficit values were taken at presentation, the patients were followed during their hospital stay and CT scan brain findings were recorded and graded as per the Rotterdam scale, the findings were cross-checked by a radiologist, Glasgow Outcome Scale was taken on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Continuous variables with normal and non-normal distributions are reported as mean ± SD. Categorical variables are presented as frequencies and percentages. Relationship of the base deficit with GCS, GOS, CT scan brain and length of stay was calculated using Spearman`s correlation. Results: 154 patients were enrolled in the study. Mean age of the patients were 30 years and 137 were males. The severity of brain injuries as per the GCS was 34 moderate and 109 severe respectively. 34 percent of the total has an unfavorable outcome with a mean of 18±14. The correlation was significant at the 0.01 level with GCS on presentation and the base deficit 0.004. The correlation was not significant between the Rotterdam CT scan brain findings, length of stay and the base deficit. Conclusion: The base deficit was found to be a good predictor of severity of brain injury. There was no association of the severity of injuries on the CT scan brain as per the Rotterdam scale and the base deficit. Further studies with large sample size are needed to further evaluate the associations.

Keywords: base deficit, traumatic brain injury, Rotterdam, GCS

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728 Quantifying Stakeholders’ Values of Technical and Vocational Education and Training Provision in Nigeria

Authors: Lidimma Benjamin, Nimmyel Gwakzing, Wuyep Nanyi

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Technical and Vocational Education and Training (TVET) has many stakeholders, each with their own values and interests. This study will focus on the diversity of the values and interests within and across groups of stakeholders by quantifying the value that stakeholders attached to several quality attributes of TVET, and also find out to what extent TVET stakeholders differ in their values. The quality of TVET therefore, depends on how well it aligns with the values and interests of these stakeholders. The five stakeholders are parents, students, teachers, policy makers, and work place training supervisors. The 9 attributes are employer appreciation of students, graduation rate, obtained computer skills of students, mentoring hours in workplace learning/Students Industrial Work Experience Scheme (SIWES), challenge, structure, students’ appreciation of teachers, schooling hours, and attention to civic education. 346 respondents (comprising Parents, Students, Teachers, Policy Makers, and Workplace Training Supervisors) were repeatedly asked to rank a set of 4 programs, each with a specific value on the nine quality indicators. Conjoint analysis was used to obtain the values that the stakeholders assigned to the 9 attributes when evaluating the quality of TVET programs. Rank-ordered logistic regression was the statistical/tool used for ranking the respondents values assign to the attributes. The similarities and diversity in values and interests of the different stakeholders will be of use by both Nigerian government and TVET colleges, to improve the overall quality of education and the match between vocational programs and their stakeholders simultaneous evaluation and combination of information in product attributes. Such approach models the decision environment by confronting a respondent with choices that are close to real-life choices. Therefore, it is more realistically than traditional survey methods.

Keywords: TVET, vignette study, conjoint analysis, quality perception, educational stakeholders

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727 Monitoring of Wound Healing Through Structural and Functional Mechanisms Using Photoacoustic Imaging Modality

Authors: Souradip Paul, Arijit Paramanick, M. Suheshkumar Singh

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Traumatic injury is the leading worldwide health problem. Annually, millions of surgical wounds are created for the sake of routine medical care. The healing of these unintended injuries is always monitored based on visual inspection. The maximal restoration of tissue functionality remains a significant concern of clinical care. Although minor injuries heal well with proper care and medical treatment, large injuries negatively influence various factors (vasculature insufficiency, tissue coagulation) and cause poor healing. Demographically, the number of people suffering from severe wounds and impaired healing conditions is burdensome for both human health and the economy. An incomplete understanding of the functional and molecular mechanism of tissue healing often leads to a lack of proper therapies and treatment. Hence, strong and promising medical guidance is necessary for monitoring the tissue regeneration processes. Photoacoustic imaging (PAI), is a non-invasive, hybrid imaging modality that can provide a suitable solution in this regard. Light combined with sound offers structural, functional and molecular information from the higher penetration depth. Therefore, molecular and structural mechanisms of tissue repair will be readily observable in PAI from the superficial layer and in the deep tissue region. Blood vessel formation and its growth is an essential tissue-repairing components. These vessels supply nutrition and oxygen to the cell in the wound region. Angiogenesis (formation of new capillaries from existing blood vessels) contributes to new blood vessel formation during tissue repair. The betterment of tissue healing directly depends on angiogenesis. Other optical microscopy techniques can visualize angiogenesis in micron-scale penetration depth but are unable to provide deep tissue information. PAI overcomes this barrier due to its unique capability. It is ideally suited for deep tissue imaging and provides the rich optical contrast generated by hemoglobin in blood vessels. Hence, an early angiogenesis detection method provided by PAI leads to monitoring the medical treatment of the wound. Along with functional property, mechanical property also plays a key role in tissue regeneration. The wound heals through a dynamic series of physiological events like coagulation, granulation tissue formation, and extracellular matrix (ECM) remodeling. Therefore tissue elasticity changes, can be identified using non-contact photoacoustic elastography (PAE). In a nutshell, angiogenesis and biomechanical properties are both critical parameters for tissue healing and these can be characterized in a single imaging modality (PAI).

Keywords: PAT, wound healing, tissue coagulation, angiogenesis

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726 Aging and Falls Profile from Hospital Databases

Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

Abstract:

Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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725 In vitro Regeneration of Neural Cells Using Human Umbilical Cord Derived Mesenchymal Stem Cells

Authors: Urvi Panwar, Kanchan Mishra, Kanjaksha Ghosh, ShankerLal Kothari

Abstract:

Background: Day-by-day the increasing prevalence of neurodegenerative diseases have become a global issue to manage them by medical sciences. The adult neural stem cells are rare and require an invasive and painful procedure to obtain it from central nervous system. Mesenchymal stem cell (MSCs) therapies have shown remarkable application in treatment of various cell injuries and cell loss. MSCs can be derived from various sources like adult tissues, human bone marrow, umbilical cord blood and cord tissue. MSCs have similar proliferation and differentiation capability, but the human umbilical cord-derived mesenchymal stem cells (hUCMSCs) are proved to be more beneficial with respect to cell procurement, differentiation to other cells, preservation, and transplantation. Material and method: Human umbilical cord is easily obtainable and non-controversial comparative to bone marrow and other adult tissues. The umbilical cord can be collected after delivery of baby, and its tissue can be cultured using explant culture method. Cell culture medium such as DMEMF12+10% FBS and DMEMF12+Neural growth factors (bFGF, human noggin, B27) with antibiotics (Streptomycin/Gentamycin) were used to culture and differentiate mesenchymal stem cells into neural cells, respectively. The characterisations of MSCs were done with Flow Cytometer for surface markers CD90, CD73 and CD105 and colony forming unit assay. The differentiated various neural cells will be characterised by fluorescence markers for neurons, astrocytes, and oligodendrocytes; quantitative PCR for genes Nestin and NeuroD1 and Western blotting technique for gap43 protein. Result and discussion: The high quality and number of MSCs were isolated from human umbilical cord via explant culture method. The obtained MSCs were differentiated into neural cells like neurons, astrocytes and oligodendrocytes. The differentiated neural cells can be used to treat neural injuries and neural cell loss by delivering cells by non-invasive administration via cerebrospinal fluid (CSF) or blood. Moreover, the MSCs can also be directly delivered to different injured sites where they differentiate into neural cells. Therefore, human umbilical cord is demonstrated to be an inexpensive and easily available source for MSCs. Moreover, the hUCMSCs can be a potential source for neural cell therapies and neural cell regeneration for neural cell injuries and neural cell loss. This new way of research will be helpful to treat and manage neural cell damages and neurodegenerative diseases like Alzheimer and Parkinson. Still the study has a long way to go but it is a promising approach for many neural disorders for which at present no satisfactory management is available.

Keywords: bone marrow, cell therapy, explant culture method, flow cytometer, human umbilical cord, mesenchymal stem cells, neurodegenerative diseases, neuroprotective, regeneration

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724 Dynamic EEG Desynchronization in Response to Vicarious Pain

Authors: Justin Durham, Chanda Rooney, Robert Mather, Mickie Vanhoy

Abstract:

The psychological construct of empathy is to understand a person’s cognitive perspective and experience the other person’s emotional state. Deciphering emotional states is conducive for interpreting vicarious pain. Observing others' physical pain activates neural networks related to the actual experience of pain itself. The study addresses empathy as a nonlinear dynamic process of simulation for individuals to understand the mental states of others and experience vicarious pain, exhibiting self-organized criticality. Such criticality follows from a combination of neural networks with an excitatory feedback loop generating bistability to resonate permutated empathy. Cortical networks exhibit diverse patterns of activity, including oscillations, synchrony and waves, however, the temporal dynamics of neurophysiological activities underlying empathic processes remain poorly understood. Mu rhythms are EEG oscillations with dominant frequencies of 8-13 Hz becoming synchronized when the body is relaxed with eyes open and when the sensorimotor system is in idle, thus, mu rhythm synchrony is expected to be highest in baseline conditions. When the sensorimotor system is activated either by performing or simulating action, mu rhythms become suppressed or desynchronize, thus, should be suppressed while observing video clips of painful injuries if previous research on mirror system activation holds. Twelve undergraduates contributed EEG data and survey responses to empathy and psychopathy scales in addition to watching consecutive video clips of sports injuries. Participants watched a blank, black image on a computer monitor before and after observing a video of consecutive sports injuries incidents. Each video condition lasted five-minutes long. A BIOPAC MP150 recorded EEG signals from sensorimotor and thalamocortical regions related to a complex neural network called the ‘pain matrix’. Physical and social pain are activated in this network to resonate vicarious pain responses to processing empathy. Five EEG single electrode locations were applied to regions measuring sensorimotor electrical activity in microvolts (μV) to monitor mu rhythms. EEG signals were sampled at a rate of 200 Hz. Mu rhythm desynchronization was measured via 8-13 Hz at electrode sites (F3 & F4). Data for each participant’s mu rhythms were analyzed via Fast Fourier Transformation (FFT) and multifractal time series analysis.

Keywords: desynchronization, dynamical systems theory, electroencephalography (EEG), empathy, multifractal time series analysis, mu waveform, neurophysiology, pain simulation, social cognition

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723 The Affective Motivation of Women Miners in Ghana

Authors: Adesuwa Omorede, Rufai Haruna Kilu

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Affective motivation (motivation that is emotionally laden usually related to affect, passion, emotions, moods) in the workplace stimulates individuals to reinforce, persist and commit to their task, which leads to the individual and organizational performance. This leads individuals to reach goals especially in situations where task are highly challenging and hostile. In such situations, individuals are more disposed to be more creative, innovative and see new opportunities from the loopholes in their workplace. However, when individuals feel displaced and less important, an adverse reaction may suffice which may be detrimental to the organization and its performance. One sector where affective motivation is eminently present and relevant, is the mining industry. Due to its intense work environment; mostly dominated by men and masculinity cultures; and deliberate exclusion of women in this environment which, makes the women working in these environments to feel marginalized. In Ghana, the mining industry is mostly seen as a very physical environment especially underground and mostly considerd as 'no place for a woman'. Despite the fact that these women feel less 'needed' or 'appreciated' in such environments, they still have to juggle between intense work shifts; face violence and other health risks with their families, which put a strain on their affective motivational reaction. Beyond these challenges, however, several mining companies in Ghana today are working towards providing a fair and equal working situation for both men and women miners, by recognizing them as key stakeholders, as well as including them in the stages of mining projects from the planning and designing phase to the evaluation and implementation stage. Drawing from the psychology and gender literature, this study takes a narrative approach to identify and understand the shifting gender dynamics within the mine works in Ghana, occasioning a change in background disposition of miners, which leads to more women taking up mine jobs in the country. In doing so, a qualitative study was conducted using semi-structured interviews from Ghana. Several women working within the mining industries in Ghana shared their experiences and how they felt and still feel in their workplace. In addition, archival documents were gathered to support the findings. The results suggest a change in enrolment regimes in a mining and technology university in Ghana, making room for a more gender equal enrolments in the university. A renowned university that train and feed mine work professional into the industry. The results further acknowledge gender equal and diversity recruitment policies and initiatives among the mining companies of Ghana. This study contributes to the psychology and gender literature by highlighting the hindrances women face in the mining industry as well as highlighting several of their affective reactions towards gender inequality. The study also provides several suggestions for decision makers in the mining industry of what can be done in the future to reduce the gender inequality gap within the industry.

Keywords: affective motivation, gender shape shifting, mining industry, women miners

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722 Organisational Culture and the Role of the Mental Health Nurse: An Ethnography of the New Graduate Nurse Experience

Authors: Mary-Ellen Hooper, Graeme Browne, Anthony Paul O'Brien

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Background: It has been reported that the experience of the organisational workplace culture for new graduate mental health nurses plays an important role in their attraction and retention to the discipline. Additionally, other research indicates that a negative workplace culture contributes to their dissatisfaction and attrition rate. Method: An ethnographic research design was applied to explore the subcultural experiences of new graduate nurses as they encounter mental health nursing. Data was collected between April and September 2017 across 6 separate Australian, NSW, mental health units. Data comprised of semi-structured interviews (n=24) and 31 episodes of field observation (62 hours). A total number of 26 new graduate and recent graduate nurses participated in the study – 14 new graduate nurses and 12 recently graduated nurses. Results: A key finding from this study was the New Graduate difficulty in articulating the role the of mental health nurse. Participants described a dichotomy between their ideological view of the mental health nurse and the reality of clinical practice. The participants’ ideological view of the mental health nurse involved providing holistic and individualised care within a flexible framework. Participants, however, described feeling powerless to change the recovery practices within the mental health service(s) because of their low status within the hierarchy. Resulting in participants choosing to fit into the existing culture, or considering leaving the field altogether. Conclusion: An incongruence between the values and ideals of an organisational culture and the reality shock of practice are shown to contribute to role ambiguity within its members. New graduate nurses entering the culture of mental health nursing describe role ambiguity resulting in dissatisfaction with practice. The culture and philosophy inherent to a service are posited to be crucial in creating positive experiences for graduate nurses.

Keywords: culture, mental health nurse, mental health nursing role, new graduate nurse

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721 Development and Validation of Work Movement Task Analysis: Part 1

Authors: Mohd Zubairy Bin Shamsudin

Abstract:

Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

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720 C-Spine Imaging in a Non-trauma Centre: Compliance with NEXUS Criteria Audit

Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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719 Two-Way Reminder Systems to Support Activities of Daily Living for Adults with Cognitive Impairments: A Scoping Review

Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

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Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

Procedia PDF Downloads 72